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Memorandum
To: ACA Members, ACA House of Delegates, Board of
Governors and Other Interested Parties
From: Garrett Cuneo
Re: ACA EVP Weekly Report
Date: July 21, 2003
The following items are covered in this week's report:
1. EVEN TRIGON (ANTHEM) IS PAYING
2. ACA'S CHIROPRACTIC PROVISION IN MEDICARE BILL CONTINUES TO ATTRACT MEDIA ATTENTION
3. HOUSE/SENATE CONFERENCE COMMITTEE IS FORMED
4. SUPPORT IS GROWING FOR THE CHIROPRACTIC PROVISION
5. PDR SCORES ANOTHER ONE
6. AMA HASN'T CHANGED MUCH
7. UPDATE ON VA ADVISORY COMMITTEE ACTIVITIES
8. STATE ASSOCIATION AWARD DEADLINE APPROACHING
9. DEADLINE APPROACHING FOR RESOLUTIONS, BYLAWS AND ACA AWARDS NOMINATIONS
10. CAN'T ACCESS THESE LINKS?
1. EVEN TRIGON (ANTHEM) IS PAYING
We have received word from our doctors in Virginia that the BlueCross BlueShield's federal employee plan (FEP) in Virginia is now paying doctors of chiropractic for physical therapy that is provided to patients enrolled in either the basic or standard Blues FEP. As we indicated in previous reports, part of the agreement to suspend our lawsuit against the national BlueCross BlueShield Association was the establishment of a chiropractic benefit within their federal plans. In January 2002, the chiropractic benefit was included in their basic plan. This year, it was determined by the U.S. Office of Management and Budget (OMB) that the federal employees insured by the company would have their physical therapy treatment paid for if the doctor of chiropractic's scope of license authorized this in his or her state. If Trigon/Anthem is paying for the service, it's a good indication that the policy has taken effect.
2.. ACA'S CHIROPRACTIC PROVISION IN MEDICARE BILL CONTINUES TO ATTRACT MEDIA ATTENTION
The Washington Post article I mentioned in last week's report regarding the various provisions in the Medicare Reform bill that included our provisions was picked up by a number of newspapers throughout the country. Additionally, the Quad City Times of Iowa devoted an entire article on the chiropractic provision, including a quote from Senator Charles Grassley (R-IA) and ACA legislative consultant Rick Miller. Also, ABC News has also been in contact with us, requesting information on what our demonstration program would do and why it was necessary. This has been a great opportunity to tell our story.
For a copy of Quad City Times story, visit: http://www.qctimes.com/local/1015011.html
3. HOUSE/SENATE CONFERENCE COMMITTEE IS FORMED
The leadership in the House of Representatives completed its appointments to the House/Senate conference committee that is charged with reconciling the differences between the House and Senate versions of the Medicare Reform Bill. There were no surprises on the House appointments, as they included Republicans Bill Thomas (R-CA), Nancy Johnson (R-CT), Tom DeLay (R-TX), Michael Bilirakis (R-FL) and Billy Tauzin (R-LA). The Democrats on the committee include Charles Rangel (D-NY) and John Dingell (D-MI). As reported previously, the Senate conference committee includes: Senate Majority Leader Bill Frist, MD (R-TN), Charles Grassley (R-IA), Orrin Hatch (R-UT), Don Nickles (R-OK), Jon Kyl (R-AZ), Jay Rockefeller (D-WV), John Breaux (D-LA), Tom Daschle (D-SD) and Max Baucus (D-MT).
This week, the conference committee will be getting a comprehensive document that will outline where the two sides have differences and where they are in agreement. This effort will not be easy, and there is no guarantee that the Medicare Reform Bill will pass both houses. We need to remember that the House version passed by only 1 vote. 20 Republican members of the House did not vote for it, and only nine Democratic members voted for it. While the Senate version was more bipartisan, the differences between the two versions are substantial. And of course, our provision is only included in the Senate bill.
4. SUPPORT IS GROWING FOR THE CHIROPRACTIC PROVISION
Our grassroots efforts are beginning to kick-in, as we are able to add to the list of representatives who have sent letters to Congresswoman Nancy Johnson (R-CT), member of the conference committee, to support the chiropractic provision in the Medicare Reform bill. We are continuing to push for support of representatives on the Ways and Means Committee. However, the support of other Republicans in the House is welcomed as well. Congresswoman Johnson is a key player from the House side during these Senate/House conferences. The list of representatives that have sent letters over the past couple of weeks includes: Representatives Rodney Alexander (D-LA), Rob Portman (R-OH), Lloyd Doggett (D-TX), Christopher Shays (R-CT), Phil English (R-PA), Jim Nussle (R-IA), Leonard Boswell (D-IA), Virgil Goode (R-VA), Steve Israel (D-NY), William Janklow (R-SD), Rick Larsen (D-WA), Ed Schrock (R-VA), Jim Ramstad (R-MN) and Earl Pomeroy (D-ND).
Many congressmen and women remain undecided, and will not weigh-in on this issue unless they are asked to by their constituents. If your representative in the U.S. House is not on the list above, please do the following as soon as possible:
5. PDR SCORES ANOTHER ONE
On July 15, 2003, Patricia Jackson of ACA's Office of Professional Development and Research (PDR) met with the leadership of BlueCross BlueShield of Texas (BCBSTX) along with Drs. White and Brown of the Texas Chiropractic Association. Prior to this meeting, BCBSTX was the only BCBS plan without a point-person in place to work with ACA on the Blue CCHIP program. With their recent cooperation, all 62 BCBS plans (not including Trigon) are now participating on some level with ACA on the Blue CCHIP initiative. The meeting was held as a last effort to prevent a legal action in the state of Texas and open the doors of communication with the local BCBS Plan. The success of the meeting has started the ball rolling for a variety of changes to take place. A few examples that are occurring as a result of this meeting include BCBSTX reexamining their E/M policy and inviting the ACA Blue CCHIP liaison to participate as a policy advisor, in addition to the plan addressing other issues. This was an encouraging, effective meeting and we look forward to working more closely with BCBSTX to provide a forum to resolve existing chiropractic concerns as well as to avert future ones.
As an aside, the Texas Chiropractic Association President, Dr Jeff Brown went out of his way to compliment Pat's performance at the meeting with both the ACA President and the ACA Chairman. Dr Dale White, also from Texas made a similar comment. Pat is terrific.
6. AMA HASN'T CHANGED MUCH
A couple of weeks ago I reported on a resolution considered by the AMA House of Delegates that acknowledged deficiencies of medical students in the area of musculoskeletel conditions. While AMA's delegates did not adopt the resolution as originally stated, they did acknowledge a problem and pledged to work with medical schools to improve the situation. I thought just maybe that medicine was headed in the right direction, until I found another one of their policy decisions that took place a couple of years earlier regarding the use of the term 'physicians.' The policy states:
"The AMA urges all physicians to insist on being identified as a physicians and to sign only those professional or medical documents identifying them as physicians. The AMA will review and revise its own publications as necessary to conform with the House of Delegates policies on physician identification and physician reference and will refrain from any definition of physicians as health care providers. The AMA supports seeking immediate modification of the social security laws to change the definition of a physician to conform with AMA policy. The AMA will seek legislation prohibiting the use of the term "physician" as a descriptor other than in the context of a medical doctor (MD) or doctor of osteopathy (DO)."
7. UPDATE ON VA ADVISORY COMMITTEE ACTIVITIES
The Chiropractic Advisory Committee to the Department of Veteran's Affairs continues to press forward with its charge to develop recommendations for the implementation of the permanent chiropractic benefit within the VHA. Since its charter, the Committee has met 3 times and is scheduled to meet again on September 16-17, 2003. Currently, the members are putting the final touches on a draft recommendation that will be posted to the VA website in the very near future, and available for review and public comment. In this document, there are specific recommendations concerning qualifications for hire within the VHA system, scope of practice and privileging, staffing within the system, and recommendations regarding direct access versus referral. Between now and September, it is hoped that the members will reach a consensus on some of the more controversial points, complete the document, and then be in a position to present it to the Secretary following the meeting. Thereafter, it will be Secretary Principi's decision to either implement, reject, or alter the recommendations as presented.
Following the first meeting, the committee recommended that the VA initiate a Major Occupational Study (MOS) of the practice of chiropractic, a process that must be completed before any doctors of chiropractic can be contracted within the system, and one that can take up to 24 months to conclude. The Secretary concurred with this recommendation, and the MOS is already underway.
To gain a sense of Secretary Principi's attitude toward the profession, I refer you to his speech at ACA's National Chiropractic Legislative Conference (NCLC). Simply visit
http://www.acatoday.com/about/nclc2003/video.shtml and click on the Principi link.
8.. STATE ASSOCIATION AWARD DEADLINE APPROACHING
The prestigious ACA State Association Journalism Awards, presented each year at our House Of Delegates meeting, will again bring recognition to the efforts of chiropractic associations to inform, and sometimes entertain, their members. If you feel your association can compete in this arena with others of its size (up to 500 members, 500 to 1,000 members, and 1,000+ members), tell your publications person/editor to give Carol Kline a call at (800) 986-4636, ext. 204, for entry forms. The deadline for postmarks has been extended by one week to Friday, July 25.
9.. DEADLINE APPROACHING FOR RESOLUTIONS, BYLAWS AND ACA AWARDS NOMINATIONS
At its annual business meeting in Albuquerque, New Mexico, scheduled for September 18-20, 2003, the ACA House of Delegates will present the major annual ACA awards, including:
 | Chiropractor of the Year |
| Humanitarian of the Year |
| Delegate of the Year |
| Flynn-Lynch Award (to an outstanding member of the Council of Delegates with no more than five years of experience on the council) |
| Research and Academic awards |
Nominations -- which must include the name of the nominee and a brief essay on why he or she should be considered for the specific award -- must be sent to the ACA by August 5, 2003. Nominations will be forwarded to the Awards Committee, which selects winners. Send nominations to the ACA Corporate Secretary, 1701 Clarendon Blvd., Arlington, VA 22209. (For more information on ACA awards, go to the bylaws section of the ACA Web site:
http://www.acatoday.com/pdf/2002_aca_bylaws.pdf and scroll to Article V, sections F, G and H.)
At the same time, the Delegates will consider amendments to ACA Bylaws, Resolutions and Position Papers. Deadlines for these items are set forth below.
Proposed resolutions must be sent to the ACA corporate secretary at least forty-five (45) days prior to the meeting (Article VIII, Section J.4, except as provided in Section J.5). Deadline for receipt of proposed resolutions is Aug. 5, 2003.
Proposed amendments to the ACA bylaws must be submitted to the ACA corporate secretary at least sixty (60) days prior to the meeting. ACA bylaws in odd numbered calendar years may be amended by a two-third (2/3) vote of the House of Delegates, only after the proposed amendment is designated as "emergency" by a majority of the House of Delegates (Article XIX, Section A). Deadline for receipt of proposed amendments to bylaws was July 18, 2003, and the deadline for position papers was June 20, 2003.
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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