From: <GCuneo@aol.com>
To: <GCuneo@aol.com>
Sent: Friday, August 17, 2001 8:38 AM
Subject: ACA Weekly Report
Memorandum to: ACA Board of Governors, House of Delegates and other interested parties
From: Gary Cuneo
Re: EVP Weekly Report
Date: August 14, 2001
In this report:
· BLUE CROSS/SHIELD UPDATE
· HCFA LAWSUIT
· CONGRESS ON AUGUST BREAK
· SIGNIFICANT ANNOUNCEMENTS
· DOD UPDATE
· GOVERNMENT RELATIONS IN INDIANA
· PHYSICAL THERAPISTS STILL ON THE MOVE
· HOW WE STACK UP WITH THE OTHOPEDIC SURGEONS AND OTHERS
· SCHOLARSHIP PROGRAM
· MAJOR SPEAKERS AT THE ANNUAL MEETING IN FLORIDA
BLUE CROSS/SHIELD UPDATE
ACA legal counsel is moving forward to the next stage in our lawsuit against Trigon Blue Cross/Blue Shield. The judge's decision to retain
six of the eight counts filed by the ACA, VCA, doctors of chiropractic and chiropractic
patients against Trigon provides an opportunity to take testimony under oath and to
request documents pertinent to the issues involved in the lawsuit. We have also learned that the chiropractors are considering
enlarging the scope of their lawsuit, seeking damages to include all chiropractors
in Virginia similarly affected by the situation. I have also learned that if the tort
and antitrust counts are upheld by the judge, it would provide an opportunity for the recovery of punitive damages and legal fees.
HCFA LAWSUIT
ACA is in the process of filing its summary judgment in response to the brief prepared by the federal government.
CONGRESS ON AUGUST BREAK
The president is in Texas and Congress is on August break. Some would argue that
the world is safe for democracy. In any case, this does provide an opportunity for you to meet with your member of congress at
his/her district office. Frankly, you will find that such a meeting in the district will be
more relaxed and maybe even more productive. We will be sending out alerts shortly regarding some of our
initiatives and ask that you consider arranging a meeting of your congressman in
the district the next few weeks. When Congress reconvenes in September, we will
have our veterans bill and student loan legislation on the front burner, along with managed care,
Medicare and the federal health plan.
SIGNIFICANT ANNOUNCEMENTS
August and September could be significant months for this profession, as we are working on a number of initiatives that I cannot discuss at
this time, but that could all be coming to a head in the next few weeks. I know this
is a sneaky way for individuals to continue to review my report…but seriously,
we could have some important accomplishments to report.
DOD UPDATE
The fact that the implementation plan for chiropractic in the armed services has still not been released by the department has not kept the
public relations and political side of the Department of Defense(DOD) from talking
it up. In the newsletter published by TRICARE, the health care plan of the military, they
listed the health care benefits currently in place and those that are "coming soon". One of the later points mentioned was
"Establish Chiropractic Health Care Benefit for Active Duty." Additionally, in testimony
before the House Armed Services Committee, Air Force Surgeon General Lieutenant General Paul Carlton
commented on the new benefits being provided to the military, saying, "We are also delighted with other
provisions of the National Defense Authorization Act, such as the expansion of TRICARE Prime
Remote to include family members, the elimination of co-payment for active duty family members enrolled in TRICARE
PRIME, and a permanent chiropractic benefit for active duty members, among other provisions."
Jay Witter, ACA vice president for Government Relations, enjoyed watching the reaction of the VA representatives while he read that statement
during the recent meeting with representatives from the Veterans Administration that I
reported on last week. It can't be emphasized enough that the comments made by the Surgeon
General last week did not reflect the opinion of the DOD prior to our passage of
the legislation last year. In fact, what we are hearing from the VA today, we heard from DOD in past years. Only when
Congress acts will the VA get the message.
GOVERNMENT RELATIONS IN INDIANA
Accepting an invitation by Congressman Steve Buyer (R-IN), Chairman of the Oversight Subcommittee of the House VA Committee, Jay Witter
traveled to Indiana to participate in a fundraiser for the Congressman. The Congressman's office
provided Jay with free tickets for the ACA's past support. This gave Jay another
opportunity to raise the VA issue and the student loan issue, since the Congressman also sits on the
committee that will consider the student issue.. He was accompanied by Indiana delegate
Dr. Robert Tennant and members of the Indiana Chiropractic Association.
PHYSICAL THERAPISTS STILL ON THE MOVE
As part of the Balanced Budget Refinement Act, Congress lifted the Medicare $1,500 cap on physical therapy services. To address the
utilization of physical therapy services, Congress mandated HCFA (now known as the Centers
for Medicare and Medicaid Services, or CMS) to develop utilization guidelines for physical
therapy services. CMS contracted with DynCorp to develop these guidelines in conjunction with input from physical therapists
and other interested parties. The ACA requested and was granted the opportunity to
work with DynCorp on the development of the PT guidelines, and Dr. Kim Christensen was appointed by the
ACA to be its representative. As the guidelines were being developed, Dr. Christensen alerted the ACAthat the PT
guidelines included language that could allow physicaltherapists to perform spinal manipulation. In a current draft,
DynCorp states thatfor CPT code 97140 (manual therapy techniques), manipulation may be medicallynecessary
for the treatment of painful joint or soft tissue restrictionsof the spine or extremities." Our Government Relations staff has
worked withlegal counsel in preparing a letter to DynCorp, expressing ourconcerns with this
language, and has reviewed physical therapy state practice actsas well as Medicare local medical review policies in developing itsresponse.
HOW WE STACK UP WITH THE OTHOPEDIC SURGEONS AND OTHERS
In my last report, I reported on the resources of the AmericanMedical Association as they compare to ACA. The week before, I citedthe resources
of the American Physical Therapy Association. This week I amreporting on the American Academy of Orthopedic Surgeons, another significantrival of
this profession. Additionally, in order to put all of this insome perspective, I am
including information regarding the resourcesof the other national chiropractic organizations in the country.Additionally, I am
including PAC information that is readily available on theInternet. Unless you live in another country or have
slept through yourgovernment classes, you will recognize that any chances for a successful legislativeprogram in
Congress requires an active and aggressive PAC.
*American Academy of Orthopedic Surgeons:
Members 25,000
Employees 220
Annual Report $34 million
**Hard Dollar PAC Contributions for 1999-2000 $368,737 (Hard dollar contributions are those that can be given directlyto members
of Congress, as opposed to "soft money" that can only be given topolitical parties or to provide administrative support.)
American Chiropractic Association:
Members 18,000
Employees 40
Annual Report $6.5 million
Hard Dollar PAC Contributions for 1999-2000 $414,379
International Chiropractic Association:
Members 8,000
Employees
Annual budget 2.5 million
Hard dollar Pac Contributions for 1999-2000 $27,584
WORLD CHIROPRACTIC ALLIANCE
(No listing in the Association Yellow Book)
(No PAC listing)
National Association of Chiropractic Medicine:
(No listing in the Association Yellow Book)
(No registered PAC)
Some observations regarding the above statistics…
a. As you know, only members of an association can contribute totheir PAC. I remain amazed at how our doctor members continue to supportthe
ACA-PAC in an amount higher than other professional organizations withlarger memberships. Can
you imagine what our PAC would be if we had amembership size similar to that of the Orthopedic Surgeons?
b. Does it make any sense that chiropractic should have fournational organizations, particularly when only one has a PAC that canmake a
difference? Clearly thehttp://herndon1.sdrdc.com/fecimg/srssea.html ACA is the largest organization, buthow long can
we continue to fight off our stronger rivals? How much longershould the members of the ACA
have to carry the load for the rest of theprofession?If you eliminated the other three, or realistically the other two
organizations, and combine the resources, then the ACA would begin to match theresources
of our rivals. I have said it before and will say it again, "Itmakes no sense."
c. The shrinking health care dollar requires a large, nationalorganization. If we can't get the other groups to recognize the need for asingle
organization, then let's increase the membership of the ACA. Doyou still need another reason
to join? Sign up here: http://www.acatoday.com/about_aca/application.html.
* The source of the information regarding the non-PAC resources of the organizations cited is the Associations Yellow Book (Winter2001), a
directory printed twice a year by Leadership Directories, Inc.It profiles 1,045 of the
leading U.S. trade and professional associations. http://www.leadershipdirectories.com
** Statistics regarding hard dollar PAC contributions to membersof Congress came from the Web site of the Federal Election Commission. Ifyou want to
verify these figures or locate the contributions of otherorganizations, goto this
web site: http://herndon1.sdrdc.com/fecimg/srssea.html
SCHOLARSHIP PROGRAM
The American Chiropractic Foundation (ACF) of the ACA and theACAuxiliary team up each year to recognize academic excellence and providefinancial
assistance to SACA college students enrolled in accreditedchiropractic colleges. Annual
awards historically consist of ten $1,000scholarships and two $2,500 scholarships, for a total of $15,000. Applicationsfor the 2001
round of scholarships were due on July 25th, and are on theirway to the ACF/ACAuxiliary Scholarship Committee.
The ACF/ACAuxiliary Scholarship Committee is comprised of theBoard Liaison to the Student ACA, two additional DC members from the ACFBoard, and one
representative of the ACAuxiliary. This year's winners will beannounced during the ACA's and ACAuxiliary's Annual Business Meetings inSt.
Petersburg, FL, August 30-September 1.
MAJOR SPEAKERS AT THE ANNUAL MEETING IN FLORIDA
· Dr. Zonnya, The First Lady of Motivation
· Dr. Alan Sokaloff, Team doctor to the Baltimore Ravens
· Dr. Allan Korn, Chief Medical Officer for National BlueCross/Blue Shield
· Mr. George McAndrews, Chief litigant in lawsuit against theFederal government and blues.
For more details, contact the ACA office at (800) 986-4636.
. 
