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Memorandum to: ACA Members, Board of Governors, House of
Delegates and Other Interested Parties
From: Gary Cuneo
Re: ACA EVP Weekly Report
Non Member Issue
Date: December 16, 2002
The following topics are covered in this week's report:
1. ACA SENDS STRONG LETTER TO ASHN
2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP
3. COURT HANDS CCA VICTORY IN ASHP SUIT
4. ACA PAC: HOW WE COMPARE TO OTHERS
5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE
6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF
7. PHYSICAN PAYMENT ISSUE STILL A MESS
8. WFC CONGRESS AT DISNEY WORLD
9. LAST EVP REPORT FOR THE YEAR
10. THE 2003 CODES ARE PENDING
11. CAN'T ACCESS THESE LINKS?
1. ACA SENDS STRONG LETTER TO ASHN
ACA President Daryl Wills, DC, sent a letter to Mr. George DeVries, President of American Specialty Health Network (ASHN) expressing concern that, at a recent meeting of the Congress of Chiropractic State Associations (COCSA), an ASHN representative implied that the views of his company were similar to the ACA and that there existed some type of affiliation or endorsement of his company by the ACA.
In his letter, Dr. Wills insisted that ASHN "cease and desist from making any reference to the ACA in your marketing or public relations efforts. To the extent that such a reference should be understood as implying a direct or indirect relationship between ASHN and the ACA, such a representation is both false and misleading. Please confirm to me that your spokespeople have been appropriately instructed of our very deep concern about this matter."
2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP
Last Thursday, ACA's executive committee(Drs Jim Edwards, Daryl Wills and George McClelland) and Pat Jackson, Vice President of Professional Development and Research, met with the benefit payment decision-makers of Wal-Mart at their corporate headquarters to discuss their decision to eliminate chiropractic as a benefit for its employees ($750 benefit with a $350 deductible). The company's representatives made clear at the beginning of the meeting that they would not change the decision to eliminate the benefit for 2003, a decision that was made in April of this year. Our representatives spent the next two hours presenting the latest chiropractic studies and learning of Wal-Mart's concerns. Their bottom line concern is the overall cost of health care. One of the decision makers is a patient.
Wal-Mart pointed out that while the chiropractic benefit for its employees under the PPO plan had been eliminated, chiropractic is still part of their HMO plan and their workers' compensation program. They offered to include an affinity program for the PPO plan, which we rejected outright. At the end of the meeting, they agreed to work with us in their future health benefit decisions. They indicated that they would be looking to again evaluate their health benefits in April of 2003 for implementation in the following year, and that they want to work with us in this process. They also plan to write a press release with us.
We were of course disappointed that we could not change Wal-Mart's decision. What is important, however, is Wal-Mart's interest in working with us in the future. As an ERISA plan they don't have an obligation to talk with us, but have decided to do so anyway. This is significant and hopefully will send a strong signal to other large ERISA plans that chiropractic does have a responsible professional organization representing its doctors that should be talked with before making decisions about employee health plans.
3. COURT HANDS CCA VICTORY IN ASHP SUIT
The California Chiropractic Association (CCA) reported that a California appellate court has ruled in favor of CCA in its lawsuit against American Specialty Health Plan (ASHP), rejecting ASHP's attempts to stay CCA's claims for injunctive relief.
As doctors will recall, in response to the chiropractic profession's complaints and concerns, CCA filed in June 2001 a lawsuit against ASHP. The landmark complaint alleges that ASHP engaged in fraudulent, unlawful and unfair business practices that have injured doctors of chiropractic and the general public.
Significantly, the court's ruling that CCA's request for injunctive relief could proceed means that ASHP must now respond to CCA's discovery requests relating to these claims. (In this instance, "injunctive relief" refers to CCA's demand that ASHP cease its alleged illegal and unfair business
practices. "Discovery" is the process by which parties to a claim obtain internal documents, records, depositions, etc., to arm the plaintiff and defendant with as much knowledge as possible to defend their positions at the time of trial). At the time of this writing, ASHP is in the process of responding to CCA's discovery requests.
As was reported to members at the outset, CCA's litigation on behalf of the chiropractic profession and its patients is likely to be a long, laborious and expensive undertaking. With the continued health of chiropractic and chiropractic patients at risk, CCA is unalterably committed to seeing this action through to its conclusion.
4. ACA PAC: HOW WE COMPARE TO OTHERS
The American Chiropractic Association-Political Action Committee (ACA-PAC) is a separately segregated fund of the ACA which is permitted under federal law to make political contributions to federal candidates. Federal law restricts the ACA to solicit only ACA members for contributions to ACA-PAC. The following is a report of various health profession PAC's receipts and disbursements taken from Federal Election Commission findings:
 | ACA PAC (2001-02)
Receipts: $294,690
Disbursements: $278,958
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| Osteopathic PAC
Receipts: $456,264
Disbursements: $474,479
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| Physical Therapy PAC
Receipts: $678,708
Disbursement: $681,756
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| AMA PAC
Receipts: $3,985,582
Disbursement: $4,493,581 |
5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE
New guidance on the HIPAA regulations was issued by the Office on Civil Rights on December 3, 2002. Among other things, the new guidance indicates that disclosure of DNA information is specifically prohibited under the regulations. The guidance also deals with the fairly complex marketing requirements which, in general, provide that a covered entity cannot disclose patient information for marketing purposes without prior patient authorization. The "Notice of Privacy Practices" has largely the same function as the consent requirement that was eliminated in the Final Rule. The Notice must contain a statement of all uses and disclosures of patient information. Doctors must have all patients read and preferably sign and acknowledge receipt of the Notice before treatment begins, according to the most recent guidance. The new guidance may be found at:
www.hhs.gov/ocr/hipaa/privacy.html.
6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF
In the July-Nov.02 issue of Palmer College's Alumni News, Dr. Guy Riekeman included an open letter to the alumni doctors calling for strong support for the lawsuits against Trigon and against HHS. Within the letter, Dr. Riekeman stated, "We are now in a position to make an immensely positive economic impact on chiropractic that will benefit the entire profession for decades to come..." He continued, "Doctor, we are not safe until we can establish this fundamental truth in federal court: doctors of chiropractic are the only health care providers qualified to diagnose and correct a subluxation..."
Palmer students have been longtime contributors to the National Chiropractic Legal Action Fund (NCLAF). During the last two weeks, we have received two checks for $100 each from this Student ACA (SACA) chapter, bringing its total to $1,177.35.
7. PHYSICAN PAYMENT ISSUE STILL A MESS
As of December 6, the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) had still not published a schedule for the 4.4% scheduled cut in Medicare, even though the agency had indicated it would be made public by December 2. Because the cut does not take effect until 60 days after the schedule is published, this delay buys some extra time for doctors while they wait for Congress to return on January 7. This year, physicians took a 5.4% cut in Medicare reimbursements. If the new schedule is published this month, physicians will face another cut in February. The issue concerns the formula used on calculating physician payments under Medicare. Tied to the GNP, the payments over the last couple of years have been lower.
Health care groups are looking at an anticipated Omnibus spending bill as a vehicle to attach language to prevent the anticipated cuts. Some Representatives are considering using the Congressional Review Act (PL 104-121) to kill the payment schedule. This law requires that agencies inform Congress of rules that are published, and then Congress has 60 days to pass a joint resolution of disapproval. However, this resolution must be signed by the president.
As earlier reported, the ACA is working with the AMA and other health care groups on this issue. We will keep you apprised of any further developments.
8. WFC CONGRESS AT DISNEY WORLD
Don't miss the World Federation of Chiropractic's (WFC) Congress to be held May 1 -3, 2003 at the Hilton at the Walt Disney World Resort, Orlando, Florida. The two main themes are the cervical spine and sports chiropractic, and the more than 60 lecturers and technique instructors are a "Who's Who" in chiropractic. It all begins with a Disney Show. You only have 22 days left to benefit from the early bird rate of $450, which comes to an end on December 31, 2002. The regular rate of US $550 applies as of January 1, 2003. For the full program, registrations, exhibit/sponsorship opportunities and all other information, visit
www.chiroweb.com/wfcorlando2003. This major event is co-sponsored by the ACA, ICA, CCA, FCER and FICS.
9. LAST EVP REPORT FOR THE YEAR
The ACA office will be closed between Christmas and New Years Day. The EVP report will also take a holiday. Look for the next issue on January 8, 2003. For Christmas, consider a subscription to the EVP Report as a stocking stuffer...only kidding (I
know, it makes a good bird cage lining). But do consider membership in the ACA and/or contribution to the National Chiropractic Legal Action Fund if you aren't already a member, and contributions to the PAC and the Legal Action Fund if you are a member. Merry Christmas and Happy New Year!
10. THE 2003 CODES ARE PENDING
ACA's 2003 Chiropractic Coding Solutions Manual is almost complete, but will not be released in December as originally planned due to delays in the release of important content.
The Federal Register has yet to release the valuable RVUs, fee schedules and the fee formula for the upcoming 2003 year. We want you to receive the highest quality coding resource and once the figures are released, we will continue production and send you the newly-designed, ACA's 2003 Chiropractic Coding Solutions Manual.
For information about what is new and updated in the 2003 edition, or to order your manual, just click here: <http://www.acatoday.com/about/products/pm_products.shtml> or call 800-368-3083.
10. 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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