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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 **Due to the holidays, next EVP report scheduled for January 9, 2002 In this report: 1. VA BILL TAKES A STEP CLOSER TO FRUITION VA BILL TAKES A STEP CLOSER TO FRUITION The creation of a permanent chiropractic benefit within the Department of Veterans Affairs (DVA) health care system took a giant step forward this past week as negotiators representing the House and Senate Veterans Committees concluded informal negotiations regarding the details of a chiropractic benefit for veterans. The two sides hope to make the benefit law before Congress adjourns for the year. When the agreement was finalized on December 10, the House of Representatives moved quickly to include the agreed-upon legislative language in a veterans benefits bill that was voted on and approved by the full House of Representatives later that same day. The U.S. Senate must now pass a bill identical to the House measure before the legislation can be sent to President Bush. If and when this takes place, the president is expected to sign the measure into law. Although the Senate "calendar" is very busy with time for action running short, most observers believe the Senate will pass the necessary language before they adjourn because House and Senate negotiators were so successful in working out their differences in advance. We will keep you posted. UPDATE ON THE HCFA LAWSUIT Both ACA and the feds are waiting for the judge to complete his review of the documents and to make a ruling, which means one of the following: a) One side or the other wins and then determines whether an appeal is necessary, or b) neither side wins, meaning the case will go forward with normal discovery, allowing ACA to explore just how HHS (formerly HEW) worked with the medical community to thwart the congressional intent to bring chiropractic services to Medicare patients. UPDATE ON TRIGON BLUE CROSS/BLUE SHIELD Discovery is proceeding quickly with documentation being exchanged, questions being answered under oath and preparation for depositions beginning. CONGRATULATIONS TO NEBRASKA DOCTORS Congratulations to Daryl D. Wills, DC, and the other doctors of Nebraska on the recent ruling by the Nebraska Attorney General. Attorney General Don Stenberg issued an opinion indicating that the Nebraska Board of Chiropractic Examiners was in their right to identify doctors of chiropractic as chiropractic physicians. A reporter from the Wall Street Journal became aware of the opinion and contacted the ACA for further information. We put the reporter in contact with Dr. Wills. HIPAA (REVISIONS) H.R. 3323, The Administrative Simplification Compliance Act, has been passed by the House and Senate and has been sent to the president. The bill would delay by one year the implementation of the electronic transaction standards mandated by HIPAA until October 16, 2003. In order to be eligible for this delay, a provider must submit to the Secretary of HHS an implementation plan. The plan must include: a) a summary of the reasons why the person is not in compliance, b) a budget, c) a schedule, d) a work plan and implementation strategy to achieve compliance, e) information on whether a person plans to use a contractor or vendor to assist in compliance and f) a timeframe for testing. HHS is required to develop a model form for submission of the plan no later than March 31, 2002. Those found to be in noncompliance would be excluded from participation in the Medicare program. Also, the bill mandates that all Medicare claims be submitted electronically, effective October 16, 2003. There is a provision, however, that the secretary may waive the electronic submissions requirement if there is no method available for the submission of electronic claims, or if the entity submitting the claim is a small provider. A small provider is defined as a physician or practitioner with fewer than 10 full-time employees. The doctors will still have to comply next year with the electronic standards and the medical records privacy aspects of HIPAA by preparing compliance plans. SIGNIFICANT IMPROVEMENT ON CCI EDITS The ACA gained a sweet victory around CCI edits as it continues its strategy to eliminate other edits that treat doctors of chiropractic unfairly in reimbursement for manual therapy procedures. As mentioned in earlier reports, the CCI edits developed and used by the Center for Medicare Services (CMS) for Medicare coverage determinations are being used by third party carriers to reduce and deny reimbursement to the chiropractic profession. Dr. Anthony Hamm, Dr. George McClelland and ACA staff have lobbied CMS in person in the last two weeks to disband edits that are totally unnecessary and which have a direct negative impact on all chiropractors. A concurrent strategy has been to directly attack the use of the CCI edits by private insurers. Dr. Jerilynn Kaibel and her coding committee have spearheaded this initiative with a large national vendor used by local Blues plans and others. This group, known as Claim Check, has notified the ACA that they will drop their edit for denial of Massage Code #97124 in their next release. This reimbursement policy change with Claim Check is literally a reimbursement gain in the millions of dollars as it is a national change affecting all doctors of chiropractic on a frequently used code. ACA WORKS WITH PENNSYLVANIA ASSOCIATION IN DEALING WITH WCRI REPORT The Workers Compensation Research Institute (WCRI) is a national research group that produces much of the workers compensation research reports for workers' compensation in the country. WCRI was recently challenged by the Pennsylvania Chiropractic Association (PCA) and ACA over a negative report that was soon to be released in Pennsylvania. Both the ACA and PCA opposed the way the data was reported, as chiropractic data was included as an integral part of PT and other therapies. WCRI acknowledged the flaw and the study has been corrected. Instead of DC's representing 33% of total workers' comp costs, it is actually .9%. WCRI has published several other studies over the last few months where chiropractic data has been mentioned. The ACA will work with WCRI to determine if prior and future data identification is chiropractic specific. Also, special recognition needs to be given to Dr Tony Rosner from FCER who provided input on this project. KRIPPENDORF HONORED AT FLORIDA CONVENTION Last weekend, ACA vice president Don Krippendorf, DC, was honored by the Florida Chiropractic Association at its winter seminar. At a special ceremony, the seminar was dedicated to Dr. Krippendorf for his contributions to both the ACA and the FCA over the last twenty-plus years in practice. The FCA honors at each of their major programs a doctor who has contributed to the success of the profession in Florida. ACA SPOKESPERSON MEETS THE MEDIA Throughout November, ACA has had numerous contacts with members of the media regarding chiropractic issues. During that time, Dr. Jerome McAndrews, ACA national spokesperson, spoke with a) Jay Green of American Medical News regarding VA legislation in Congress; b) Julius Karash of the Kansas City Star; c) Patricia Murphy of the Children's Press on the subject of "touch;" d) Colleen Moriarty of Self Magazine on the subject of handling multiple packages/bags in shopping malls; e) Kirk Johnson of Heart and Soul magazine concerning shooting pains down one's leg; f) Brian O'Riley of Fortune Magazine; g) the Army Times on the recent veterans legislation; h) Avery Hurt of Life Health Magazine on the general topic of chiropractic; i) Katrina Waznicki of United Press International on back injuries. He also accepted an offer by the National Women's Health Resource Center of D.C. and New Brunswick to review the manuscript dealing with chiropractic. A SPECIAL MEMBERSHIP CATEGORY Please note that ACA Governors Advisory Cabinet (GAC) members may register to attend the March 2002 National Chiropractic Legislative Conference (NCLC) for free. ACA's newest membership classification, an enhancement of Full General DC membership, was launched this spring for leaders in the chiropractic profession who want to take a more active role in shaping the future of the chiropractic profession. Other GAC member benefits include special briefings on hot issues by leadership, free ACA products and/or audio teleconferences, a personalized plaque, membership pin, decal, and badge to denote the special contribution, a free Chiropractic Assistant membership, and much more. Doctors already enrolled as GAC members include: Martin J. Alpert, DC, Donald L. Baldwin, DC, Lewis J. Bazakos, DC, David A. Bohn, DC, Leo J. Bronston, DC, James D. Edwards, DC, Terrance M. Eyerly, DC, Howard Fidler, DC, J. Michael Flynn, DC, Anthony W. Hamm, DC, Charles M. Hendricks, DC, Warren T. Jahn, DC, Donald J. Krippendorf, DC, Edward L. Maurer, DC, Edward D. McKenzie, DC, Douglas A. Nordstrom, DC, Harold Privette, DC, Viki S. Resler, DC, John J. Triano, DC, William J. Vendittelli, DC and Daryl D. Wills, DC. If you are reading this report, you are probably participating in many of these ways already, so why not maximize your investment and get the recognition you deserve? For more information and a membership application, visit www.acatoday.com/about_aca/membership_gac.html. ACA OFFICE CLOSES BETWEEN CHRISTMAS AND NEW YEAR'S; EVP REPORT TAKES A BREAK The ACA office will be closed from 3:00 pm Eastern time on December 24th until 8:30 am Eastern time on Wednesday, January 2nd. During this time, we will be monitoring calls to the ACA office, and I will be checking my email account in case there are any problems that need to be resolved before we get back to work. This will also be the last EVP report for the year. Expect the next report to be emailed to you on January 9th or 10th. I hope you have enjoyed these reports as much as I have in putting them together. This is a truly a NEW ACA, and each week I try to show how we are an active and aggressive organization with a single goal of assuring that our profession reaches its proper position in the health care community. If you believe this report would have value to others who aren't members, please feel free to share it with them. |
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