Memorandum
To: ACA Members, House of Delegates, Board of
Governors and Other Interested Parties
From: Garrett Cuneo
Re: ACA EVP Weekly Report
Date: June 23, 2003
The following items are covered in this week's report:
1. AFTER SENATE FINANCE COMMITTEE WIN AND HOUSE INACTION, ACA TO USE GRASSROOTS TO IMPACT HOUSE-SENATE CONFERENCE IN MEDICARE BILL
2. RECENT PLEADINGS IN TRIGON CASE GIVE GLIMPSE OF EVIDENCE FOR TRIAL
3. DR. BILL HARRIS MAKES SIGNIFICANT CONTRIBUTION TO NATIONAL CHIROPRACTIC LEGAL ACTION FUND
4. OTHER ORGANIZATIONAL CONTRIBUTORS
5. MEMBERSHIP DRIVES IN PA, NJ, CT & OH RECEIVE LOCAL SUPPORT
6. EVEN MORE MEMBERSHIP ACTIVITY
7. HOUSE PASSES AHP BILL
8. DC ON A PHYSICAL THERAPY BOARD
9. THE ACA PRACTICE ADVISORY
10. CAN'T ACCESS THESE LINKS?
1. AFTER SENATE FINANCE COMMITTEE WIN AND HOUSE INACTION, ACA TO USE GRASSROOTS TO IMPACT HOUSE-SENATE CONFERENCE ON MEDICARE BILL
Since the 108th Congress convened in January, ACA lobbyists have been working to incorporate the ACA's "full scope" Medicare demo provision into the broader Medicare modernization legislation that's been a top priority Congress and the President this year. On June 12th, we won an important victory when -- with strong leadership from its Chairman, Senator Charles Grassley (R-IA), the Senate Finance Committee included our demo provision in S. 1, the Senate Medicare bill. In addition to Senator Grassley, the chiropractic demo was strongly supported by senators Orrin Hatch (R-UT), Max Baucus (D-MT), Tom Daschle (D-SD), Kent Conrad (D-ND), Ben Nelson (D-NE) and Norm Coleman (R-MN). In spite of concerted efforts by Senate Majority Leader Bill Frist, M.D. (R-TN), the White House, CMS and certain special interest groups to strip it from the bill, ACA believes that our chiropractic demo will remain intact when the full Senate likely approves S. 1 later this week.
Unfortunately, our lobbying team's efforts -- including a heroic last minute fly-in by Dr. Keith Overland (Thank You!) -- did not result in the inclusion of a companion chiropractic provision in the House bill that was approved by the Ways and Means and Energy and Commerce committees last week. ACA is now preparing for a House-Senate Conference intended to resolve the differences between the two Medicare bills and produce a final version for "up-or-down" votes in both chambers. With Senator Grassley continuing to do all that he can, and well-placed friends in the House including Reps. Jim Ramstad (R-MN) and Earl Pomeroy (D-ND), a key to success in conference will be an all out grassroots campaign -- including DCs, CAs, ACA Auxiliary and Medicare patients -- targeting House conferees and urging them to agree to the Senate's chiropractic demo language. Stay tuned, and get ready to write, call, fax or e-mail your Member of Congress.
2. RECENT PLEADINGS IN TRIGON CASE GIVE GLIMPSE OF EVIDENCE FOR TRIAL
Our attorneys recently filed an extensive set of pleadings regarding our lawsuit against Trigon Blue Cross Blue Shield with the U.S. Court of Appeals. The pleadings contain a list of legal issues and questions that we will ask the Court to review. Item #29 and item #30 also provide a brief glimpse into the evidence of Trigon's and the state medical groups' efforts to limit access, referrals and payment to chiropractors. Item #29 references a meeting of the "Managed Care Advisory Panel," composed of representatives of the various state medical associations. We believe the excerpted portion of the evidence and other evidence demonstrate that Trigon and the Panel acted to downplay and rewrite the AHCPR guidelines, fearing they would be used as "referral guidelines" to chiropractors for manipulation services. Item #30 references the interplay and negotiations between Trigon and the Medical Society of Virginia on Trigon's fee schedule and its announcement that the RBRVS fee schedule changes "can be much more favorable for network physicians." Trigon's RBRVS fee schedule was and is skewed against chiropractors including its provision to pay chiropractors 40% less for the same services than what is paid to physicians. We also believe this type of thing is just the tip of the iceberg and has happened and is still happening with many different insurance and managed care companies across the country. That is why we are still in this fight. The full listing of the legal issues and questions can be viewed at the ACA website on the main page under "Fighting for Chiropractic:"
http://www.acatoday.com/pdf/DocketingStatementSectionG.pdf
3. DR. BILL HARRIS MAKES SIGNIFICANT CONTRIBUTION TO NATIONAL CHIROPRACTIC LEGAL ACTION FUND
Prominent chiropractic philanthropist Dr. Bill Harris, of Georgia, made a contribution of $10,000 to the National Chiropractic Legal Action Fund through his Foundation for the Advancement of Chiropractic Education. Dr. Harris has through the years made numerous and substantial contributions through his foundation to chiropractic colleges and other worthwhile causes. It is my understanding that Dr. Harris was moved to support the National Chiropractic Legal Action Fund after viewing the "Simple Justice" video shown at the Parker Seminar in January, and after seeing the level of support for the lawsuits at that event.
The Simple Justice Video can be viewed on ACA's Web site at: http://www.acatoday.com/hot_topics/simplejustice.shtml
4. OTHER ORGANIZATIONAL CONTRIBUTORS
Over the last three weeks, a number of chiropractic organizations have submitted contributions to the National Chiropractic Legal Action Fund:
· Delaware Chiropractic Society: $1,000 (bringing its total to $2,000)
· ACA Council on Nutrition: $2,500 (bringing its total to $12,500)
· Ward Success Systems: $100 (bringing its total to $800)
· The Masters Circle: $500 (bringing its total to $8,000)
· Performance Health/Biofreeze: $100 (bringing its total to $800)
· Missouri Chiropractic Association: $100 (bringing its total to $1,400)
· Missouri Chiropractic Association, District 1: $100 (bringing its total to $6,200)
· Breakthrough Coaching: $9,850 (bringing its total to $29,850)
· Baldwin County Chiropractic Society (AL): $800 (bringing its total to $2,700)
· Iowa Chiropractic Society, SE District: $300 (first contribution)
5. MEMBERSHIP DRIVES IN PA, NJ, CT & OH RECEIVE LOCAL SUPPORT
The leadership of the state associations from Pennsylvania and Connecticut are joining the ACA delegates from those states in encouraging state association members to join the ACA. These doctors are being sent letters on state association letterhead that include a list of ACA activities that specifically benefit the doctors in that particular state. The Ohio State Chiropractic Association is considering a request by ACA delegate Dr. Rick McMichael to distribute a similar letter.
These letters are complimented by a recruitment team organized within each state. In Connecticut, ACA delegate Keith Overland, DC, is joined by David Dziura, DC, Michael Kane, DC, Stephen Perle, DC, and Paul Grimmeisen, DC. In Pennsylvania, ACA delegate Mario Spoto, DC, is joined by Mary Rutkowski, DC, Dennis Rehrig, DC, and Dennis Ridenour, DC. In New Jersey, ACA delegate Frank Stiso, DC, runs an effective effort. And in Ohio, ACA delegate Rick McMichael, DC, is joined by Robert Sheely, DC, Judson Sprandel, DC, and Robert Poteete, DC.
If you practice in one of these states, please provide assistance in this effort. Not only is each state attempting to increase membership, which helps the entire association, but each state is also attempting to increase the clout its delegate has at the House of Delegates meetings, where ACA policy and direction are formulated.
6. EVEN MORE MEMBERSHIP ACTIVITY
Thanks to Robert Dubro, DC, of Northern California who spoke to the graduating class at Palmer West, and signed up 11 of the 19 graduating doctors for ACA membership. Thanks also to Dr. Fabrizio Mancini, President of Parker College of Chiropractic, who submitted Student ACA (SACA) membership applications for 50 of his freshman students.
7.THE HOUSE PASSES AHP BILL
On June 19th, the House of Representative in a 262-162 vote approved (H.R.660) that would allow association health plans offering health coverage to small businesses to operate without state health insurance regulations. Nor surprisingly, only 35 Democrats voted in fabor of the bill, while only one Republican voted against it. The House had passed a similar version a couple of years ago, only to have it flounder on the Senate side.
The battle switches to the Senate side where the proponents will have a more difficult time getting the necessary votes and where our coalition plans to make a concerted effort to stop it.
8. DC ON A PHYSICAL THERAPY BOARD
In what must be the worst nightmare for the physical therapy association in Mississippi, and pretty tough for the national organization to swallow as well, Governor Ronnie Musgrove (D-MS) recently appointed ACA member Michael Patterson, DC, to the Mississippi State Physical Therapy Board for a four-year term. Dr. Patterson, who was elected by the board to the position of treasurer, serves as a consumer representative.
Governor Musgrove has been a strong supporter of the chiropractic profession, and is a good friend of ACA's Mississippi delegate, Dr. Al Norville.
9.. THE ACA PRACTICE ADVISORY
The popular ACA Addendum has a new design and a new name: ACA Practice Advisory: Regulatory and Insurance Reimbursement Policies and Current Practical Applications. Four times a year, the advisory will guide you through proper applications of often-confusing treatment and diagnostic codes. The advisory will contain fact-filled articles on the latest coding issues, and will feature a special Q&A section based on reader feedback. This is a must-have resource for every office and is the perfect compliment to your CPT 2003 coding manual. Those who have already subscribed should have received the spring edition of the ACA Practice Advisory. The summer edition will include such topics as the HIPAA October extension deadline, how a code becomes a code, Q and A's, the physical therapy benefit and more!
Don't delay. Subscribe today!
SPECIAL SAVINGS! For additional savings when you renew your subscription to the ACA Practice Advisory: Regulatory and Insurance Reimbursement Policies and
Current Practical Applications, order in conjunction with ACA's 2003 Chiropractic Coding Solutions Manual.
ACA Member Price: $67.00
Non-Member Price: $103.95
Order Item CPT03Sub
To order, call 800-368-3083 or go to www.shopaca.com
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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