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Orange County Chiropractic District
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Memorandum to: ACA Members, Board of Governors, House of
Delegates and Other Interested Parties This week's report includes the following items: 1. CHIROPRACTIC BENEFIT IN VA: THE BATTLE CONTINUES 2. MCANDREWS, DALY VS. TRIGON: Round 3 3. NACM ROLE IN THE HOUSE VA VICTORY??? 4. NATIONAL CHIROPRACTIC LEADERSHIP CONFERENCE 5. DO YOU WANT TO HELP MAKE ACA POLICY? UPCOMING DELEGATE ELECTIONS 6. CHIROPRACTIC POSTAGE STAMP 7. NEW MEDICARE PHYSICIAN FEE SCHEDULE 8. ACA CHAIRMAN SPEAKS TO KANSAS ASSOCIATION I regret the length of some of these stories, but the issues are complicated and I want to be sure you get the full flavor of what is occurring. These are very interesting times! CHIROPRACTIC BENEFIT IN VA: THE BATTLE CONTINUES As we expected, the fight in the Senate has become a battle royal. The Office of Management and Budget (OMB) came out with concerns about the chiropractic provision opposing the designation of doctors as primary care providers, as well as the cost for implementation. The osteopaths and family physicians have weighed in mainly because of the primary care designation. The physical therapists are simply opposing our inclusion. I am pleased to report that the ACA, ACC and ICA continue to be in lock step over this legislation. The lobbying of this bill has been complicated by a number of new factors: 1) The anthrax scare has been a problem. The Hart building, occupied by nearly half of the U.S. Senators, is closed. Senators have scattered throughout the capital, making finding them and communicating with them difficult. 2) A conference committee of Senate and House representatives is trying to resolve the differences in the conflicting VA bills, one of which includes our provision. It is not unusual that the Senate version and House version of a bill would be different. Conference committees are in place to resolve such differences. What is unusual is that instead of one bill on each side being discussed, you have multiple bills on the House side and multiple bills on the Senate side being merged by a single conference committee. 3) Because of the numerous bills under discussion, each with numerous projects involved, a turf war is developing between the House and Senate, with both sides playing chicken with their own favorite items. A lobbyist's nightmare is trying to ensure that his or her provision isn't discarded during negotiations between the House and Senate. These negotiations take place behind closed doors. 4) The Senate negotiators (mostly on the staff level) don't want to accept the chiropractic provision adopted by the House because they don't like the designation of chiropractors as primary care providers and because they think it's too expensive. They are suggesting demonstration projects, which we have rejected out of hand. 5) A $350 million price tag sticks out like a sore thumb. 6) Adding to the confusion, a number of non-chiropractic provisions even more controversial than ours are involved. What is the old expression - you may like politics and sausages, but you don't want to see either being made. But we are clearly in the game. Senator Thurmond has been very helpful in offering amendments that will hopefully loosen the logjam. Dr. Kerwin Winkler, former ACA chairman of the board, personally met with Tom Daschle, Senate Majority Leader, In South Dakota about this issue. Jay Witter, ACA vice president of Governmental Affairs flew out to attend the meeting as well. The final outcome of this issue remains unclear. The medical establishment is working hard to kill this bill, and Congress may recess for the year in the next couple of weeks. For these reasons, it is imperative that doctors, students and patients continue to call their Senators and ask that they support the chiropractic provision in H.R.2792. The ACA will keep you apprised of any further developments. MCANDREWS, DALY VS. TRIGON: Round 3 As reported previously, the ACA has filed a new pleading with the federal court in Abingdon, Virginia, in connection with the crucial issue of whether Trigon has entered a "judicial admission" that it conspired with the national Blue Cross/Blue Shield Association to wrongfully discriminate against doctors of chiropractic. Trigon had maintained that the dismissal of the national association "without prejudice" from the law suit meant that it did not need to respond to ACA's allegation of the conspiracy between it and the national association. ACA responded that "No one, at any time, ever represented that plaintiffs were dropping any allegations that Trigon conspired with the national Blue Cross/Blue Shield Association ("Blue Cross" or "BC/BSA"). "Trigon is attempting to distort the rule (of Federal Procedure) and hide behind some bogus argument that plaintiffs somehow misled them and the Court. Trigon blames plaintiffs' counsel for Trigon's misunderstanding and asks for sanctions for responding to plaintiffs' motion. That request is both baseless and frivolous as argued." These various exchanges of fire between Trigon and ACA attorneys are much more than an argument over pleading procedures. Mr. McAndrews' concern is that Trigon may be posturing with the Court to restrict access to essential documentation dealing with the conspiracy between BC/BSA, Trigon and other BC/BSA plans to wrongfully discriminate against chiropractors. This reflects the seriousness that Trigon, as one licensee of the BC/BSA trademark, is taking in resisting ACA's efforts. Check my two previous weekly reports for further background information (Weekly Report 10/22/01 and Weekly Report 10/26/01). NACM ROLE IN THE HOUSE VA VICTORY??? If there is an award given this year for the best "spin," it would have to go to the unsigned email that was floating around the Internet which gave credit to the National Association of Chiropractic Medicine (NACM) for the chiropractic provisions in the recent VA bill. Aside from the fact that NACM has no PAC, no lobbyist and no grassroots organization, they have no credibility. At the first meeting sponsored by the Department of Veterans Affairs, Dr Charles DuVall represented the NACM. I remember when the issue came up about the possibility of VA contracting with our doctors in the field instead of working at the hospital. DuVall, almost shaking, stated in clear terms that, while a chiropractic doctor could operate in a VA hospital under the supervision of a medical doctor, they should never be allowed to operate independently. Their idea of chiropractic involvement is more as a technician than anything else. I am not surprised the email was unsigned. That way no one can be held accountable for the statement. Also not surprising, they submitted a letter of opposition to our chiropractic provision and forwarded copies to the physical therapists, the osteopaths and the family physicians. With friends like these, who needs enemies? NATIONAL CHIROPRACTIC LEADERSHIP CONFERENCE This coming Thursday, ACA chairman James D. Edwards, DC, and ACA president Daryl D. Wills, DC, will join with representatives from nearly all of the chiropractic organizations in the country for a meeting in Albuquerque, New Mexico, to continue discussions on identifying ways to work together on behalf of the profession. This will be the fourth meeting of the group, which is sponsored by COCSA. Among others, It includes representatives from the ACA, ICA, WCA, ACC, and FCER. At their last meeting in May the group agreed on a framework to bring internal conflicts into the open forum for resolution, establish certain principles of behavior and discuss other activities. They established a strategic long-range plan that included the following objectives: distributing the ACC Paradigm to each of the organization's members, convene a task force to: a) address terminology and definitions; b) support a chiropractic postage stamp and boy scout merit badge; establish a library program; c) establish an inventory of current research and analyzing the gaps; d) set a goal of reaching an annual investment of new money totaling $2.5 million for chiropractic research. There will be a lot of work for the group to do this week, but the forum established by COCSA makes progress possible. DO YOU WANT TO HELP MAKE ACA POLICY? UPCOMING DELEGATE ELECTIONS Members seeking election as delegate or alternate delegate must signify such intent in writing via certified mail by December 15, 2001, to the Corporate Secretary of the American Chiropractic Association, 1701 Clarendon Blvd, Arlington, VA 22209. Ballots will be sent Jan. 15, 2002, to voting members in the states of Alabama, Arizona, California-North, California-South, Connecticut, District of Columbia, Georgia, Idaho, Illinois-Downstate, Indiana, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New York-Metro, North Carolina, Ohio, Puerto Rico, Rhode Island, South Dakota, Texas, Vermont, Virgin Islands, Washington, Wisconsin, and Wyoming. Term of office is two years. For further details of the delegate election qualifications and procedures, consult the ACA Bylaws, Article VIII, Section Cz. CHIROPRACTIC POSTAGE STAMP It really is a shame that chiropractic has not been recognized by the U.S. Postal Service with an official postage stamp. Every profession has one, and so does Elvis. ACA is joining with other chiropractic organizations to push for a new stamp. Getting a new postage stamp approved is a real challenge. Each year, the U.S. Postal Service receives 40,000 proposals recommending subjects for stamps. The suggestions and proposals are evaluated by the Citizens' Stamp Advisory Committee, which was established in 1957. The 15 members of the committee-who represent a wide variety of Americans from all walks of life-meet four times a year in Washington, D.C. In addition to the actual information in the proposal, the committee tries to judge how much public support a stamp would receive. If you are interested in helping, please go to Web site where you will find additional information and suggested letters. NEW MEDICARE PHYSICIAN FEE SCHEDULE I have been reporting over the last couple of weeks the concerns by all health care providers regarding the Single Conversion Factor. On November 1, 2001, the Centers for Medicare and Medicaid Services (CMS) published the FY 2002 Medicare Physician Fee Schedule. Due to new economic data from a slowing economy, the conversion factor used to calculate Medicare payments will decrease in FY 2002 by 5.4 percent. It is important to note that this decrease will affect all health care professions under Medicare and is not targeted specifically at the chiropractic profession. The following are the national average Medicare reimbursement rates for chiropractic manipulation as established under the FY 2002 Medicare fee schedule. It is important to note that these figures do not take into account geographic variations.
The ACA is currently working with numerous health care groups to address concerns with the current formula utilized by CMS to develop the conversion factor. The ACA recently sent a letter to members of Congress requesting a delay in the implementation of the 2002 fee schedule until permanent changes can be made in the update formula. ACA CHAIRMAN SPEAKS TO KANSAS ASSOCIATION ACA chairman Dr. James D. Edwards was the featured speaker at the Kansas Chiropractic Association ACA Luncheon in Kansas City on September 27th. As a result of the presentation and the efforts of Kansas delegates Darrell Fore, DC, and Ed McKenzie, DC, 4 doctors signed up as new ACA members, several wrote National Chiropractic Legal Action Fund checks for $1,000, and the KCA contributed an additional $5,000 for the lawsuits. This brings the total contribution for the Kansas association and its districts to $36,500! We have placed my Weekly EVP Report on our Web sitee, where doctors can download the report in various formats. We will have the report available in Microsoft Word (.doc), Corel WordPerfect (.wpd), and standard text (.txt) formats. This message is being sent to you as a courtesy of the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@amerchiro.org and change the subject to read "REMOVE - EVP Report." | |||||||||||||||||
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