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Orange County Chiropractic District
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Memorandum to: ACA Members, ACA Board of Governors,
House of Delegates and Other Interested Parties In this report: 1. AMERICAN MEDICAL ASSOCIATION, AMERICAN OSTEOPATHIC ASSOCIATION AND AMERICAN PHYSICAL THERAPY ASSOCIATION STRONGLY OPPOSE INCLUSION OF CHIROPRACTIC CARE IN VETERANS ADMINISTRATION 2. UPDATE ON OUR LAWSUIT AGAINST HHS 3. UPDATE ON FEDERAL HEALTH BENEFIT 4. UPDATE ON LAWSUIT AGAINST TRIGON BLUE CROSS/BLUE SHIELD 5. LAWSUIT CONTRIBUTIONS 6. HHS REQUESTS PUBLIC TESTIMONY ON RURAL ACCESS 7. MEETING WITH REPRESENTATIVES OF HIAA 8. A PICTURE IS WORTH A THOUSAND WORDS: HOW OTHER ORGANIZATIONS STACK UP TO THE ACA 9. MARK YOUR CALENDER FOR 2002 LEGISLATIVE CONFERENCE AMERICAN MEDICAL ASSOCIATION, AMERICAN OSTEOPATHIC ASSOCIATION AND AMERICAN PHYSICAL THERAPY ASSOCIATION STRONGLY OPPOSE INCLUSION OF CHIROPRACTIC CARE IN VETERANS ADMINISTRATION As earlier reported, the ACA and ACC successfully lobbied for the inclusion of a strong chiropractic provision in H.R. 2792. The provision would: a) create a permanent chiropractic benefit, b) authorize the hiring of doctors of chiropractic as VA staff, c) set a broad scope of practice and d) allow veterans to designate doctors of chiropractic as their primary care providers. As soon as the bill was passed by the full committee, the medical establishment (AMA, AOA and APTA) initiated an intense campaign to kill the chiropractic provision in H.R. 2792. The physical therapists are now contacting Capitol Hill and are using the cost estimate by the Congressional Budget Office (CBO) as their weapon. Recently, the CBO estimated the cost of the chiropractic provision in H.R. 2792 at $315 million over five years. The ACA believes this high cost estimate is unrealistic and does not take into account dramatic cost savings. In their lobbying materials, the physical therapists are arguing that the money going to the chiropractic provision will be taken away from other important veterans programs, such as physical therapy. While the political environment is unclear because of the recent terrorist acts, the ACA plans to continue its aggressive lobbying campaign regarding this issue. The ACA will alert the chiropractic profession when grassroots action is most timely. LATE BREAKING NEWS: VA bill that includes the chiropractic provision passed out of the House by a voice vote. Look to the ACA GR department for further details and expect a big fight in the Senate. UPDATE ON OUR LAWSUIT AGAINST HHS There is nothing new to report from the judge regarding our lawsuit against the Department of Health and Human Services. Both ACA and HHS have filed their motions for summary judgment. The judge will not only rule on these motions, but also on the motion from the APTA who has asked to intervene on the side of the government. If you have not yet read our Motion for Summary Judgment, please visit our Web site at: http://www.acatoday.com/pdf/OppositionToAPTA_sMotionForSJ.pdf . It is very good and provides not only our sound legal arguments in this case but also an excellent history on what the intent of Congress was in 1974 when they added the following language to the Medicare Laws: "…Manual Manipulation of the Spine to Correct a Subluxation..." UPDATE ON FEDERAL HEALTH PLAN As you know, the national Blue Cross/Shield Association (BC/BSA) has included for the first time a chiropractic benefit in the federal health care plan that is available to over 4 million federal workers. While the cost is estimated at $120 million dollars, the coverage provided is not what we are looking for, and we have expressed our strong disappointment. When we suspended without prejudice national BC/BSA from our lawsuit, we did so because of their promise to help establish better liaisons with their local Blue Cross/Blue Shield plans in order to resolve the problems with these plans. They also promised, as a sign of good faith, to include a chiropractic benefit in their federal health plans, which up to now did not exist. We are still trying to get further clarification from them regarding some of the provisions in the so-called benefit, but overall it is not satisfactory. This remains a very fluid situation. We retain the right to reintroduce the lawsuit against BC/BSA. For more information regarding the coverage and for more details regarding our position on this issue, please visit: http://www.acatoday.com/lawsuit_info/discrimination_blues.html Our lawsuit against Trigon Blue Cross/Shield continues. The story below provides the most up to date status on this suit. UPDATE ON LAWSUIT AGAINST TRIGON BLUE CROSS/BLUE SHIELD On October 4th, the ACA asked the federal court in Abingdon, VA, to issue an order granting partial summary judgment on two central issues in the overall litigation in ACA et al. vs. Trigon et al. Specifically, ACA is asking the court to establish two of ACA's fundamental allegations as admitted facts. These are: (a) Trigon and the national Blue Cross/Blue Shield Association conspired to use the Blue Cross/Blue Shield marks to sell health care plans and services that wrongfully discriminate against doctors of chiropractic; and (b) All acts of Trigon to restrain access to doctors of chiropractic from a person covered by Trigon health care plans were approved and aided by the national Blue Cross/Blue Shield Association. ACA argues that well-established federal case law and the applicable rules of court require a defendant to either deny, admit or state insufficient information to deny or admit any particular allegation. Failure to answer in such a manner constitutes a "judicial admission." ACA pointed out to the court that Trigon failed to answer allegations relating to the above issues, stating instead that "no response is required" because of the dismissal without prejudice of the national Blue Cross/Blue Shield Association from the case. ACA points out to the court that nothing in the voluntary dismissal without prejudice of the national Blue Cross/ Blue Shield Association affected any of the repeated allegations in the lawsuit concerning the conspiracy between the national group and Trigon to wrongfully discriminate against doctors of chiropractic. Since Trigon failed to deny these allegations in its answer to the federal court, ACA argues that it has as a matter of law admitted to these allegations. Again, the ACA has asked that the court issue an order establishing these allegations as admitted facts. Trigon will have the opportunity to respond to ACA's motion. Whatever the outcome, this is another indication that the ACA intends to aggressively pursue the Trigon litigation in order to get at the heart of the wrongful discrimination against doctors of chiropractic plaguing so many Blue Cross/Blue Shield plans. While the ACA has not re-filed its lawsuit at this time against the national BC/BSA, its actions as a co-conspirator nevertheless remain at issue in the overall Trigon litigation. LAWSUIT CONTRIBUTIONS This week I would like to highlight and thank the Michigan ChiroNet Corporation for their $1000 contribution to the lawsuit.. This is the 5th contribution from that organization, brining its total to $14,000. I would also like to recognize Dr. Howard Fidler, delegate from Minnesota. At the recent David Singer annual convention, Dr. Fidler was given the opportunity to promote our lawsuits against HHS and Trigon Blue Cross/Blue Shield. He carried away $3,000 in checks and $15,000 in pledges. In addition, Dr Singer joined the ACA. We need your help. Please send your contribution today to the National Chiropractic Legal Action Fund at P.O. Box 75359 Baltimore, MD 21275. HHS REQUESTS PUBLIC TESTIMONY ON RURAL ACCESS In response to a request by the Federal Department of Health and Human Services for input regarding the issue of improving rural communities' access to quality health and human services, the ACA submitted written testimony indicating that doctors of chiropractic can and do play an integral role in the delivery of quality health care to rural Americans. In order for us to participate on an equal footing with medical doctors, the department should consider doing the following: · In addition to including the chiropractic wellness approval in its overall strategies for rural health, also officially recognize doctors of chiropractic as primary health care providers in all of its programs. · Support the inclusion of doctors of chiropractic in the National Health Service Corps as it moves throughout the legislative process as a means of providing needed care to rural Americans. · Lift existing regulatory and statutory barriers that preclude doctors of chiropractic from receiving Medicare reimbursement for the covered services they provide to their Medicare patients. Our doctors already play a role as primary care providers in many rural areas. However, many statutory and regulatory barriers continue to exist for doctors to fully realize their potential. MEETING WITH REPRESENTATIVES OF HIAA Two weeks ago, Pat Jackson and I met with Dr. Don Young, president of the Health Insurance Association of America (HIAA), to open discussions with an organization of insurance companies that in the past had opposed chiropractic legislation and most others as well. Our meeting was cordial, and we are exploring ways to improve communication between our two organizations. To begin with, we have agreed to swap free booth space at our conventions. In early November we will exhibit at their major program in Orlando, Florida. This is one of the major trade shows in the country. It includes the CEOs, COOs, vice presidents and managers of commercial health insurance companies, managed care plans, health maintenance organizations, preferred provider organizations, Blue Cross/Blue Shield carriers, third-party administrators, reinsurers, etc. We are not under the illusion that we suddenly have a new ally, but discussions are ongoing. As long as there is a forum for discussion, some confrontations can be avoided. It also provides us with another opportunity to interface with HIAA's membership that includes the major players in the industry. A PICTURE IS WORTH A THOUSAND WORDS: HOW OTHER ORGANIZATIONS STACK UP TO THE ACA Some times words alone are not sufficient to persuade someone to join the ACA. Visit the section of our Web site (provided below) to see a picture of our problem. It shows the PAC, membership and budgets of some of our major rivals. Each is competing with us for the same health care dollar. For those of you trying to determine whether there is a need to join the ACA, please take a look: http://www.acatoday.com/pdf/membershipscalead.pdf MARK YOUR CALENDER FOR 2002 LEGISLATIVE CONFERENCE The 2002 National Legislative Conference is scheduled for March 6-9, 2002. NCLC 2001 found over 500 doctors and students at the nation's capitol to hear from influential Congressmen and Senators. They also were treated to a surprise visit from Secretary Tommy Thompson. With the significant issues before the profession, the 2002 conference is going to be critical. Mark your calendars and make sure your state association is represented to lobby Congress and participate in the profession's most important meeting of the year. |
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