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Memorandum
To: ACA Members, House of Delegates, Board of Governors and Other
Interested Parties
From: Gary Cuneo
Re: ACA EVP Weekly Report
Date: January 13, 2003
ACA Mission -- A Purpose for Being: The ACA is a professional organization representing doctors of chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of doctors of chiropractic for the benefit of the patients they serve....
This week's report includes the following items:
1. ACA MEETS WITH FEDERAL TRADE COMMISSION ON REIMBURSEMENT ISSUES
2. ACA AND WAL-MART DO JOINT PRESS RELEASE
3. DOCTORS IN THE FIELD OFFER REASONS TO SUPPORT THE LAWSUITS
4. FLORIDA CHIROPRACTIC SOCIETY CONTRIBUTES TO LAWSUIT
5. MARK THE DATE - NATIONAL CHIROPRACTIC LEGISLATIVE CONFERENCE 2003!
6. NPI AND EIN: NUMBERS REQUIRED UNDER HIPAA
7. NOTICE TO ACA MEMBERSHIP REGARDING UPCOMING HOD MEETING
8. STRONG CHIROPRACTIC PRESENCE AT APHA CONVENTION
9. SENATOR JOHNSON EXPRESSES APPRECIATION
10. ACA EVP ADVISORY COMMITTEE
11. THE VALUABLE RVUs ARE HERE; CPT 2003 PRODUCTION CONTINUES
12. CAN'T ACCESS THESE LINKS?
1. ACA MEETS WITH FEDERAL TRADE COMMISSION ON REIMBURSEMENT ISSUES
Dr. Donald Krippendorf, ACA Vice President; Tom Daly, ACA Legal Counsel; Pat Jackson, ACA Vice President for Professional Development and Research; David Page, Insurance Manager; and Angela Richardson, Legal Assistant, met with three representatives from the U.S. Federal Trade Commission (FTC) in Washington, DC on January 8, 2003. The purpose of the meeting was to explore the ACA's options in surveying doctors of chiropractic on payor/network contract reimbursement rates. While the topic of collecting or discussing any information on reimbursement rates is typically considered taboo, the ACA would conduct such a survey under FTC allowed Antitrust Safety Zone provisions. ACA leadership conducts the investigation pursuant to the ACA House of Delegates-approved Managed Care Practices resolution passed in March 2002. Following this meeting, the ACA will develop a proposal for FTC to review and issue advisory opinion on later this year. A copy of the ACA policy on investigation of chiropractic managed care companies can be found on page 22 of this document: <http://www.acatoday.com/pdf/2002_aca_policies.pdf>
2. ACA AND WAL-MART DO JOINT PRESS RELEASE
As reported previously, the ACA and Wal-Mart met at the headquarters of Wal-Mart in December to discuss the self-insured company's decision to eliminate chiropractic from the health plan offered to their employees. While we were not successful in changing their minds regarding a policy decision made months earlier, they did agree to establish a dialogue with us and to consider our input as they review their policy decision in 2003. They contacted us last week and offered some dates for the next stage of the discussions. They have also worked with us in preparing a joint press release. A copy of this release is available at:
<http://www.acatoday.com/hot_topics/010703.shtml>
3. DOCTORS IN THE FIELD OFFER REASONS TO SUPPORT THE LAWSUITS
No issue since the landmark Wilk lawsuit of the 1970s and 80s has brought this profession together as the lawsuits against the federal government and against Trigon Blue Cross/Shield have. However, there are still some doctors who question the significance of the suits. You occasionally hear comments like, "Why should I care about a lawsuit against the federal government -- I don't take Medicare patients," or, "The suit against Trigon Blue Cross/Blue Shield concerns a health plan in Virginia. I practice somewhere else -- why should I care?" Recently, we interviewed four doctors from various parts of the country to gain their perspectives on the legal action. Any of you who have doubts should read their comments. The interviewees included: Dr. Peter Spencer, a practicing doctor of chiropractic in Sacramento, California, who is also the president of the California Chiropractic Association; Dr. Bill Holmberg of Palmer College, one of the original members of the Wilk Anti-Trust Committee and President of the Chiropractic Centennial; Dr. Dick Thompson, a practicing doctor of chiropractic in Ironton, Ohio; and Dr. Jerry Willis, a practicing doctor in Virginia and one of the plaintiffs in the suit against Trigon.
Please read the article and share it with others: <http://www.acatoday.com/legal/trigon/holmberg.shtml>.
4. FLORIDA CHIROPRACTIC SOCIETY CONTRIBUTES TO LAWSUIT
The Florida Chiropractic Society, an affiliate of the ICA, contributed $1,200 to the National Chiropractic Legal Action Fund (NCLAF). This association was one of the first to come out publicly in support of these lawsuits. Yet another example of how this legal action has brought this profession together.
5. MARK THE DATE - NATIONAL CHIROPRACTIC LEGISLATIVE CONFERENCE 2003!
The American Chiropractic Association would like to invite you to attend the 2003 National Chiropractic Legislative Conference (NCLC) scheduled for March 5-7, 2003 in Washington, DC. NCLC will be held at the Hyatt Regency Washington conveniently located on Capitol Hill. To make your room reservation, please call the Hyatt Regency Washington at 202-737-1234. When making your room reservation, please mention that you are with the American Chiropractic Association to get the special group room rate of $219.00 per evening for a single or $244.00 for a double room. The Hyatt Regency is located at 400 New Jersey Ave., NW, Washington, DC 20001. Please note the room reservation cutoff date is February 7, 2003. After that date, the hotel will not guarantee room availability or the special group rate.
6. NPI AND EIN: NUMBERS REQUIRED UNDER HIPAA
In order to promote standardization in the medical community, two unique identification numbers to be utilized by the health care industry have been developed under the Health Insurance Portability and Accountability Act of 1996. They are the NPI and the EIN. The NPI is the National Provider Identifier. It is a unique identification number for health care providers and plans. The provider number would be assigned to those health care providers that need to submit claims and conduct various HIPAA transactions. Next, there is the Employer Identification Number. This 9-digit number serves as the identifier for employers, which is assigned by the Internal Revenue Service (IRS). This is required of ANY business that pays wages to one or more employees. According to the Federal Register -- effective July 30, 2002 -- covered health care providers, health plans, and health care clearinghouses are bound to used the standard, where required in electronic transactions.
Keep in mind the two different functions of the two identifiers. When making claims for health care services furnished, the NPI is used. The EIN is used when a covered entity is identifying itself when conducting transactions in an employer role. For more information regarding HIPAA, the following Web sites are helpful:
www.hipaadocs.com; www.aspe.hhs.gov/admnsimp/faqemp.htm;
and www.aspe.hhs.gov/admnsimp/faqnpi.htm.
Other Sources: Federal Register Volume 67 -- May 31, 2002 -- Rules and Regulations
7. NOTICE TO ACA MEMBERSHIP REGARDING UPCOMING HOD MEETING
There will be a midyear House of Delegates meeting, March 7-8, 2003 at the Hyatt Regency Washington on Capitol Hill, Washington, DC.
ACA Bylaws provisions (Article V, Section A-5) state that the midyear meeting is held in conjunction with the National Chiropractic Legislative Conference (NCLC) to allow the delegates and members two days to:
a. To conduct business except bylaws and amendments
b. To hear midyear reports of progress
c. To receive recommendations on, and initiate policies and procedures for,
the functioning of the ACA
Proposed resolutions must be sent to the ACA Corporate Secretary at least forty-five (45) days prior to the meeting (Article VIII, Section J-3, except as provided in Section J-4&5). Deadline for receipt of proposed resolutions is January 22, 2003.
As an ACA member, you have a right to submit, through your delegate, policy issues for consideration. Your views are important and would be considered by the sixty members of the ACA House of Delegates. No issue is frivolous. This is your association and your profession.
8. STRONG CHIROPRACTIC PRESENCE AT APHA CONVENTION
The American Public Health Association (APHA) is the oldest, largest and most influential public health association in the world, with over 50,000 national and affiliated members, representing over 70 occupations in public health. On November 9-11 in Philadelphia, the APHA held its annual meeting, and over 12,000 health professionals were in attendance. Additionally, all the major health care organizations, public and private, were present, including CDC, HHS, WHO, HRSA, PAHO, plus three former U.S. Surgeon Generals.
For the 18th consecutive year, the chiropractic profession was well-represented at the meeting, appearing among the 900 scientific and technical paper presentations which covered over 30 specialty areas. This year there were four program sessions dedicated to chiropractic topics, including some 19 paper presentations prepared by 50 co-authors. Several of the co-authors were associated with more than one paper. Two other chiropractic papers were presented at sessions co-sponsored by other disciplines.
ACA representatives Karen Konarski-Hart, DC, John Palmer, DC, and Rand Baird, DC, attended the meeting.
9. SENATOR JOHNSON EXPRESSES APPRECIATION
One of the ACA's major goals in its involvement in the November elections was to make a strong impression. Giving $500 to a candidate is nice, but when you consider the hundreds of thousands given to campaigns, such a small amount might not even be noticed by the candidate. Last year we decided to get noticed in a few targeted Senate races by not only rallying the profession behind our candidate, but also making significant contributions at a time when they were most appreciated -- the last two weeks of the campaign. We did this in six close senate races. One race in which our participation was most significant was Senator Tim Johnson's highly contested campaign against Congressman John Thune. The ACA contributed the maximum amount directly to the Johnson campaign, and also made an independent expenditure, purchasing 2,000 30-second spots on various radio stations in South Dakota. We purchased the ads in late August, anticipating that the race would be close and radio spots difficult to obtain. Did our efforts pay off? Johnson won re-election by less than 600 votes - what do you think? And did our efforts get noticed? In December we received a thank you note from Senator Johnson that read, in part, "The financial support of the American Chiropractic Association during the campaign as well as the support of individual members in South Dakota during the critical latter days of our effort were greatly appreciated and helped us get across the finish line with a victory...I am looking forward to working with you on issues of mutual interest during the coming Congress."
10. ACA EVP ADVISORY COMMITTEE
ACA vice presidents, legal counsel and I held our monthly conference call with state association representatives on Thursday, December 12th. Participating on the call were representatives from South Dakota, Alabama, North Carolina, Iowa, Rhode Island, Colorado and Kentucky. We covered a number of issues, including an update on HIPAA regulations, the key contact program and the Wal-Mart meeting. Dr. Wills briefed the group on the meeting that had just concluded in Rogers, AR, with representatives of Wal-Mart. The next meeting is scheduled for Thursday, January 23rd at 12:00 noon ET
11. THE VALUABLE RVUs ARE HERE; CPT 2003 PRODUCTION CONTINUES
In my report just before the holidays, I reported that the valuable RVUs, fee schedules and the fee formula for 2003 had not been released. Luckily, these anticipated figures were released on December 24, 2002. We have added this section to our newly designed ACA's 2003 Chiropractic Coding Solutions Manual, and are completing the last stages of production.
We plan to have the 2003 coding manuals printed by the end of January.
To order this resource developed by doctors of chiropractic for doctors of chiropractic, just visit:
<http://www.acatoday.com/about/products/pm_products.shtml>, or for more information, call 800-368-3083.
12. 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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