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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 In this report: 1. 50th ANNIVERSARY PARKER SEMINAR: AN HISTORICAL HAPPENING: NO KIDDING 2. ERISA DEVELOPMENTS 3. MEMBERS OF CONGRESS DEMAND MORE CHIROPRACTIC CARE 4. A RACE WORTH WATCHING 5. FIRST CHIROPRACTIC MANAGED CARE SUMMIT: MUCH WORK TO BE DONE 6. ACA IS PROACTIVE REGARDING POTENTIAL TERRORISM AT OLYMPIC GAMES 7. SACA STUDENTS WILL BE HIGHLY VISIBLE AT NCLC 8. NORTHWESTERN COLLEGE OF CHIROPRACTIC STUDENTS DOING THEIR PART 9. DEMYSTIFYING MEDICARE LATE BREAKING NEWS: HHS ISSUES REVISED POLICY DIRECTIVE TO CARRIERS REGARDING PHYSICAL THERAPIST PROVIDING THE CHIROPRACTIC BENEFIT UNDER MEDICARE. IT'S TERRIFIC. MORE DETAILS WILL FOLLOW THIS REPORT. 1) 50th ANNIVERSARY PARKER SEMINAR: AN HISTORICAL HAPPENING The 50th Anniversary Parker Seminar was everything I thought it would be. Over seven thousand doctors, students and chiropractic assistants converged on the Rio Suites in Las Vegas for a four-day conference featuring some of the leading chiropractic and pro-chiropractic speakers in the country. It was also an opportunity for us to get the message out about our two lawsuits to an audience that we are seldom able to reach. The principle sponsors, Dr. Fabrizio Mancini, representing Parker Seminars, and Dr. Kent Greenawalt of Foot Levelers, helped promote the lawsuits by providing us with multiple locations to display our materials, writing letters to the attendees in support of the suits, and by encouraging Parker instructors to promote the issue in their classrooms. George McAndrews was given three different opportunities to address the attendees. Mark Victor Hansen, one of the major speakers at the program, proudly wore the Save Our Subluxation (S.O.S.) badge and told his audience of over 5,000 people about the importance of supporting the lawsuits. To me, the most significant moment occurred Friday evening when the leadership of the entire profession, with individuals who haven't been able to agree on a single issue since Wilk, came together to show their support for the lawsuits. Take a look at our Web site at: http://www.acatoday.com/about/meetings.shtml to see a portrait of solidarity. These pictures were taken immediately following the presentation by Morris Goodman. What you do not see is that immediately before Mr. Goodman's presentation, Dr. Mancini and Mr. Greenawalt introduced the presidents of the ICA, ACA and WCA. All three indicated their support for the lawsuits. Even the most battle-hardened warrior from the philosophy wars would be impressed by this event. You might want to make a copy of the picture and put it in your scrapbook. You can bet that when the history of the profession is written, this occasion will achieve prominence. The Parker Seminar was also successful from a financial standpoint, as we were able to raise a quarter of a million dollars for the National Chiropractic Legal Action Fund. More about that in my next report. 2) ERISA DEVELOPMENTS You may have noticed in the news that the U.S. Supreme Court heard arguments in a landmark ERISA case this past Wednesday. The case, titled Rush v. Moran, deals with the central question of preemption of a state law established to assure proper external review of a HMO beneficiary's claim. The HMO is arguing that the state law is preempted by ERISA. There are over 40 similar state laws that currently hang in the balance with this decision. ACA aggressively lobbied last year for the inclusion of an external appeals provision in the Federal Patients Bill of Rights that would have, among other things, assured that chiropractic services are reviewed by chiropractors. The eventual outcome of this case will have a strong impact not only on the various state external review laws but also upon the eventual shape of any federal external review protection. We are obviously watching this one closely. In a somewhat related development, the U.S. Department of Labor has published a new set of standards for processing health benefit claims under ERISA. These new regulations are now in effect. Among other things, these new regulations require ERISA plans to identify and provide upon request to the patient a copy of the "internal rule, guideline or similar criteria" used as a basis for making a benefit determination. In addition, the new rules require ERISA plans to identify the medical experts consulted in the course of an adverse benefit claim determination. This approach is very much in line with the recent decision of CMS to provide greater information in connection with the release of utilization criteria related to chiropractic claims under Medicare. 3) MEMBERS OF CONGRESS DEMAND MORE CHIROPRACTIC CARE Dr. Bill Morgan, with the assistance of Dr. Terence Kearney, has been providing chiropractic care one day a week at the Capitol to members of Congress. Both doctors practice out of Bethesda Naval Hospital in Washington, D.C. Located in the basement of the Capitol is a fully equipped health care facility, which only members of Congress can visit to receive treatment. All medical and dental services are made available to members of Congress. The demand for chiropractic care has been so great that prominent members of Congress recently wrote the Rear Admiral responsible to the clinic requesting that Dr. Morgan be authorized to spend additional time at the facility. Quoting from the letter, "…the schedule of Congress does not afford opportunities for all to see Dr. Morgan on the day he is scheduled to visit. Many members of Congress have expressed great interest in expanding chiropractic care in the Office of the Attending Physician." The letter is signed by the following: Speaker of the House Dennis Hastert, Senators Jim Inhofe, Strom Thurmond, Orrin Hatch and Rick Santorum, and Representatives Dana Rohrabacher, Donald Manzullo, Dan Burton, Gary Condit, Marion Berry, Neil Abercrombie, Karen McCarthy, Alcee Hastings, David Drier, Jim Ryan, Mary Bono, Gary Ackerman, Dennis Rehberg, Wes Watkins, Robert Aderholt and Barbara Lee. I understand that this is only a partial list. The letter is really something. See it on the Web Page at http://www.acatoday.com/pdf/feb04.pdf As you will recall, legislation initiated by the ACA and passed in 1998 established a chiropractic presence at the Bethesda and Walter Reed Hospitals in Washington, D.C. It wasn't long after that when members of Congress took the opportunity to have our doctors present at the medical center in the Capitol building. 4) A RACE WORTH WATCHING The ACA-PAC is currently tracking a number of close and important congressional races. One race of particular interest involves a strong chiropractic champion in Michigan. Congressman Fred Upton (R-MI) has been a strong supporter of chiropractic initiatives during his eight terms in Congress. It is the ACA-PAC's understanding that Rep. Upton faces a significant primary challenger. Michigan's 6th district is typically a Republican seat, however the boundaries have recently been withdrawn. Even so, the winner of the primary will most likely win in the general election. While he has not officially announced, term-limited state senator Dale Shugars is shaping up to be a formidable challenger. The ACA will continue to watch this race very closely and will alert the profession of any developments. As I indicated previously, don't look to this report to indicate a preference in this race. I will let other periodicals provide that information. In a previous report, I discussed the difficult race between Congressman Jim Maloney and Congresswoman Nancy Johnson. According to a report from Congressman Maloney's office, Maloney has out-raised Johnson during a period of 7/1/01 to 12/31/01 $336,000 to $316,000. This information continues to confirm that this will be a close race and that a lot of money will be spent by both sides. Look to future reports on the race between Senator Tom Harkin and Congressman Greg Ganske, MD. A report came out the other day which showed that Harkin had in the bank $2.2 million to Ganske's $1.1 million. This is going to be an interesting and expensive political year. 5) FIRST CHIROPRACTIC MANAGED CARE SUMMIT: MUCH WORK TO BE DONE In early January, the ACA held its first Managed Care Summit with representatives from several national chiropractic managed care organizations. The main goals of the meeting were to discuss issues of concern between practitioners and MCOs, initiate an open forum on ways ACA can support practitioners while working with the networks, and to review a proposed MCO "code of conduct" drafted by ACA. Chiropractic MCOs represented at the summit included Access Managed Health Care, Alignis, Alternative Medicine, Inc., American Chiropractic Network, Inc., American Specialty Health Network, ChiroAlliance Corporation, Complementary Healthcare Plans, Landmark Health Care, Inc., Managed Physician Network, Michigan Chiro/Net Corporation, Prism Health Networks, The Dominion Consulting Group and Triad Health Care, Inc. Representing the ACA were Professional Development and Research vice president Pat Jackson, members of the ACA Insurance and Managed Care Committee including Don Krippendorf, DC, John Gentile, DC, and Mario Spoto, DC. Also participating were Mr. Tom Daly and myself. It was a lively discussion (sometimes disappointing) covering a broad spectrum of subjects, with the needs of practitioners and patients often at the center of discussion. I made the open remarks, noting that ACA and the chiropractic networks were at a crossroads, needing to find a means of working together collaboratively. I indicated that if satisfactory results could not be achieved after all means of working together had been exhausted, the only alternative to assist practicing doctors of chiropractic is to take a more confrontational approach to the issues. We learned of the problems facing their industry and began the work of attempting to reach consensus on a code of conduct. Look to future issues of my ACA EVP weekly report for further updates, including the status of the code of conduct. 6) ACA IS PROACTIVE REGARDING POTENTIAL TERRORISM AT OLYMPIC GAMES As the 2002 Winter Olympics in Salt Lake City approach, the American Chiropractic Association (ACA) is urging doctors in Utah and surrounding states to be prepared to assist the Red Cross in the event of a crisis situation. The ACA has a formal relationship with the American Red Cross to provide assistance during times of disaster. As part of this relationship, ACA doctors of chiropractic need only complete a short orientation/training program in order to be authorized to serve as volunteers in the event of disasters. This program, open to ACA members only, represents a great opportunity for the chiropractic profession. While participants do not provide chiropractic treatment, they are authorized to offer invaluable volunteer support that will not only assist disaster victims, but also increase the chiropractic profession's visibility and improve relationships with other health care professionals in our communities. It is possible that the volunteer role will eventually be expanded to include providing chiropractic services. If you would like more information about ACA's statement of understanding with the Red Cross, contact Patrick Bernat at pbernat@amerchiro.org. In addition, call your local Red Cross for more information on dates, times and locations of local training programs. 7) SACA STUDENTS WILL BE HIGHLY VISIBLE AT NCLC Once again, a large number of SACA students of chiropractic colleges from throughout the country will converge on the Capitol from March 6-9 in support of chiropractic legislation. Already, ten schools have reported the following numbers of attendees: Palmer College of Chiropractic: 20; Palmer College of Chiropractic-West: 6-8; Parker College of Chiropractic: 8; National University of Health Sciences: 20; Texas Chiropractic College: 20; Western States Chiropractic College: 10; Los Angeles College of Chiropractic: 20.; NYCC 60; Logan 22; and Northwestern 38 It is important to note that the cost for travel and lodging is generally borne by the students themselves. They spend the entire year raising money for the opportunity to support this cause. 8) NORTHWESTERN COLLEGE OF CHIROPRACTIC STUDENTS DOING THEIR PART Over twenty-five students from the Northwestern College of Chiropractic plan to work during a game of the Minnesota professional hockey team, hoping to earn up to $3,500 to be contributed at NCLC for the ACA-PAC and the Legal Action Fund. 9) DEMYSTIFYING MEDICARE The ACA has developed a revised edition to help provide even greater understanding of Medicare regulations. ACA's Medicare Solutions Manual will guide you through the claims process, building accuracy and helping to ensure you receive the reimbursement you deserve! This revised edition also features: new, non-covered service modifiers for 2002, the new ABN form with clarification, an expanded documentation section, and a section on health professional shortage areas. To order, call 800-986-4636 or visit us at: http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2&pf%5Fid=137 We have placed my weekly EVP report on our Web site, where members and non-members 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. |
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