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TO: ACA MEMBERS, BOARD OF GOVERNORS, HOUSE OF
DELEGATES AND OTHER INTERESTED PARTIES
FROM: GARY CUNEO
RE: ACA EVP WEEKLY REPORT
DATE: October 28, 2002
This week's report includes the following items:
1. Judge Cancels Trial Date
2. President Signs Student Loan Bill
3. CCE Announces Life College's Loss of Accreditation
4. ND Blues and State Insurance Department Enter into Settlement
5. ACA Pursues the Wal-Mart Problem
6. Are Faxes Covered Transactions under HIPAA?
7. State Associations Support Membership Efforts
8. Update on Key Races
9. ACA Leadership on the Road
10. An Update on the Parker Seminars
11. EVP Advisory Committee Call
12. New Kit Prepares Your Practice for HIPAA
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1.JUDGE CANCELS TRIAL DATE FOR ACA vs. TRIGON
U.S. District Court Judge Jones, who is the presiding judge in the ACA et al vs.
Trigon et al case in Virginia, faced with an extensive motion by Trigon to
dismiss the case as a matter of law and an extensive response by the ACA, VCA,
chiropractic doctors and patient plaintiffs, has issued an order canceling the
November 12th trial date and halting all court activity in the case pending
resolution of the existing motions. There is no doubt that resolving the
multi-faceted motion will set the guidelines for either trial of the case or an
immediate appeal to the 4th circuit.
2. PRESIDENT SIGNS STUDENT LOAN BILL
S. 1533, a bill that includes a provision to include doctors of chiropractic in
the National Health Service Corps, a program that provides participants with
reimbursement of their student loans in exchange for service in medically
underserved areas, was presented to the president on Oct. 23 and signed by him
on October 26th.
3. CCE ANNOUNCES LIFE COLLEGE'S LOSS OF ACCREDITATION
On Oct. 20, 2002, the Council on Chiropractic Education conducted a hearing
before the CCE Appeal Panel regarding the Life University College of
Chiropractic (LUCC) appeal of the CCE Commission on Accreditation (COA) decision
not to reaffirm the accreditation of LUCC. Representatives of LUCC and the COA
participated in the hearing.
The CCE Appeal panel has announced its ruling in the matter, and has upheld the
decision of the COA. This ruling means that as of Oct. 20, 2002, LUCC has no
form of accredited status with CCE.
CCE accreditation is voluntary in nature. A chiropractic program can initiate
the normal processes for CCE accreditation by application at anytime
4. NORTH DAKOTA BLUES AND STATE INSURANCE DEPARTMENT ENTER INTO SETTLEMENT
In May 2000, the North Dakota Insurance Department initiated an examination of
Blue Cross Blue Shield of North Dakota's (BCBSND) chiropractic claims handling
practices. The department issued a report that was challenged by BCBSND. A
settlement agreement and order has been entered by the North Dakota insurance
commissioner and contains 16 items.
Among the recommendations are the following: 1) "For services that are
within the scope of practice of chiropractors, BCBSND should not reimburse
services of certain professionals while denying similar services provided by
chiropractors;" 2) "The written [appeal] policies and procedures will
address notice, the right of the patient or affected chiropractor to be heard
and receive an independent review, avoidance of conflicts of interest, and the
selection and length of terms of Peer Review Committee members;" 3) "BCBSND
should adhere to its contractual appeals provisions and the URAC standards, to
the extent URAC applies to chiropractic treatment;" 4) "BCBSND should
revise its descriptions of supportive and maintenance care to more closely
resemble ACA definitions;" and 5) "BCBSND should establish written
guidelines for placing chiropractors under focused medical review and
communicate those guidelines, once formulated, to each chiropractor."
The settlement agreement also requires BCBSND to provide the state insurance
department with a copy of its written policy and procedures adopted in
connection with the recommendations on or before Jan. 2, 2003.
5. ACA PURSUES THE WAL-MART PROBLEM
Wal-Mart Stores Inc. recently informed its associates of the elimination of
chiropractic benefits, effective Jan. 1, 2003. While benefits in 2002 were slim
at best, we believe the elimination of all chiropractic benefits creates a
hardship for Wal-Mart employees. ACA leadership attempted to meet with
Wal-Mart's vice president of health benefits in early 2001. Wal-Mart's reply
indicated they had no interest in meeting with ACA representatives. A letter
from ACA President Dr. Daryl Wills was forwarded last week to Wal-Mart's
president, H. Lee Scott. The ACA is considering all options while it awaits a
response from Scott including increased emphasis on patient education stressing
the value of chiropractic treatment. . In the December issue of ACA Today, ACA
members are encouraged to send letters to Scott expressing their concern over
Wal-Mart's elimination of chiropractic benefits.
A copy of Dr. Wills' letter can be found in that issue and on the ACA Web site
at: http://www.acatoday.com/insurance/managed_care/WalMart.shtml.
Future updates will be provided in this report and in ACA Today.
6. ARE FAXES COVERED TRANSACTIONS UNDER HIPAA?
At a presentation before the District of Columbia Bar Association, Jodi
Goldstein, JD, from the HHS Civil Rights Division, Office of the General
Counsel, provided clarification on an issue that has caused much confusion:
whether faxes are covered transactions under HIPAA. Goldstein, who wrote
portions of the final modifications to the Privacy Rule, states that electronic
HIPAA transactions do not include basic paper faxes, also known as
paper-to-paper faxes.
Please note that faxes originating from a computer would be considered covered
HIPAA transactions and necessitate compliance with all HIPAA regulations.
7. STATE ASSOCIATIONS SUPPORT MEMBERSHIP EFFORTS
I'm sure it's happened before, but I certainly haven't heard of it. The
presidents of the Texas Chiropractic Association, Florida Chiropractic
Association and the Illinois Chiropractic Society have each agreed to send a
letter to their members urging them to become members of the ACA. Sure makes
sense...and we hope more state associations will take this position. This
profession needs both strong state associations and a strong national
association.
8. UPDATE ON KEY RACES
There are just under two weeks before the Nov. 5 elections, and political
activity is heating up. Following is an update of the races that both Democrats
and Republicans have targeted in the House and Senate, and that ACA has been
most heavily involved in:
SENATE
* Iowa: Senator Tom Harkin vs. Congressman Greg Ganske. Harkin is clearly our
candidate and polls show him in the lead.
* South Dakota: Senator Tim Johnson vs. Congressman John Thune. Johnson is
supporting our Medicare provision and has the strong support of Senator Tom
Daschle. Need I say more? Three recent polls showed Johnson ahead, while one
Republican survey gave Thune the advantage. Bottom line: too close to call.
* Missouri: Senator Jean Carnahan vs. Jim Talent, former member of Congress.
When Talent was in Congress, he was a member of the Armed Services Committee.
His efforts were extremely important in reviving the chiropractic provision in
the DOD bill and ensuring its passage. We support Talent. Polls show this race
is dead even.
* Minnesota: Senator Paul Wellstone vs. Norm Coleman. The tragic death of
Senator Wellstone has naturally stopped all politics in this race. Over the
weekend there were news reports about what the Democrats might do next . There
was also speculation on what Governor Jesse Ventura would do since he is
authorized to appoint Wellstone's replacement. Nothing is certain. In fact, I
rewrote this paragraph three different times. Let me say the only thing for
certain (fairly certain, anyway) is that former Vice President Walter Mondale
will replace Wellstone on the ballot. We have been supporting Coleman in an
extremely tight race.
* Arkansas: Senator Tim Hutchinson vs. Attorney General Mark Pryor. This is
another tight race where the latest polls show Pryor 2 percent up. Hutchinson
was very helpful to chiropractic when our DoD bill was being considered in the
Senate. He once stated that he wanted to be known as the profession's new "Thurmond"
in the Senate (referring to Sen. Strom Thurmond, one of chiropractic's
staunchest supporters over the years).
HOUSE
* Connecticut: One of the most closely watched congressional campaigns has been
that of Rep. Nancy Johnson vs. Rep. Jim Maloney. Due to redistricting, both
members of Congress were placed into the same district. The polls are showing
Johnson with a 7 percent lead--although 17 percent of the voters remain
undecided (a significant number). We support Congresswoman Johnson. She has
written a letter to Connecticut doctors indicating her intention to support our
chiropractic provision should the Medicare bill get to the conference committee
stage.
* South Dakota: In the only congressional race in South Dakota, Governor William
Janklow is having a tougher race than anticipated against attorney Stephanie
Herseth (D). One poll has him trailing her. Our doctors in South Dakota urged
ACA to support Janklow because of his strong support of the profession as
governor.
All of the races are extremely tight. One political pundit speculated that five
Senate races are so tight that they could be decided by a total of 15,000 votes.
We are definitely in the thick of it!
9. ACA LEADERSHIP ON THE ROAD
ACA President Dr. Daryl Wills joined the delegate and alternate delegate for
Kansas to promote the National Chiropractic Legal Action Fund, which supports
ACA's lawsuits against HHS and Trigon Blue Cross Blue Shield. They were
successful in raising $14,100 and signing up several new members. Also speaking
with the group was ACA Past President Dr. James Mertz.
Dr. Wills spoke earlier to doctors attending the meeting of Allied Health in
Wisconsin. After tallying the results, he was pleased to report that there were
a total of 28 contributors to the lawsuit fund, including some contributions
with a five-year commitment and a few one-time contributions, for a grand total
of $109,335. Allied Health has already contributed $32,925.00.
Dr Wills also reported on a successful presentation before the Chiropractic
Knights, which brought in additional pledges and support.
10. AN UPDATE ON THE PARKER SEMINARS
Last weekend, former ACA Chairman Dr. J. Michael Flynn joined ACA staff in
exhibiting at the Parker Seminar in Miami. Dr. Flynn was given the opportunity
to speak at the Parker team teachers' luncheon and later to seminar attendees.
Joining Dr. Flynn at various times were Drs. John Gentile, Ken Dougherty, and
Steve Perman. We were successful in raising additional funds for the lawsuit and
in signing up some new ACA members.
11. EVP ADVISORY COMMITTEE CALL
On Oct.1, ACA vice presidents, legal counsel and myself held our monthly
conference call with state association leadership. Included on the call were
representatives from North Carolina, Colorado, Ohio, Iowa, Kentucky, South
Dakota, North Dakota, Missouri, Florida, Louisiana and Alabama. The topics
discussed included an update on HIPAA implementation, the revised ABN form, a
review of the recent ACA visit to CIGNA headquarters, Medicare legislation and
the lawsuits. The next call is scheduled for Tuesday, Nov. 5. We will again
include on the agenda a discussion about HIPAA as these requirements continue to
evolve.
12. NEW KIT PREPARES YOUR PRACTICE FOR HIPAA
ACA has developed a HIPAA kit that will help to answer your questions about
HIPAA and what the Privacy Rule requires. Our 90-minute audiocassette of the
live teleconference tells you what the act requires in order to be compliant by
April 14, 2003, and includes an outline of the actual conference and a valuable
supplement page. In addition, ACA has also developed an 11-page introductory
insert about HIPAA that provides background information about the law and
focuses on its transaction standards, privacy standards, consent, authorization,
restrictions and penalties. The insert includes a sample patient privacy notice
form and sample consent and authorization forms. Purchase both of these ACA
HIPAA products and get the facts you need.
The kit includes the 90-minute audiocassette of the live teleconference and the
11-page HIPAA insert. Speaker of the tape: Marc Cohen, Esq.
 | ACA Member Value: $58.95
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| Non-member Price: $104.95 |
To order (Item HIPAA1Kit), call 800/368-3083 or go
to www.shopaca.com.
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