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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 Topics In This Report: 1. VA BILL STILL IN DOUBT 2. COURT DOCUMENTS: TRIGON ADMITS THAT THEY CONSIDER DC'S LIMITED PRACTIONERS WHO MAY DELIVER THE SAME SERVICES AS OTHERS BUT SHOULD BE PAID LESS 3. HCFA LAWSUIT UPDATE: PHYSICAL THERAPISTS CONTINUE TO INSIST THEY CORRECT SUBLUXATIONS (YES, THERE IS A SANTA CLAUS) 4. EVP ADVISORY COMMITTEE CONFERENCE CALL 5. SINGLE CONVERSION ISSUE GETS LEGISLATION 6. CONFERENCE CALLS WITH MCANDREWS AND DALY DRAWS WELL 7. PATIENT APPRECIATION DAY: MARK YOUR CALANDER 8. SIGN OF THE TIMES 9. NEUROLOGY COUNCIL HELPS WITH MEMBERSHIP 10. SACA REPORTS GOOD NEWS 11. ACA LEADERSHIP SPEAKS TO NEW YORK IPA 12. HELP US BUILD OUR E-MAIL DATABASE 13. MEDICINE, MONOPOLIES, AND MALICE IS AN ETHICAL PRACTICE BUILDER VA BILL STILL IN DOUBT Our efforts to convince the Senate to adopt the House provisions for full implementation of chiropractic in the VA system continue to meet resistance in spite of strong grassroots support and the support of the majority leader. Senators John Rockefeller, chairman of the Veterans Affairs Committee, and Senator Arlen Specter, lead Republican on the Committee have provided the most resistance. There has been some movement from the Senate's initial proposal of six demonstration projects, which we vigorously oppose, but still a distance from what came out of the House provision of full implementation and direct access. Over the Thanksgiving recess that begins today, we would urge that you contact your senator and request that he/she contact Senators Specter and Rockefeller and urge that they adopt the provisions being advocated by the House of Representatives. If you want further information about your senator's address and other pertinent information, visit our Web site at: www.acatoday.com/government/index.html. COURT DOCUMENTS: TRIGON ADMITS THAT THEY CONSIDER DC'S LIMITED PRACTIONERS WHO MAY DELIVER THE SAME SERVICES AS OTHERS BUT SHOULD BE PAID LESS As a routine in any court action, ACA requested specific admissions from Trigon on a number of issues regarding the lawsuit. One that got my attention and should make your hair stand on end concerned a statement by a Trigon spokesman that ran in the Richmond Times-Dispatch in August 2000 regarding its payment policy towards doctors of chiropractic. Trigon in their court admissions admitted to its policy of paying doctors of chiropractic less than medical doctors for the same procedures. The following are exact quotes from the brief filed by Trigon, titled DEFENDANT'S OBJECTIONS AND RESPONSES TO PLANTIFF'S REQUEST FOR ADMISSION NOS. 1-8, which acknowledge this practice and the rationale behind it: "...the applicable Defendants (Trigon) admit that they pay limited-license providers less than they pay medical doctors for some procedures that are billed under the same CPT code. Some of the payments made to limited-license providers are less than the payments made to medical doctors for procedures billed under the same CPT code for several reasons: market forces factor into the determination of how much providers are paid and market demand has justified making some lower payments to limited-license providers than to medical doctors for procedures that are billed under the same CPT code; the procedure preformed by a medical doctor under a particular CPT code often is not identical to the procedure performed by a limited-license provider under the same CPT code because the medical doctor has a higher degree of education, expertise, training, skill and medical knowledge; the conditions treated by medical doctors can be different and can be more severe than the conditions treated by limited-license providers; and the applicable Defendants pay limited-license providers, such as chiropractors, in accordance with the terms and conditions of the Professional Provider Agreements, which the limited-license providers have voluntarily accepted and agreed to in order to participate in the Defendants' networks." "Defendants admit that medical doctors and doctors of chiropractic can both provide some healthcare treatments that are billed under the same CPT code. However, Defendants state that these healthcare treatments are frequently different because of the differences in education, expertise, skill and medical knowledge between medical doctors and doctors of chiropractic; difference in the techniques and procedures that may be employed to perform the treatments; and differences in the types and severity of the conditions treated." While we should not be surprised by these comments, their willingness to put this in print demonstrates the arrogance of these guys and the importance that we prevail in this lawsuit. While some insurance plans have seen the light, have reviewed the studies both scientific and otherwise that demonstrate the superiority of chiropractic education, training and practice in relieving problems associated with the neck and back, and other related areas, Trigon's position is as much an insult as it is inaccurate and misleading. The ACA doesn't intend to let any insurance company adopt and maintain, with the collusion of competitive medical physicians, a program that discriminates against the best care for an ailing patient or the provider of that best care. When we prevail in Virginia, the ACA will be carefully monitoring insurance programs that might have similar discriminatory provisions. They will be called to account for these actions before the judicial system. For an entire copy of Trigon's DEFENDANTS' OBJECTIONS AND RESPONSES TO PLAINTIFFS' REQUEST FOR ADMISSION NOS. 1-8, please go to the ACA Web site at: www.acatoday.com/pdf/Trigon_1101.pdf. HCFA LAWSUIT UPDATE: PHYSICAL THERAPISTS CONTINUE TO INSIST THEY CORRECT SUBLUXATIONS (YES, THERE IS A SANTA CLAUS) We have received a new set of pleadings from the American Physical Therapy Association (APTA) filed with the court yesterday. They characterize our argument as "ridiculous" and claim that we have a profound ignorance of how the Medicare system works. They again claim that we are out to prevent them from performing manual manipulation while they belittle our arguments concerning the subluxation. They continue to dance around the issue of their lack of status as physicians, claiming they can perform all reasonable and necessary services, while evading the point that as non-physicians they may not perform physician services. They have dedicated a lot of effort to making the argument that there is nothing special about the subluxation, and of course that physical therapists can correct the same. However, the expert affidavits provided to support this line of argument merely state that if one defines subluxation broadly enough to include what physical therapists do, then physical therapists do treat subluxations. Hardly a compelling rationale. As you know, the court has yet to rule on whether the APTA may intervene into the lawsuit. EVP ADVISORY COMMITTEE CONFERENCE CALL The committee that is composed of executive directors and leadership from various state associations throughout the country held its monthly conference call last week. Participating on the call were representatives from Texas, Kentucky, Iowa, Louisiana, Pennsylvania, Rhode Island, Arizona, California, Florida and Colorado. Representing the ACA on the call were legal council Tom Daly, ACA vice presidents and myself. These conference calls provide an opportunity for both the state associations and the ACA to exchange ideas and programs. On the agenda for the call were discussions regarding the VA legislation, The Muse report, the implementation of the liaison program with the Blues and the Federal Health Plan. Our next call is scheduled for December 4th. SINGLE CONVERSION ISSUE GETS LEGISLATION You will recall during the last few reports that I have discussed the consequences of the Single Conversion Factor as it relates to Medicare reimbursement and the attempts by the major health care groups to gain congressional interest on the issue. We are happy to report that legislation has been introduced in the Senate: S.1660. The bill was introduced by Senators Jeffords and Breaux. It currently it has 4 cosponsors. The coalition is currently working to develop more support and cosponsors for this legislation. We will continue to monitor the situation and keep you apprised of any developments. CONFERENCE CALLS WITH MCANDREWS AND DALY DRAWS WELL According to statistics provided by the phone company, 69 doctors and executive directors participated in a conference call with George McAndrews and Tom Daly to get an update in the lawsuits against Trigon and the Feds, as well as answer questions regarding the new liaison program and federal health plan. This was the largest conference call that ACA has organized in years and shows the level of interest in the important activities results from the lawsuits. PATIENT APPRECIATION DAY: MARK YOUR CALANDER The ACA, in cooperation with FCER, is sponsoring a patient appreciation day on Valentine's Day next year. As an effort to raise contributions for our research arm, doctors are asked to donate the cost of their treatments to FCER. Look to the ACA for future details regarding this effort. SIGN OF THE TIMES Dr. Al Adams reported after attending a meeting of administrators of health care colleges that the podiatry profession has received only 300 applicants for its six podiatry schools in the country. He also reported that the number of students taking the entrance exams for medical schools has been in a steady decline over the last seven years. NEUROLOGY COUNCIL HELPS WITH MEMBERSHIP The ACA Council on Neurology is doing its part to help with membership. Last weekend, representatives of the council, including Julie Bjornson, DC, attended a special ADD/Behavioral Disorder program given by the Carrick Institute for Graduate Studies. Over 200 hundred doctors attended. Dr. Bjornson was given an opportunity to address the attendees. She promoted the ACA and the council. SACA REPORTS GOOD NEWS National SACA president Lisa Olszewski reported good news regarding her recent visit to Colorado College of Chiropractic! She had an opportunity to meet the students and discuss numerous SACA activities including their planning for the upcoming NCLC scheduled for March 7,8,9 in D.C. There is strong support on this young campus for the ACA, as all the students have filled out ACA membership applications. ACA LEADERSHIP SPEAKS TO NEW YORK IPA Dr. Lewis Bazakos, ACA governor, and Dr. Lenny Venezia, ACA delgate, spoke recently to the members of Alternative Care Solutions, an IPA in New York made up of ACA members and non- members. The doctors were able to discuss the various activities of the ACA, including its lawsuits against the Blues and against the Feds. The response was very positive. HELP US BUILD OUR E-MAIL DATABASE Please help us inform the profession. If you know other doctors who would like to receive these and other ACA e-mail updates directly, please ask them to email us at memberinfo@amerchiro.org. Thank you. MEDICINE, MONOPOLIES AND MALICE IS AN ETHICAL PRACTICE BUILDER The ACA and Dr. Chester Wilk, one of the most influential individuals in chiropractic history, have teamed up to provide doctors of chiropractic and patients with Medicine, Monopolies and Malice, an educational book written by Dr. Wilk to help minimize the misconceptions of chiropractic training, history, treatment, safety and efficacy. Many chiropractors were not in practice during the Wilk vs. AMA lawsuit and may not understand the magnitude of the stigma that medical doctors placed on the profession. Medicine, Monopolies and Malice serves as a history book by highlighting the basic concept of chiropractic, its safety, scientific evidence, therapeutic superiority, cost effectiveness, training and scientific evidence supporting chiropractic. "This book will help doctors of chiropractic become better communicators to patients, thus more successful practitioners," said Dr. Wilk. "It enhances self-esteem and confidence of the chiropractic doctor and provides an excellent training manual for all chiropractors to communicate with better knowledge, authority, research and history when speaking to patients," added Dr. Wilk. For more information, call 773-725-4878. |
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