Memorandum
To: ACA Members, House of Delegates, Board of
Governors and Other Interested Parties
From: Garrett Cuneo
Re: ACA EVP Weekly Report
Date: June 30, 2003
The following items are covered in this week's report:
1. MEDICARE FULL-SCOPE CHIROPRACTIC DEMONSTRATION TO BE DECIDED IN HOUSE-SENATE CONFERENCE: IMMEDIATE GRASSROOTS ACTION REQUIRED
2. TOUGH WEEK FOR THE PHYSICAL THERAPISTS
3. HOUSE COMMITTEE ACTS, CHAIRMAN DELIVERS GOOD NEWS AND HIGH-FIVES TO ACA-PAC BOARD
4. STATE ASSOCIATION CONFERENCE CALL ANOTHER SUCCESS; NEXT PROGRAM SCHEDULED
5. ACA DISTRIBUTES STATEMENT ON MANAGED CARE
6. MASTERS CIRCLE WAS SHORTCHANGED
7. TEXAS GETS BLUE CCHIP CONTACT
8. AMA HOUSE OF DELEGATES CONSIDERS TWO SIGNIFICANT RESOLUTIONS
9. PALMER CHIROPRACTIC LYCEUM - CHANGING HEALTH CARE ONE PATIENT AT A TIME
10. CAN'T ACCESS THESE LINKS?
1. MEDICARE FULL-SCOPE CHIROPRACTIC DEMONSTRATION TO BE DECIDED IN HOUSE-SENATE CONFERENCE: IMMEDIATE GRASSROOTS ACTION REQUIRED
On June 26th, the House and Senate both approved separate $400 billion plans to modernize Medicare and offer a prescription drug benefit to seniors. The stage is now set for a House-Senate conference committee to begin resolving the differences between the two bills and to prepare a final version for an "up or down" vote in both chambers. Among the issues the conference committee will consider is the ACA's full-scope Medicare chiropractic demonstration project, which is in the Senate bill (S. 1), thanks to the strong support of Senator Charles Grassley (R-IA). The provision, however, was not included in the House bill (HR 1). Although Senate Majority Leader Bill Frist, MD (R-TN), anti-chiropractic bureaucrats at CMS and lobbyists for the physical therapists were unsuccessful in defeating the chiropractic demo in the Senate, they will continue working against it in the House-Senate conference.
As announced in my report last week, the ACA is launching a national grassroots campaign to build further support for the chiropractic demonstration provision and to ensure that it is included in the final Medicare bill. After meeting with ACA-PAC Officer Dr. Howard Fidler in Washington, Rep. Jim Ramstad (R-MN) agreed to join with Rep. Earl Pomeroy (D-ND) in sending a letter of support for the chiropractic demonstration to Rep. Nancy Johnson (R-CT), a key member of the conference committee. Pomeroy is the only Democrat on the House Ways and Means committee to support the bill. Also, Rep. Steve Israel (D-NY), another of only nine Democrats to vote in favor of the House Medicare bill, announced his intention to support the chiropractic demonstration in the conference process.
The members of the House-Senate conference committee have not yet been selected, nor has their first meeting been scheduled. We do anticipate that the committee will include Senators Grassley and Frist, as well as Representatives Nancy Johnson and Billy Tauzin (R-LA). ACA Board members Dr. J. Michael Flynn and Dr. Glenn Manceaux of Louisiana will begin this week to organize their state's grassroots effort with Rep. Tauzin. We are continuing to work with Representative Johnson. .
Here's a link the ACA Action Bulletin on Medicare: http://www.acatoday.com/government/medicare/alert_050503.shtml
Please read it, share it with CAs, Medicare patients and ACA members, and contact your member of Congress today. We can win, but only if there is a strong, positive _expression of support for our provision.
2. TOUGH WEEK FOR THE PHYSICAL THERAPISTS
Two weeks ago, the American Physical Therapy Association (APTA) held its annual event in Washington, D.C. More than 1,500 physical therapists, physical therapy assistants and students assembled on Capitol Hill on Thursday, June 19, in an attempt to persuade their representatives and senators in support of the Medicare Patient Access to Physical Therapists Act (HR 792 / S 493) legislation, allowing Medicare beneficiaries to go directly to a physical therapist without obtaining a physician referral, as well as support for removing the $1,590 therapy cap. Nothing appeared in the Senate version that would address either provision. In the House version, they obtained a study (not a demonstration project) to find out if direct access is a money-saver or a money loser. No wonder the PTs lobbied strongly against our demonstration project.
3. HOUSE COMMITTEE ACTS, CHAIRMAN DELIVERS GOOD NEWS AND HIGH-FIVES TO ACA-PAC BOARD
On June 26th, the House Veterans' Affairs Committee met and unanimously approved the "Department of Veterans Affairs Chiropractic Employment Act of 2003." This measure, which was combined with other veterans health care legislation in HR 2357, is designed to eliminate a number of bureaucratic barriers and speed the hiring and employment of chiropractors by the Department of Veterans Affairs. In recent weeks, ACA lobbyists have worked closely with the bill's sponsor -- Rep. Jerry Moran (R-KS) -- and the Chairman of the Veterans Affairs Subcommittee, Rep. Rob Simmons (R-CT) to develop legislative language and build support for the bill. Other key supporters of this pro-chiropractic legislation, which is due to be considered by the full House of Representatives in July, included Rep. Bob Filner (D-CA) and Rep. Jeb Bradley (R-NH).
The committee mark-up session coincided with a Washington, DC meeting of the ACA-PAC Board which included a previously scheduled session with Rep. Simmons, who had been selected to receive ACA's Veterans Health Care Leadership Award. Rep. Simmons came straight from the hearing room to the PAC meeting -- held on Capitol Hill -- excited to announce the committee's action and delivered congratulatory "high fives" to each PAC Board member and the ACA lobbying team. Rep. Simmons called the bill a "big win" for veterans and for the chiropractic profession. Also attending the PAC meeting was Representative Edward Schrock who was responsible for the amendment to the DOD bill that accelerated the implementation of the chiropractic benefit in the armed services by one year and increased the allocation next year for the chiropractic program from 12 million to 18 million
4. STATE ASSOCIATION CONFERENCE CALL ANOTHER SUCCESS; NEXT PROGRAM SCHEDULED
Over 20 representatives from state associations participated in the June conference call of the ACA Executive Directors Advisory Committee. Participating were representatives from Florida, Alabama, Iowa, Louisiana, Arizona, North Dakota, North Carolina, Mississippi, Ohio, California, Michigan, Pennsylvania, Kentucky, Nebraska and Virginia. The principle issue on this call was Medicare, with specific discussions on the billing of electrical stimulation codes, ABN requirements and documentation concerns. Susan McClelland led the discussion on these issues and received numerous compliments from the participants. Joining Susan were Tom Daly, Bobby Gibson and Dennis Smith.
McClelland will be leading the discussion for the next conference call, scheduled for Thursday, July 10th at 1:00 pm Eastern. The focus of this call will be Medicare local medical review policies: care definitions, frequency guidelines and things to look out for.
5. ACA DISTRIBUTES STATEMENT ON MANAGED CARE
In March 2003, ACA's House of Delegates ratified a resolution that highlights the need for change in managed care policies and makes recommendations to rectify these practices. The Payer and Health Plan Accrediting Agency Quality of Care Responsibility resolution speaks to payers, self-insured employers, managed care organizations (MCOs), and MCO accreditation and licensure agencies, highlighting many unfair managed care practices applied to practitioners and their patients. The resolution goes a step further linking the negative impact of managed care cost-cutting practices to the availability and delivery of patient care. In recent weeks, ACA distributed the resolution to the state associations, college presidents, ACC, COCSA, URAC, NCQA, AAPPO, chiropractic networks, payers, and Blue CCHIP representatives, requesting they take this quality of care document to local payers to stress that limits on care can harm the quality of care. Those individuals in decision-making positions need to review this resolution to so that changes can be implemented. Here is a link to the full resolution:
http://www.acatoday.com/about/resolutions_2003_march.shtml#1
6. MASTERS CIRCLE WAS SHORTCHANGED
Last week, I reported on a contribution presented by the Masters Circle to the National Chiropractic Legal Action Fund (NCLAF), which brought their contribution total to $13,125. However, if you consider what they have contributed as a company and what their clients have contributed, the total figure comes out to $21,625. Drs Larry Markson, Bob Hoffman and Dennis Perman have been strong supporters of the NCLAF and we appreciate their support.
7. TEXAS GETS BLUE CCHIP CONTACT
With the exception of Virginia (because of the ongoing Trigon suit), we had just one state without a contact at a local Blue Cross Blue Shield (BCBS) plan. As of June 25th, that has changed. A high-level operations director at BCBS of Texas has agreed to work with ACA and the Texas Chiropractic Association on matters related to chiropractic. For the past year, ACA has been working to get a contact in that state without success. Now, the plan has agreed to meet with members of the ACA and the Texas Chiropractic Association in July to discuss issues relating to reimbursement, particularly with respect to a recent news release from the plan citing the denial of E/M codes 99203 and higher beginning in August. We are hopeful this meeting will result in direct reimbursement improvements and that a planned lawsuit by the Texas Chiropractic Association against BCBS of Texas can be averted.
8. AMA HOUSE OF DELEGATES CONSIDERS TWO SIGNIFICANT RESOLUTIONS
Two weeks ago, the AMA House of Delegates met in Chicago to conduct its annual business meeting and to consider numerous resolutions. Included for discussion were two resolutions that help to illustrate the best and worse of political medicine. I have provided a link to each below so that you can observe them yourself.
The first resolution (# 310) was sponsored by the American Academy of Orthopedic Surgeons. It points out the lack of adequate training for medical students in the area of musculoskeletal education and encourages medical schools to take various steps to strengthen their curriculum in this area. This of course is an argument that Mr. George McAndrews has been making in his briefs -- that our education is superior to medicine in this area. The AMA adopted the resolution with an amendment, indicating that it supported the intent of the resolution, but that it wasn't within their purview to require curriculum changes. Instead they will have their curriculum committee work with individual academic institutions to increase training in musculoskeletal care. Could this acknowledgement be a sign of the second coming?
Musculoskeletal Education: http://www.ama-assn.org/ama1/upload/mm/annual03/c310a03.rtf
The second resolution (#605) is a step back to the pre-Wilk days. It complains that medical doctors and osteopaths are lumped together with other health care providers -- including chiropractors -- under the general heading of "providers." Get real! This is the 21st Century. Unfortunately, there are still some in the medical community who consider themselves God-like.
Eradication of the term "Provider:"
http://www.ama-assn.org/ama1/upload/mm/annual03/f605a03.rtf
The AMA HOD took no action on this, indicating that the provision of this resolution already exists within existing policy.
9. PALMER CHIROPRACTIC LYCEUM - CHANGING HEALTH CARE ONE PATIENT AT A TIME
Join your fellow ACA members at the chiropractic event of the year to be held August 7-9 at The Fountainhead of chiropractic in Davenport, Iowa. Lyceum, a seminar designed for today's chiropractor, offers something for everyone. This three-day event includes nearly 100 sessions, over 80 speakers, a jam-packed EXPO and over 3,400 people -- one of which should be you!
See Dr. Daryl Wills and other profession leaders during Friday morning's general session "Getting Politically Active - The Power of One."
Lyceum 2003 aspires to help you "Revolutionize Tomorrow by Changing Health Care One Patient at a Time" with the latest information on philosophy, science, technique and practice management. These sessions will aid you in enhancing your chiropractic skill, cultivating your practice and enriching your spirit. This phenomenal seminar includes up to 26 hours of continuing education credit, a first-class program for your office staff and empowering sessions for women in chiropractic. For additional information, check out the Web site at
www.palmerlyceum.com.
Don't wait. Register now! Log on to the Web site and register on-line or call toll-free at (866) 592-3861.
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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