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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 This week's report includes the following issues: 1. TIME TO EXPRESS YOURSELF ABOUT CHIROPRACTIC
MANAGED CARE COMPANIES 1. TIME TO EXPRESS YOURSELF ABOUT CHIROPRACTIC MANAGED CARE COMPANIES In February 2002, ACA's House of Delegates (HOD) passed a Managed Care Resolution that reads in part: "…the ACA vehemently opposes these harmful and discriminatory practices, including but not limited to: limiting full scope of practice, inappropriate CPT applications and reimbursement policies, use of discount/affinity programs, restrictive limits of care, and improper utilization review." It continues: "…that ACA staff and leadership are directed to communicate our concerns to the profession; obtain detailed data on these abuses; develop and implement a plan to halt these unfair practices; and give a status report in August 2002 and at each subsequent House of Delegates meeting." To address the last portion of the resolution, PDR has prepared a Chiropractic Network/MCO Issue Form. Practitioners with concerns should complete the form for situations relating to network access, reimbursement methodology, etc. Issues are reviewed and included in a database for trend analysis, feedback to the network and reporting at future HOD meetings. Complete, written information may be solicited from the practitioner at a future date. Trend analysis provided to the networks will not include the practitioner's name or identifying information. The form is available on the ACA Web site, and will also be included in ACA Today: http://www.acatoday.com/pdf/managed_care_collection.pdf The data collection form should be faxed to: ACA - PDR @ 703-243-2593. 2. DOCTORS IN MEDICALLY UNDERSERVED AREAS HAVE AN ADVANTAGE As you may know, the ACA was instrumental in the institution of a first-time chiropractic benefit under the Blue Cross/Blue Shield "Basic Option" plan for federal employees and their dependants. Federal law also provides that all federal employee health benefit plans must permit doctors of chiropractic to provide for all covered services in non-HMO plans that are located in "Medically Underserved Areas (MUA)" as determined by the federal government. There was a degree of confusion in at least two Blue Cross/Blue Shield plans operating in two MUA states that viewed the new chiropractic benefit as a substitute for their obligation under the federal MUA statute. ACA intervened with the Montana Blue Cross/Blue Shield plan, outlining our view that the new benefit did not eliminate their MUA obligation to permit doctors of chiropractic to provide all covered services under the federal employee plan. We recently received confirmation from them agreeing with our position, stating that chiropractic would be included in the "Standard Option" as well as the "Basic Option." There will also be coverage for services beyond the manipulation services afforded by the "Basic Option" plan. MUA states for 2002 are Alabama, Georgia, Idaho, Kentucky, Mississippi, Missouri, Montana, New Mexico, North Dakota, South Carolina, South Dakota, Texas, Utah and Wyoming. If you are having similar problems in a MUA state, please contact ACA and we will provide a copy of our legal analysis. All Blue Cross ACA liaisons in these areas have been briefed on this matter. 3. ACA CHAIRMAN AND PAST CHAIRMAN SHINE AT BREAKTHROUGH PROGRAM Current ACA chairman Dr. James D. Edwards and immediate past chairman Dr. J. Michael Flynn spoke recently at the Breakthrough Coaching Seminar held in New York, addressing the attendees regarding the ACA lawsuits and other ACA activities. They must have been outstanding, as they really brought home the bacon. From the weekend presentation alone, they signed up eleven doctors for general membership for the year, collected 20 pledges of $100 per month for the duration of the lawsuit and one pledge for $50 per month. The annual value of these pledges is $24,600. I would say that they had a good weekend of work -- and thanks to Breakthrough Coaching for giving them the time to make the pitch. We have a story to tell -- we just need the opportunity to present our case. 4. LLOYD TABLE COMPANY CONTRIBUTES TO THE CAUSE Lloyd Table Company has added to their contributions to the legal action fund by donating a table valued at $4,290. They have guaranteed from this a contribution of $6,000. Adding to what they have already contributed, Lloyd Table Company's total contribution to date is $12,000. This would make the table company the fifth-highest vendor contributor to the lawsuit. The first four include:
5. EVP ADVISORY COMMITTEE CALL The monthly conference call of the EVP Advisory Committee was held on May 21st. Joining the ACA vice presidents, legal counsel and me were representatives from the following state associations: Michigan, South Dakota, North Carolina, Colorado, Michigan and Pennsylvania. During the call, Felicity Feather provided an update on the Canadian Inquest. Jay Witter brought everyone up-to-date about the Medicare bill. Tom Daly, ACA legal counsel, provided two updates, including: 1) the new regulation on ERISA that becomes effective on July 1, which could provide an important weapon in fighting managed care, and 2) new information regarding the chiropractic benefit in those states that are designated as Medically Underserved Areas (MUA). The next call of the advisory committee is scheduled for June 18 at 1:00 pm Eastern. 6. WEEKLY UPDATE ON THE CANADIAN INQUEST Testimony in the Canadian inquest continues to support the chiropractic profession's position that natural causes - not chiropractic cervical manipulation - caused the 1996 death of 45-year-old Lana Dale Lewis. The past week's proceedings started off on May 27 with testimony by Dr. Richard Moulton, head of neurosurgery at St. Michael's Hospital in Toronto. He stated that Ms. Lewis died of a thrombosis, or blood coagulation, and flatly rejected claims that chiropractic manipulation had anything to do with her death. Dr. Moulton noted that the thrombosis could have occurred spontaneously or it could have been caused by elevated levels of hemoglobin in Ms. Lewis' blood. The doctor pointed out that vertebral artery dissection "appears to be absent in this case." Then on Tuesday, May 28, Tim Danson, lawyer for the Canadian Chiropractic Association and the Canadian Memorial Chiropractic College, revealed that Ms. Lewis had called in sick so often from work prior to her death that her employer was threatening to fire her. An occupational health nurse from the GlaxoWellcome plant where Ms. Lewis worked then testified that Ms. Lewis experienced high levels of stress believing her job was on the line because of her absenteeism. "She was expressing very real medical concerns that she had," the nurse testified. Watch my report next week for a first-hand perspective from ACA Governor Dr. J. Michael Flynn, who will be attending the inquest this week in Canada. The Canadian Chiropractic Association has started putting weekly updates on the inquest on its Web site. Click on www.ccachiro.org and then go to the "media" section. 7. NEW 3-D INTERACTIVE CD-ROM WILL HELP YOU IMPROVE PATIENT CARE Interactive Spine: The Chiropractic Edition is an innovative, anatomical and clinical pathology CD-ROM developed by Primal Pictures that includes selections on anatomy and manipulative therapy, and features a 3-D computer model of the complete spinal anatomy and more than 1,500 individually labeled structures. The anatomy section includes descriptions of bones and bone regions, range of motion animations, and muscle and ligament attachment points. The manipulative therapy section's text focuses on the cervical, thoracic, lumbar and sacral spine. Includes tests with accompanying videos on muscle and orthopedic testing, motion palpation, and rehabilitation and injuries. "Interactive Spine: The Chiropractic Edition is an outstanding resource for practicing doctors and an absolute must for chiropractic students. From anatomy...to neurology...to orthopedics, the CD has it all and is amazingly simple to navigate. It is one of the best resources a doctor of chiropractic can have for neuromusculoskeletal information, and I recommend it highly." - James D. Edwards, DC, ACA Chairman of the Board. To order, or for more information, go to: www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2&pf%5Fid=99 8. CAN'T ACCESS THESE LINKS? Some of you have been unable to download my PDF links. To view these file types, you need Adobe's Acrobat Reader. This is a free utility available at www.adobe.com. If you need further assistance viewing anything referred to in this report, please email me at gcuneo@amerchiro.org. |
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