Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties 
From: Gary Cuneo 
Re: ACA EVP Weekly Report 
Date: July 8, 2002

In this week's report are the following issues: 

1) DEPOSITIONS ARE FOCUS OF LAWSUIT AGAINST TRIGON 

2) CANADIAN INQUEST: DR NORRIS ON THE STAND 

3) MEDICARE PRESCRIPTION BILL UPDATE(PASSED THE HOUSE) 

4) COLORADO DOCTORS DO THEIR PART 

5) HIPAA TELECONFERENCING SEMINAR: LAST MINUTE CHANCE TO REGISTER

1) DEPOSITIONS ARE FOCUS OF LAWSUIT AGAINST TRIGON Two weeks ago, I spent the morning being deposed by the Trigon attorneys in McLean, Virginia. Contrary to rumors, the Trigon stock on the New York Stock Exchange didn't jump 10 points upon the release of this news. I did fine, as did Pat Jackson, who was deposed in the afternoon. This was an interesting experience, to say the least. Attending the deposition were my counsels, George McAndrews and Tom Daly. Also present was a transcriber taking down my every word, as well as an individual manning a video camera, recording my every expression and sound. I mention this not to gain any sympathy, because I doubt there would be any, but rather to note that we are in the middle of depositions, one of the most critical stages and most expensive parts of the litigation. In fact, over the last two months and scheduled for the next couple of months will be a total of 38 depositions. We have deposed a number of individuals from Trigon, including the former medical director whose testimony is still under seal. We have deposed representatives of the National Blue Cross/Blue Shield Association. We are scheduled to depose representatives from the Medical Society of Virginia and the Virginia Physical Therapy Association. Trigon has deposed or is scheduled to depose all the plaintiffs in the suit, including the 18 patients and 11 doctors. In each instance, we have our team of attorneys present, as does the opposition. The depositions have been held in Richmond, Virginia; McLean Virginia; and Chicago, Illinois. This has been a very busy four months in the litigation and more is planned. Not only have we filed two "Motions to Compel" and one "Motion for Sanctions," each requiring follow-up motions, but also there has been all the planning and time spent in dealing with 38 depositions. These depositions can run as little as three hours, as was my deposition, or as long as eight hours, which has been the rule. Litigation is never easy, but as long as Trigon appears to be dragging its feet in providing documentation, we must continue to pursue these avenues. On Thursday, the U.S. District Court judge ordered a new deposition of Trigon's former medical director due to the late production of a substantial number of documents by Trigon and has ordered the Medical Society of Virginia to produce all documents regarding chiropractors in its possession "whether or not formerly authorized by the Medical Society of Virginia." The deposition of the Medical Society of Virginia will follow the production of this information. Help us fund this lawsuit by pledging $100 per month for the suit. Go to the web page today to make your contribution: http://www.acatoday.com/pdf/legal_action.pdf

2) CANADIAN INQUEST: DR NORRIS ON THE STAND

If you have been a regular reader of this newsletter, you know that for the last few months we have provided an update on the official Canadian inquest into the stroke death of Lana Dale Lewis -- whose family claims she died as a result of chiropractic manipulation. This case has generated tremendous press coverage, and from what I hear, has seriously affected the bottom line for doctors in Canada. Although our side continues to refute successfully the allegations of the woman's family, the bad publicity from the case hasn't helped.

A couple of weeks ago this report had an on-the-scene commentary from Dr. Mike Flynn, who attended a couple of days of the hearings. The report below covers the last two weeks, with an emphasis on the testimony of Dr. John Norris, immediate past chair of the Canadian Stroke Consortium (CSC). His testimony is significant since he presented a paper on chiropractic and stroke earlier this year at the American Stroke Association Conference in Texas. His report, which the ACA referred to as "junk science" at the time, made many unfounded allegations against the profession. During the inquest, Dr. Norris was questioned extensively about the subject of that paper -- called the SPONTADS study. Dr. Norris agreed with counsel for the chiropractic profession that the study is not fully developed - that it is more of a "feasibility study" -- and admitted that the figures have not been updated regularly.

Dr. Norris was then questioned about a February 3, 2002 press release attributed to a group of Canadian neurologists which publicized the SPONTADS study and claimed that the risk of stroke from chiropractic adjustment was 1 in 5,000. As you might recall, that release resulted in significant negative media coverage here in the United States as well. According to Dr. Norris, he "had nothing to do with this petition" and he "didn't actually see that phrase" about the 1 in 5,000 risk. He claimed that his name was merely listed as a contact person, and the fact that it cited the CSC's work did not mean that he supported the information in the release. When asked if he felt it was his professional responsibility to correct the misinformation in the release, Dr. Norris testified that he felt he had no responsibility to correct it. During testimony, Dr. Norris stated that, "I've never deviated from the figure we've always used - 1 in 100,000." Dr. Norris then confirmed that he believes the actual risk figure is 1 in 100,000 patients - or 1 in 2.2 million adjustments.

3) MEDICARE PRESCRIPTION BILL UPDATE(PASSED THE HOUSE) Close to 2:30 a.m. ET, a week ago Friday, the Republicans were able to secure enough votes to pass the Medicare reform bill out of the House of Representatives. With the exception of a few Republicans who voted against the bill and a few Democrats who voted for it, it was strictly a party line vote. The bill had been framed the week before by the Energy and Commerce Committee as well as the Ways and Means Committee. In spite of our strong lobbying efforts and strong grassroots support, we weren't successful in getting a chiropractic provision in the bill. We could have had a study, which is what the P.T.s received, but we should be beyond a study. Early in the week, we continued the fight to get the provision in the bill. We petitioned the Rules Committee to have our bill considered. We specifically lobbied Congressman Tom Reynolds who sits on the committee, and our New York doctors did a great job in contacting his office. The leadership sent out the word that they would not accept any amendment and, in the end, party disciplined prevailed. This fight will continue in the Senate where, as I have reported previously, we have the commitment of some important senators to push our provision. If the Senate passes a Medicare provision, which will clearly be more in tone with the Democrats and less like the House version, it will go to conference committee where the leadership of the House and Senate will try to hammer out an agreement. Before I leave this issue, it is important to emphasize that our failure to include a provision rested squarely with Congressman Bill Thomas, chairman of the Ways and Means Committee. Many members of both committees (Ways and Means and Commerce) tried to persuade Thomas to include our provision, without success. One of the most committed is Congressman Bil ly Tauzin, Chairman of the Energy and Commerce Committee. Our Louisiana doctors, particularly Drs. Mike Flynn and Glenn Manceaux, have a close relationship with the Congressman. He wanted the chiropractic provision but was eventually forced to drop the effort, because of Thomas' objection. If a conference committee is scheduled for the bill, he will undoubtedly be part of the negotiating team and his commitment for a chiropractic provision will begin anew. This battle will continue over the next six months. We aren't going to give up until we have a chiropractic provision in this bill.

4) COLORADO DOCTORS DO THEIR PART I am sure you have been reading about the devastating fires in Colorado. Like the efforts of the profession during the tragedy of 9-11, our doctors in Colorado have come forward and set up treatment centers for the firefighters in the area. I want to specifically recognize Drs David Boyd, John Warner and Tom Garcia in this effort. One other comment: The doctors in Colorado had the same problem as doctors in New York in attempting to provide their services. They had to go through various bureaucratic hoops before they were permitted to treat the firefighters. We recommend that where possible, the doctors in the area in cooperation with their state association attempt to establish a relationship with the Red Cross unit in the community before any disaster occurs. . In this way, the doctor already has credentials and name/face recognition with their local Red Cross and to allow access to the disaster site. Although our national contract with the Red Cross does not include "chiropractic services", experience has been that local Red Cross units allow treatment of disaster workers . We are working nationally with Red Cross to include protocols for chiropractic care of workers. 5) Register for ACA's HIPAA Live Phone Conference Need Help with HIPAA? No need to travel to a seminar. Dial into the phone conference from your office or home. Invite your staff to participate at no additional charge. This session will focus on the administrative simplification aspects of HIPAA with a primary emphasis on medical records privacy. The speaker, Marc Cohen, Esq. will discuss the requirements of this statute and medical records privacy. Participants receive handouts and an audiocassette of the 90-minute session free with conference registration. Interactive Q & A ensures all your concerns are addressed. Date: Thursday, July 11, 2002 Time: 12:30 - 2p.m., EST ACA Member Price: $49 Non-member Price: $59 *Can't attend the live teleconference? Order the 90-minute audiocassette of the seminar. ACA Member Price: $39; Non-member Price: $65. About the Speaker: Marc Cohen, Esq. is a principal at the Health Law Department of Ober, Kaler, Grimes & Shriver. Cohen's areas of expertise are scope of practice, professional compliance, regulatory and disciplinary matters related to DCs and other licensed health care professionals. For further information contact ACA at 1-800-986-4636 . 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.