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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: November 4, 2002
The following items are included in this week's report:
1. COMMENT ON ELECTIONS
2. UPDATE ON THE TRIGON LAWSUIT
3. ACA TACKLES THE TOUGH NEW JERSEY INSURANCE MARKET
4. NATIONAL BOARD COMES THROUGH AGAIN
5. CANADIAN INQUEST UPDATE
6. ACA CHAIRMAN ATTENDS AND PARTICIPATES IN SAO PAULO CONFERENCE
7. NATIONAL MEDIA CONTINUES TO RELY ON ACA
8. ACA LEGAL COUNSEL HELPS VERMONT ON MEDICAID ISSUE
9. ACA PRESIDENT ON THE ROAD
10. ACA'S CPT 2003 - THE MOST AUTHORITATIVE BOOK ON THE SUBJECT IN THE
PROFESSION - IS COMING
11. CAN'T ACCESS THE LINKS?
1. COMMENT ON ELECTIONS: WE ARE IN THE THICK OF IT
I was listening the other day to Charles Cook, a prominent political pollster
and consultant. He was analyzing the various races for governor, the House of
Representatives and the Senate. He concluded that, while the democrats will
probably get the majority of governorships, it would be extremely difficult but
not impossible for the democrats to gain control of the House of
Representatives. Cook pointed out that the democrats would have to capture at
least eight out of about 10 races that are currently considered too close to
call. Another pollster indicated that there are 14 such seats that are too close
to call, and that the democrats would have to carry all of them to succeed.
Again, not impossible - but difficult. The Senate side is another story. The
pollster could argue a couple of scenarios in which republicans would gain
control, and a couple of scenarios in which the democrats would gain control. He
indicated that in the last two weeks, the number of really competitive races in
the Senate grew from five to ten - an incredible number. In his 15-plus years in
this business, he hasn't seen things so tight and so unpredictable.
If we as a profession were going to send a message, this would be the right
election in which to do it. We are heavily involved in some of the closest races
including in two instances conducting an independent expenditure campaign
including radio ad spots. We are working very aggressively on this. Some of you
may question our decisions for partisan-based reasons. I would respond to those
concerns by saying that this profession does not have the luxury of allowing its
personal political views to dominate its decisions. We need to support those
candidates who support chiropractic, regardless of their party affiliation.
Heck, if this former San Francisco Goldwater campaign worker can sign a PAC
contribution check to a democrat without my hand shaking, then each of us can do
the same. And we aren't alone. You can be sure that the medical community is
taking the same approach. In fact, they have spent $120,000 this past week alone
on behalf of Congressman Greg Ganske of Iowa.
Tuesday evening will undoubtedly be an interesting election night. However,
because the election is tight in so many races, the eventual outcome of the
races and who controls the House and Senate probably won't be decided until the
next day, if then.
2. UPDATE ON THE TRIGON LAWSUIT
There is nothing new to report on the lawsuit against Trigon. The judge has yet
to rule on the motion for summary judgment. We'll keep you posted on any
developments.
3. ACA TACKLES THE TOUGH NEW JERSEY INSURANCE MARKET
Dr. Frank Stiso, ACA's delegate to New Jersey, working in concert with the state
chiropractic associations, the Forum and the ACA, has done what no one else has
been able to do before in New Jersey. While there has been a lot of discussion
about Aetna's $200 cap in New Jersey and the efforts by various associations and
individual doctors, Dr. Stiso captured the attention of Aetna officials and
pushed through a major victory. As of January 2003, Aetna will return to a
fee-for-service program for doctors of chiropractic. While direct access remains
an obstacle, ACA officials and Dr. Stiso will continue to push for change in
this area well.
4. NATIONAL BOARD COMES THROUGH AGAIN
We received an email message on Friday from Dr. Peter Ferguson, President of The
National Board of Chiropractic Examiners (NBCE), indicating that his board of
directors had just agreed to contribute an additional $75,000 to the National
Chiropractic Legal Action Fund (NCLAF). Dr. Ferguson indicated that, "The
entire Board believes that the Trigon suit will benefit the entire profession by
providing opportunities for current and future practitioners and the delivery of
chiropractic to the patient public." This brings the National Board of
Chiropractic Examiners' total NCLAF contributions to $200,000. We certainly
appreciate the efforts of the NBCE. No other issue since the Wilk suit has
galvanized this profession as our lawsuits have. We need the profession's
continued support.
5. CANADIAN INQUEST UPDATE
Two more expert witnesses have testified during the Canadian inquest that
chiropractic cervical manipulation could not possibly have caused the fatal
stroke of 45-year-old Lana Dale Lewis in 1996.
On October 21, Dr. Paul Carey, president of the Canadian Chiropractic Protective
Association, testified that the woman's left neck artery could not have been
damaged by treatment performed on the opposite side of her neck. Dr. Philip
Emanuele, Lewis' doctor of chiropractic, treated only her right upper neck,
according to his testimony and treatment records.
When asked by the lawyer for the Canadian Chiropractic Association if this would
be "the first case in the world where a right-sided neck adjustment
produced a left vertebral artery injury," Dr. Carey replied, "Yes it
would."
And on October 30, Dr. Dominic Rosso, a neuroradiologist, told the coroner's
jury that hardening of the arteries - and not chiropractic neck manipulation -
caused Lewis' death. "This lady had, unfortunately, severe and quite
unusual hardening of the arteries in the back of the brain," Dr. Rosso
testified, according to an article in The Toronto Star. According to Dr. Rosso,
negatives of an angiogram showed that Lewis' right vertebral artery was 70
percent narrowed inside the skull, and her left vertebral artery was totally
blocked. There was also no evidence that the left vertebral artery had been
split - which would have been the case if a neck adjustment had caused an
injury.
For weekly updates on the inquest, visit the Canadian Chiropractic Association's
Web site at www.ccachiro.org. Click on
"Media," then "Lewis Inquest Weekly Summaries." You can also
follow media coverage of the inquest on the Toronto Star's Web site at www.thestar.com.
6. ACA CHAIRMAN ATTENDS AND PARTICIPATES IN SAO PAULO CONFERENCE
Dr Jim Edwards, ACA Chairman of the Board, traveled to Sao Pablo, Brazil to
participate in an educational symposium on chiropractic education sponsored by
the Association of Chiropractic Colleges, the National Board of Chiropractic
Examiners and the World Federation of Chiropractic from October 26-29. Dr
Edwards made a presentation relative to the educational training of the modern
chiropractor and then participated in a panel discussion on that subject. He
also toured the new chiropractic college in Sao Paulo. Approximately 75 national
leaders from around the world attended the event, including numerous college
presidents from the United States.
7. NATIONAL MEDIA CONTINUES TO RELY ON ACA
ACA continues to be called upon by the media nationwide to represent the
chiropractic profession on a variety of topics. Just a few of the media outlets
that have interviewed ACA staff and spokespersons over the past month are listed
below.
The Wall Street Journal interviewed Dr. Scott Bautch, past president of ACA's
Council on Occupational Health, on repetitive motion injuries caused by new
technologies such as text pagers. The American Medical News interviewed ACA
spokesperson Dr. Jerome McAndrews on the subject of the VA Committee
appointments. ePregnancy magazine interviewed Dr. McAndrews on the subject of
pregnancy and back problems. The National Underwriter interviewed Pat Jackson,
ACA's Vice President of PDR, on ACA's anti-fraud efforts. New York Magazine
interviewed Dr. McAndrews on the chiropractic profession's struggles with the
AMA and traditional medicine. And both Allure magazine and First for Women
magazine interviewed Dr. McAndrews regarding the problems women's fashions can
cause for the musculoskeletal system.
8. ACA LEGAL COUNSEL HELPS VERMONT ON MEDICAID ISSUE
Tom Daly, ACA Legal Counsel, reported the following to me:
"I received a call from Anthony Otis, the Vermont Chiropractic
Association's attorney and lobbyist. He explained that they were having problems
with payment for chiropractic services under Medicaid in Vermont. In discussing
the issue, he indicated that while the osteopaths may use the OMT Codes for
spinal manipulation, the code used by chiropractors was not the CMT code series
but rather a bundled code. I pointed out that the statutory and regulatory
definitions for chiropractic manipulation under Medicaid were almost exactly the
same as those under Medicare, and that the CMT Codes are used under Medicare's
RBRVS to describe this manipulation service. I therefore pointed out the unequal
treatment being applied to chiropractic service under the Vermont Medicaid
policy by its selective refusal to recognize and pay for CMT Codes as an
unbundled service with its higher relative value, while at the same time paying
osteopaths and other provider consistent with CPT and RBRVS. He said that this
was very helpful and would include this point in his testimony. He also said
that they were considering litigating the issue." This type of Trigon-like
special treatment for services provided by chiropractors is a recurring problem
- and another reason our litigation is so important.
9. ACA PRESIDENT ON THE ROAD
ACA President Dr. Daryl Wills continues to maintain a tough travel schedule
promoting the ACA and our legal action fund. Last week, Dr. Wills visited the
New York Chiropractic College (NYCC), then traveled to Georgia where he spoke to
the Georgia Chiropractic Association (GCA).
Dr. Wills spent a day at NYCC, first being given a tour of the campus by NYCC
President Dr. Frank Nicchi, and then addressing 75 students, to whom he offered
his comments about our legal action and about our recent successes regarding
student loans. The NYCC SACA chapter made a contribution to the National
Chiropractic Legal Action Fund.
Dr. Wills then traveled to Georgia, where he spoke to 600 doctors in attendance
at the GCA convention. He was given six opportunities to speak, and was shown
tremendous support from Dr. John Dull, ACA's delegate to Georgia, and Dr. Robert
Hayden, ACA's alternate delegate to Georgia. During Dr. Wills' presentation on
ACA's legal action, he succeeded in getting 26 doctors to pledge $100 per month
- the majority of whom pledged this amount for a period of five years. This
projects to a 5-year total of $148,500. Dr. Wills then traveled to Life
University, where he was given a tour of the campus by interim president Dr.
Michael Schmidt.
10. ACA'S CPT 2003 - THE MOST AUTHORITATIVE BOOK ON THE SUBJECT IN THE
PROFESSION - IS COMING
I am pleased to announce that ACA's 2003 Chiropractic Coding Solutions
Manual--our authoritative resource on CPT codes and their applications that
allow doctors of chiropractic to efficiently and accurately process insurance
claims--will be available in December. ACA's 2003 Chiropractic Coding Solutions
Manual's high level of detail further enhances the understanding of current and
new codes, assuring correct usage by individual offices as they seek fair
reimbursement. The 2003 edition is the only chiropractic-specific resource
developed by doctors of chiropractic for doctors of chiropractic, including the
chiropractic representatives who serve on the AMA CPT Committees. Our 2003 CPT
manual includes an expanded section on consultation codes, a new section on
laboratory services, an expanded, easy-to-use ICD-9 coding section, nutritional
counseling codes, updated insert on HIPAA, updated Medicare section and an
updated federal workers' compensation section. And, to further enhance
ease-of-use, a FREE searchable CD-ROM accompanies each order for the 2003
publication.
ACA Member Price: $49.95, plus S&H fees; Non-member Price: $79.95 plus
S&H fees. Order Item CPT03.
To reserve your copies, call 800-368-3083.
11. 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 e-mail me at gcuneo@amerchiro.org.
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