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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 From: Garrett F. Cuneo Re: EVP Weekly Report Date: January 6, 2002 In this report: 1. HHS SECRETARY APPOINTS DR JOE JOHNSON TO PPAC HHS SECRETARY APPOINTS DR. JOE JOHNSON TO PPAC Dr. Joe Johnson, ACA member and alternate delegate from Florida, was appointed by HHS Secretary Tommy Thompson to the Practicing Physicians Advisory Council (PPAC). PPAC was mandated by the Omnibus Budget Reconciliation Act of 1990 to advise the Secretary of Health and Human Services and the Administrator of the Centers for Medicare and Medicaid Services on changes to Medicare regulations and carrier manual instructions. PPAC is comprised of 15 physicians, all of which must have billed at least 250 Medicare claims. Eleven of the members must be either medical doctors or doctors of osteopathy, and the others may include doctors of chiropractic, podiatrists, dentists and optometrists. Dr. Johnson replaces ACA Governor Dr. Jerilynn Kaibel, who has served on the council since it inception. What is significant about this appointment is that there isn't a chiropractic position as such designated on the council and we were competing with candidates from other professions for the position. When I worked in the Reagan administration I was responsible to the Secretary for appointments to HHS, so I think I have a good understanding of the various advisory committees in the department. Of all the committees available, there isn't another that gives us a better opportunity to present our concerns about Medicare than PPAC. Some of the issues that we addressed with PPAC were the auditing abuses of our doctors by HCFA as well as the reasons for our lawsuit against the department. In fact, HHS first acknowledged that they were taking a different position on physical therapists performing spinal manipulation at a council meeting during a question and answer period initiated by Dr. Kaibel. This is an important appointment for this profession. STRONG EDITORIAL FROM DYNAMIC CHIROPRACTIC FOR TRIGON SUIT Look to the January 1 issue of Dynamic Chiropractic for a strong editorial by Don Petersen, Editor/Publisher of Dynamic Chiropractic, in support of our lawsuit against Trigon. Under the headline, "Conspiracy Gone, but Mindset Lingers", the editorial talks about the brief submitted by Trigon Blue Cross/Shield to the court in which they acknowledge that they pay our doctors a lower fee than other practitioners for the same service because of their belief that our education is inferior. Petersen editorial states, "Trigon has purposefully chosen to continue the war on the chiropractic profession started by the AMA. But the beliefs expressed by Trigon are also held by many other insurance carriers in this country. If we beat Trigon, we send a message to every other insurance company that we won't accept being treated as second-class 'limited license' providers." Petersen closes with a strong appeal for the profession to support this effort. "We have an opportunity to respond with this lawsuit in a way we could never do as individuals. If you are a state association leader, you should urge your members to support this suit and contribute to its support. If you are a doctor of chiropractic, there is no better way to respond than by making a contribution to the fund. How much should you contribute? How much is your practice worth.? How much is your self respect worth? Checks should be made out to The National Chiropractic Legal Action Fund, P.O. Box 75359, Baltimore,Maryland 21275. Lets send a message to Trigon that we're done working for second-class wages while MDs are paid in full! At the same time, let's send a message to the rest of the insurance community. 'Who's next?'". I couldn't have expressed it better. For a full text of the editorial go to http://www.chiroweb.com/archives/20/01/14.html ADEQUACY OF MEDICAL SCHOOL EDUCATION IN MUSCULOSKELETAL MEDICINE You will recall that I reported in an earlier issue of EVP Weekly Report the filing of Trigon's brief citing our "inferior education" for the lower fee that was the target of Petersen's editorial. Dr. Jay Triano read about the brief and thought we would be interested in a research paper published in the October 1998 issue of The Journal of Bone and Joint Surgery, the journal of the orthopedic surgeons. The study was designed to test a group of recent medical school graduates on basic topics in musculoskeletal medicine in order to assess the adequacy of their preparation in this area. Conclusion: In summary, 82% of the medical school graduates failed a valid musculoskeletal competency examination. "We therefore believe that medical school preparation in musculoskeletal medicine is inadequate." Thanks Jay for the information. You know we will use it. BLUE CCHIP IN FULL SWING The ACA recently kicked off its most recent insurance initiative called BLUE CCHIP (Blues Chiropractic Clinical Healthplan Integration Program). This is a direct result of the lawsuit against Trigon BCBS and the national BCBS Association. A conference call was recently held with all of the state liaisons, delegates, and state associations who are involved in this initiative. After a brief introduction by ACA president Daryl Wills, DC, ACA legal counsel Tom Daly, gave a brief history of the lawsuit against the Blues, and then Dr. Allan Korn, chief medical officer for the national BCBS Association, gave a statement about the Blues' involvement in this integration plan and answered questions. PDR staff then reviewed the resource manual that was sent to all liaisons and discussed strategy in the upcoming meetings that the liaisons will hold with their local Blues contacts. PDR staff and legal counsel also briefly outlined the new chiropractic benefit in the national BC/BS "Basic Option" plan, now available to all federal employees and their families. This first-time chiropractic benefit in any federal BCBS plan is also a direct result of our litigation with the Blues. Participation was extremely high, with over 100 people taking part in the two conference calls. Both Dr. Wills and Dr. Korn expressed their commitment to this program and look forward to working together for a common goal in obtaining a core chiropractic benefit for all DC's in all plans. The resource manual that was sent out outlines the core benefit criteria that the liaisons should attain at the state level through the negotiations with their local BCBS health plan. Dr. Korn stated that the high-level contact people in the Blues plans are waiting for our liaisons to contact them so they can begin to proceed with this integration plan. January should be a busy month for meetings across the country. NEW REQUIREMENT FROM HCFA (CMS) The Centers for Medicare and Medicaid Services (CMS) is now requiring its carriers to check and record dates for expirations of licenses and certification. If a Medicare provider's license or certificate expires, the carrier is required to deny all claims until the provider submits to the carrier a renewed license. It is important to check with your local carrier on how they plan to implement this requirement and how and where you should submit your renewed license. MCANDREWS AT PARKER George McAndrews will be the featured speaker on two occasions at the 50th Anniversary of Parker Seminars and Foot Levelers on January 17-20 at the Rio Suite Hotel and Casino in Las Vegas. Other speakers include: Dr. Deepak Chopra, Mark Victor Hansen (author of the "Chicken Soup for the Soul" series), Dr. Wayne Dyer and others. ACA leadership plans to attend and promote our lawsuits. It will be the placed to be for chiropractic. For further information, call 800-986-4636. SILENT PPOs: WHAT THEY ARE AND HOW TO DEAL WITH THEM A talking point on 'Silent' PPOs have been distributed PDR to the state associations and state delegates in an effort to provide a brief explanation of what a 'Silent' PPO is, how to determine if a practitioner has been accessed under a 'Silent' PPO arrangement between networks and who to contact to terminate the access. Practitioners unfortunately could be losing considerable revenue each year to 'Silent' PPO arrangements. This talking point should provide a practitioner with enough information to determine if a 'Silent' PPO arrangement exists and steps to take to stop inappropriate discounts to the practitioner's bills. http://www.acatoday.com/insurance/silent_ppo.html ACA LEADERSHIP AT COCSA AND NCLC FORUM The second weekend of November, the leadership of the ACA, including the ACA Executive Committee, traveled to New Mexico to attend the annual meeting of the Congress of Chiropractic State Associations. COCSA's convention is an annual event that brings together a cross-section of state associations (both ACA and ICA-connected) and provides a good opportunity for the leadership of the profession to mingle. This weekend was no exception. It began on Thursday when Drs. Wills and Edwards represented the ACA at the National Chiropractic Leadership Forum. This group, which is composed of the major chiropractic organizations in the country, has met on at least four occasions and has used the forum to try to reach consensus on a number of issues. We also took the opportunity to attend the classes sponsored by COCSA and to put on some programs of our own. Pat Jackson, vice president of PDR, made an excellent presentation on the outreach program that ACA has initiated with insurance carriers and our other insurance-related activities. I was also given an opportunity to speak, sharing a panel with Ron Hendrickson of ICA discussing our national legislative programs. Our chairman, Dr. Jim Edwards was given time to present information regarding our lawsuits. The audience, which included a cross-section of the profession, was very positive about Edwards' remarks. Following his presentation we raised nearly $10,000 in cash and pledges. The support for the lawsuits continued to resonate throughout the weekend. At the luncheon sponsored by Foot Levelers promoting the upcoming Parker Seminar, the president of Parker College spoke strongly about the need for the entire profession to support the lawsuit against HCFA. These strong comments continued the next day when Dr. Louis Sportelli, president of NCMIC, spoke about the Trigon lawsuit and how a successful verdict in this case would resonate throughout the country and positively effect the 80 million consumers who are currently covered by BSBS plans. FACULTY COUNCIL CONFERENCE CALL Two years ago, as a way to increase the voice and participation of faculty members in the activities of the association, the ACA established a Faculty Council. The council includes representatives from each chiropractic college and has a representative with voting power at our HOD meetings. Since the council was established, Dr. Allan Perry of Logan College has served as the council's representative at HOD. In last December, the council held its quarterly conference call. Included on the call were representatives from Cleveland (Kansas City), Logan, LACC, National, Parker, and Palmer West. The call provided an opportunity to discuss various ACA activities and to discuss ways to improve communication with other faculty and within the council. BRASSARD SELECTED PRESIDENT-ELECT OF TEXAS COLLEGE ACA Council of Delegates president Richard Brassard, DC, was selected by the Board of Regents as president-elect of the Texas Chiropractic College. The College has made a great selection. DR. FIDLER SPEAKS AT CLEVELAND COLLEGE Dr. Howard Fidler, delegate from Minnesota, delivered the recent commencement address to the graduating class of the Cleveland College of Chiropractic in Kansas City. HOD SPECIAL MEETING ACA's House of Delegates is holding a special meeting in conjunction with NCLC on March 8-9 at the Hyatt Regency Hotel in Washington, D.C. on Capitol Hill. Any member who wishes for the House to consider a resolution must submit it to the ACA Secretary by January 22, 2002. |
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