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Orange County Chiropractic District
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Memorandum to: ACA Members, ACA Board of Governors, ACA
House of Delegates and Other Interested Parties In this report: 1. UPDATE ON THE LAWSUITS 2. PLAINTIFFS IN TRIGON SUIT DESERVE SPECIAL RECOGNITION 3. PRESIDENT SIGNS CHIROPRACTIC VA BILL: WHO DESERVES SPECIAL RECOGNITION? 4. WHAT CHUTZPAH! 5. HELP NEEDED ON STUDENT LOAN ISSUE 6. EVP ADVISORY COMMITTEE CONFERENCE CALL 7. NCLC INFORMATION UPDATE ON THE LAWSUITS There is nothing new to report on the lawsuits. The judge in the HHS suit has the summary judgments filed by the ACA and HHS, as well as the physical therapists' petition to intervene in the case. The lawsuit against Trigon Blue Cross/Blue Shield has advanced through the discovery phase. More about this below. PLAINTIFFS IN TRIGON SUIT DESERVE SPECIAL RECOGNITION Of course each of us supports the suit filed against Trigon, and many of us have contributed to the effort. But I doubt that any of us has shown as much commitment to this matter than have the plaintiffs in the lawsuit. Five doctors initially signed on, along with fifteen patients, the ACA and the Virginia Chiropractic Association (VCA). The original list of doctors included Drs. George Chirkinian, Douglas Cox, William Thesier, John Willis and Jerry Willis. That list has expanded tp include Drs. Douglas Ambrose, George McClelland, James Porter, Larry Stine, Kevin Westby, Wendy Holden Willis and Steven Yates. One plaintiff doctor in particular told me that he received a subpoena recently from Trigon Blue Cross/Blue Shield asking for all his patient records since 1996, including all instances in which he used CPT codes, indicating which codes he used. They also requested all of his private and corporate tax returns since 1996. He mentioned all this to me after some prodding. He also noted that while he was recently testifying in court on another matter, two individuals were in the back of the courtroom taking notes. He asked his attorney who they were, and the attorney indicated that they were from Trigon Blue Cross/Blue Shield. These guys play rough, just as the AMA attorneys did with Drs. Pedigo and Wilk in the 70s. This doctor is committed...have you shown your commitment? PRESIDENT SIGNS CHIROPRACTIC VA BILL. WHO DESERVES SPECIAL RECOGNITION? Despite strong opposition by the Veterans Administration, medical groups and the physical therapists, chiropractic care is now a permanent benefit in the Veterans Administration. President Bush signed the bill late in the evening of January 23rd. There are a lot of reasons for this success, and I'd like to take a moment listing the most significant players in making this happen. While I know there are others, I believe these individuals deserve special recognition: 1. Senator Tom Daschle, majority leader of the Senate, who personally got involved in negotiating the Senate version of our provision, pushed Senator Jay Rockefeller from supporting three demonstration sites to agreeing to a permanent chiropractic benefit . One must be impressed with the amount of time Senator Daschcle spent on this issue, given everything else he has had on his plate (negotiations with the White House over the stimulus package, terrorism, etc.). Yet he found time to address our issue. As a political junkie, I am in awe over this. Special recognition to Dr. Kerwin Winkler from South Dakota (former ACA Chairman of the Board), whose personal relationship with the Senator provided an opportunity to make our case and to persuade him to become involved on such a personal basis. 2. The ACA Government Relations staff and ACA leadership, who over the last couple of years have pushed this measure through Congress under difficult circumstances and rallied the profession behind the effort. 3. Our strong partnership with David O'Bryon and Bobby Mills of the Association of Chiropractic Colleges. These guys could always be trusted to do their part. They were there when it counted, not just for photo opportunities. When they called us, it was to share information and not just to learn what was happening with the bill. It's a lot easier to be part of a coalition of equal partners. 4. Congressman Chris Smith and Jim Moran, the Republican leaders on the House Veterans Affairs Committee who pushed for an aggressive House version of the bill. 5. Congressman Bob Filner (D-CA), ranking Democrat on the VA Committee who was the constant thorn in the side the VA and a strong advocate of our position. 6. Dr. Joe Martin and the doctors from West Virginia who carried out an intensive campaign to try and persuade Senator Rockefeller to modify his position. According to Rockefeller's own office, in a five-day period, over 654 calls from doctors, patients and veterans were registered in support of the chiropractic provision. 7. Gene Veno and the Pennsylvania doctors who worked hard to persuade Senator Specter of Pennsylvania to support our measure. As ranking minority member of the Senate Veterans Committee, Specter could have exercised his veto on the provisions but did not. 8. PAC contributors and grassroots of the ACA. Contributions and grassroots don't buy votes, but they do buy attention and an opportunity to make the case. ACA by any standard has the only viable national grassroots and PAC entity. Check out the Federal Election Commission Web site to compare us with any other chiropractic organization, as well as medical PACs. You will either not find them listed, or find that their contributions are paltry, even when compared with a chiropractic organization from the smallest state in the country. 9. Finally, the membership and ACA leadership of the past who labored in the vineyards of politics and contributed to the PAC for so many years without showing any tangible return. Consider that up to 1997 only one piece of significant legislation involving chiropractic passed Congress, and that was the Medicare amendment. I don't think anyone is pleased with Medicare. But since 1997 the following has taken place: (a) elimination of the X-ray requirement in Medicare (1997), b) chiropractic becoming a prominent part of DOD (2000) and now (c) the Veterans Administration. I became EVP of the ACA in 1995, and I like to think that all of this was because of my efforts and those of my staff. Get real Cuneo! You can't have success in D.C., the town notorious for chewing up organizations and their legislative agendas, without having a solid foundation. Thanks to those members who helped build the foundation. In 1937, the profession first introduced in Congress a bill to create a veterans administration benefit for chiropractic. It went nowhere. In the 50s, JACA talked about an ACA-sponsored law creating a VA benefit. It also went nowhere. It's been a tough row, but we have arrived. Now it's time to take on Medicare. WHAT CHUTZPAH! I try to keep politics out of this report, at least most of the time. But I got an email the other day from a student at Life University that screams for a comment. He told me that there is a large banner hanging over the Life University campus in Georgia that reads: "ANOTHER VICTORY FOR THE ICA: THE PASSAGE OF THE VETERANS BILL." Now I am sure that ICA made some visits in support of this legislation, but I can tell you that at the critical subcommittee markup hearing of the VA House Committee, when the members went from supporting only a demonstration project to supporting full implementation, only two organizations were present: the American Chiropractic Association and the Association of Chiropractic Colleges. I already described above Senator Daschle's efforts. As for the reference to "another victory," I am only aware of two other pieces of chiropractic legislation passed since the dismal Medicare bill of 1974 : The elimination of the X-ray requirement in 1997 and the passage of the DOD bill, both ACA initiatives. In neither instance was the ICA in support of these measures. Dr. Flynn stated it best in learning of this email: "Kinda like the rooster taking credit for the dawn of a new day." Coalitions are important, but let's communicate the straight scoop. HELP NEEDED ON STUDENT LOAN ISSUE Last year the ACA and ACC (Association of Chiropractic Colleges) succeeded in inserting a legislative provision into a larger Senate Bill (Section 338L of S.1533) that would allow the chiropractic profession to participate in the Student Loan Repayment Plan of the National Health Service Corps for a three-year period. Doctors of chiropractic have always been excluded from this program that was established to enhance access to primary care services in medically under-served areas. However, the ACA and ACC supported a provision that would allow selected doctors of chiropractic who locate their practices in designated medically underserved areas to participate in the program and have their student loans repaid. Doctors of chiropractic provide important primary care services, and it is unfair for them to be excluded from any loan repayment program that seeks to expand access to primary care services. It is important to note that the U.S. House of Representatives has not yet passed a similar bill. Anticipating that the House will soon take action, negotiations are already underway between the U.S. Senate and the House of Representatives over the content of a final version of a bill acceptable to both the House and Senate. The outcome of these negotiations will determine whether the chiropractic provision is included in the final version of the bill that will pass Congress. Not surprisingly, various medical provider groups are opposed to the inclusion of the chiropractic profession in this program and are actively working to defeat the chiropractic provision we inserted into S.1533. In addition, the optometrists and podiatrists are actively seeking inclusion, as they were dropped from the program in the House side. On Friday, Drs Mike Flynn and Glenn Manceux, members of the BOG from Louisiana, along with ACA lobbyists met with the chief of staff of Congressman Billy Tauzin (Louisiana) chair of the House Commerce Committee that has oversight over this issue. The meeting went well and we were able to address a number of issues that had been raised by the opposition. But clearly this will be a tough battle. It is urgent that the chiropractic profession takes swift grassroots action to convince members of the House of Representatives to support this chiropractic provision. This type of reauthorization only comes up every four or five years. So if we aren't successful this year, it will be a long time before we have another opportunity. Accordingly, please call your members of the House of Representatives urging him/her to take action to ensure that Section 338L of S.1533 is included in any House bill re-authorizing the National Health Service Corps that is to be approved by the House. You can reach your representative by calling the Capitol Switchboard at (202) 224-3121. EVP ADVISORY COMMITTEE CONFERENCE CALL Last Tuesday, we held the monthly conference call of state association executive directors and/or presidents with ACA staff. This month's call included representatives from Ohio, Minnesota, Kentucky, Alabama, North Carolina, South Dakota, Iowa, Missouri, Colorado, Nebraska and Texas, plus COCSA (Congress of Chiropractic State Associations). ACA president Daryl Wills, DC, also joined us on the call. The issues discussed included the recent ERISA actions, noted above, the new HIPPA legislation, an update on the Blue CCHIP Program, CMS changes regarding utilization parameters, tips on lobbying Congress after September 11th, State Association Roundtable (scheduled for March 9th from 1-3) and our new CPT and Medicare manuals. The next scheduled call of the committee is Tuesday, February 12th at 1:00 pm Eastern. NCLC INFORMATION Go to ACA Web Site at http://www.acatoday.com/about_aca/meetings.html |
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