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Memorandum
To: ACA Members, House of Delegates, Board of
Governors and Other Interested Parties
From: Garrett Cuneo
Re: ACA EVP Weekly Report
Date: October 20, 2003
This week’s report includes the following items:
1. ACA’S REPLY BRIEF IN TRIGON CASE POSTED ON ACA WEB SITE
2. INCREDIBLE TWO WEEKS IN CHIROPRACTIC INSURANCE RELATIONS
3. ACA PARTICIPATES IN PANEL DISCUSSION SPONSORED BY THE NATIONAL BLUE CROSS BLUE SHIELD ASSOCIATION
4. ACA PRESENTS AT FARMERS INSURANCE ADJUSTERS MEETING
5. ACA PRESENTS TO NATIONAL ASSOCIATION OF INDEPENDENT INSURERS
6. ACA SEEKS INFORMATION ON BLUES PLANS RESISTANT TO PT COVERAGE FOR CHIROPRACTORS
7. CMS ISSUES GUIDANCE DOCUMENTS REGARDING HIPAA
8. ACA’S ANNUAL MEETING PROVIDES SUCCESSFUL FUNDRAISING
9. FORENSIC GROUP HELPS NCLAF
10. DEADLINE FOR DELEGATE ELECTIONS APPROACHING
11. CAN’T ACCESS THESE LINKS?
1. ACA’S REPLY BRIEF IN TRIGON CASE POSTED ON ACA WEB SITE
A copy of ACA’s response to Trigon’s appeal brief can be found on ACA’s Web site at:
http://www.acatoday.com/pdf/FullReplyBrief.pdf
There is a possibility now that oral arguments will go before the Appeals panel before Christmas. Look to this report for further details.
2. INCREDIBLE TWO WEEKS IN CHIROPRACTIC INSURANCE RELATIONS
I am sure you are tired of hearing me talk about how great things are with the profession as you struggle with reduced reimbursement and further restriction. But from the perspective of someone who has been involved with this profession for 30 years, the achievements we are enjoying today would have been unheard of even just ten years ago. Whether we’re talking about legislative victories, advancements in insurance relations and greater exposure from the media, we are making real progress. The examples below are evidence, and while none of these events will provide immediate reimbursement, they will bring about better understanding between the insurance industry and the chiropractic community. This, I believe, will result in policies that are developed based on fact, rather than on preconceived and discriminatory notions. That is why these meetings are so important and significant.
3. ACA PARTICIPATES IN PANEL DISCUSSION SPONSORED BY THE NATIONAL BLUE CROSS BLUE SHIELD ASSOCIATION
We begin on October 7 in Chicago, as ACA Chairman George McClelland, DC, sat on a panel along with representatives of the American Medical Association and the American Hospital Association in a meeting sponsored by the national BlueCross BlueShield Association. The purpose of the meeting was to bring the payer and provider communities together to discuss the need to develop standardized benchmarks around quality performance and reporting. Dr. McClelland discussed the integration of our profession into the current health care system and highlighted ACA’s efforts toward developing best practices.
Participating on the panel and observing from the audience were a cross-section of the private and governmental insurance community. Included were representatives from AARP, General Electric, CMS, Institute of Medicine, Midwest Business Group on Health, National Breast Cancer Foundation, American Academy of Family Practice, American College of Cardiology, American Academy of Pediatrics, the Food and Drug Administration and numerous BlueCross BlueShield medical directors.
4. ACA PRESENTS AT FARMERS INSURANCE ADJUSTERS MEETING
This past week, ACA Governor John Gentile, DC, attended and lectured at the annual meeting of the Tennessee Farmers Insurance Company, presenting on chiropractic claims and coverage. Each adjustor received a copy of ACA’s Claims Adjusters Orientation package on chiropractic.
Dr. Gentile had made a similar presentation at the ACA-sponsored Claims Solutions Work Group meeting. His invitation was a result of an insurance carrier hearing his presentation and recommending it to a Farmers Insurance representative. Farmers Insurance now plans to send a representative to our next Claims Solutions Work Group meeting in March 2004.
5. ACA PRESENTS TO NATIONAL ASSOCIATION OF INDEPENDENT INSURERS
I participated on a panel discussion last week with a state senator from Florida and the vice president of the Erie Insurance Group, on how the insurance and chiropractic communities are getting along. The meeting was sponsored by the National Association of Independent Insurers (NAII)-an organization of over 600 insurance carriers-at its annual legislative conference.
Each of us on the panel was given 20 minutes to make opening comments. I spoke about the positive things that had taken place with our two communities since 1999, when our Claims Solutions Work Groups began, including joint cooperation in developing a claims adjusters orientation kit. I also pointed out the problems that still exist, and challenged those in the audience to learn more about our profession and to act on fact rather than on preconceived notions. I urged them to work with our state associations and to accept their requests for dialogue. While my presentation was well received, the real stars were the other two panelists.
Richard Wisniewski, Vice President of Erie Insurance, was one of the original participants of ACA’s Claims Solutions Work Group. He spoke about the tension that existed at the beginning of the meeting and how it changed as the two groups learned that they had more in common than in disagreement. He noted the success in putting together the claims adjuster orientation packet on chiropractic, and how he was in the process of teaching his claims managers about these important documents. He encouraged other insurance carriers to reach out to the chiropractic profession locally and to encourage their claims managers to be trained on the chiropractic orientation package.
Richard was followed by State Senator Durrell Peaden of Florida. The Senator also spoke positively about his relations with the chiropractic community and in particular his relationship with Dr. Dennis Jones, who serves with him in the State Senate. He indicated his strong support for a state-supported chiropractic institution, and that the outcome looks very positive. While these supportive remarks from a state legislator would be important to the audience, even more significant is that they were coming from someone who also happens to be a medical doctor.
You couldn’t buy these kinds of positive remarks that were heard by over 100 attorneys, medical doctors, claims managers and lobbyists.
6. ACA SEEKS INFORMATION ON BLUES PLANS RESISTANT TO PT COVERAGE FOR CHIROPRACTORS
Local BlueCross BlueShield plans that administer the Federal Employee Plan (FEP) were notified with a July 1 memorandum of the new Blues policy to reimburse doctors of chiropractic for physical therapy services. We have heard from providers in some states that the coverage has been implemented and that doctors are being paid. However, there are still states that have not yet implemented the coverage. If you continue to be denied for PT services by your local plans, the ACA wants to know about it.
For more information on the Federal Employee Plan’s physical therapy benefit-including a list of covered PT codes and dates of coverage-visit the ACA Web site at
http://www.acatoday.com/insurance/managed_care/dcs_benefit.shtml.
7. CMS ISSUES GUIDANCE DOCUMENTS REGARDING HIPAA
CMS has issued guidance documents outlining its most recent revisions to its compliance policy. The documents provide contingency planning guidelines. CMS says it wants to ensure that the health care industry understands its enforcement as the industry moves toward compliance with HIPAA electronic transactions and code sets. To review the documents, visit:
http://www.cms.hhs.gov/hipaa/hipaa2/
general/default.asp#contingency_guide
8. ACA’S ANNUAL MEETING PROVIDES SUCCESSFUL FUNDRAISING
The HOD meeting was successful on many levels-not the least of which was fundraising. The ACA-PAC, through a successful auction and direct appeals, raised $20,000. And following George McAndrews’ presentation, Drs. Max Atnip and Mario Spoto combined their efforts to raise $162, 841 in cash and pledges to the National Chiropractic Legal Action Fund (NCLAF). This effort made September a very successful month for NCLAF, receiving contributions in the amount of $170,007.69. More importantly, the number of doctors pledging monthly contributions to NCLAF increased by 41, bringing the new total to 946 doctors participating in “E-Z Pay.”
Some of the organizations that contributed during and after the annual meeting include the following:
| Breakthrough Coaching:
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$9,850, brings total to $70,450 |
| Michigan Chiropractic Fraternal Order:
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$5,000, brings total to $15,000 |
| ACA Council on Diagnosis of Internal Disorders:
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$500 (first contribution) |
| Virginia Chiropractic Association:
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$5,000, brings total to $11,500 |
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SACA Palmer College (West):
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$1,000, brings total to $1,220 |
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SACA--Palmer College:
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$400, brings total to $3,077.35 |
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SACA New York Chiropractic College:
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$200, brings total to $809.37 |
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SACA Life Chiropractic College West:
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$51.05 (first contribution) |
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SACA Life Chiropractic College:
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$593.65, brings total to $653.65 |
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SACA Cleveland College (KC):
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$500, brings total to $1,338 |
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Rhode Island Chiropractic Society:
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$2,500, brings total to $9,500 |
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NYCC Class of 1986:
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$2,000, (first contribution) |
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Nebraska Chiropractic Physicians Assoc:
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$5,000, brings total to $60,001 |
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Mississippi Chiropractic Association:
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$2,500, brings total to $7,500 |
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Illinois Chiropractic Society:
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$500, brings total to $5,856 |
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ACA Council on Chiro Physio Therapeutics/Rehab:
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$2,000, brings total to $3,000 |
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Connecticut Chiropractic Network, Inc:
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$4,000, brings total to $9,000 |
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Connecticut Chiropractic Association:
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$4,000, brings total to $11,000 |
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Chiropractic Rehabilitation Association:
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$5,000 (first contribution) |
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Association of Chiropractic Colleges:
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$10,000, brings total to $120,000 |
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Arkansas Chiropractic Society:
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$1,350, brings total to $2,350 |
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American Chiropractic Auxiliary:
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$100, brings total to $12,600 |
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Master's Circle:
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$500, brings total to $10,500 |
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Performance Health:
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$100, brings total to $1,300 |
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SACA-Logan College:
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$300, brings total to $2,025 |
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Arizona Assn of Chiropractic:
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$1,000, brings total to $3,500 |
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Uncle Paul's Business Training:
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$1,000, brings total to $3,000 |
Other notable contributions include:
Dr. Ken Luedtke contributed $2000 in memory of Dr. Arnold Cianciulli.
A contribution from the Arizona Association of Chiropractic was the result of donations by members attending their annual state convention. HESSCO contributed an adjusting table to this effort.
9. FORENSIC GROUP HELPS NCLAF
Members attending a conference sponsored by the ACA College of Forensic Sciences heard a presentation on the lawsuit and ACA activities by Dr. Warren Jahn. Through this event, ACA received ten contributions totaling $1150 and 3 monthly pledges of $100 each, as well as one new ACA “Governor’s Advisory Cabinet” member.
10. DEADLINE FOR DELEGATE ELECTIONS APPROACHING
Members seeking election as delegate or alternate delegate must signify their intent in writing via certified mail by December 16, 2003, to the Corporate Secretary of the American Chiropractic Association, 1701 Clarendon Blvd, Arlington VA 22209
Ballots will be sent January 15, 2004 to voting members of the states of Alabama, Arizona, California North, California South, Connecticut, District of Columbia, Georgia, Idaho, Illinois South, Indiana, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New York Metro, North Carolina, Ohio, Rhode Island, South Dakota, Texas East, Vermont, Puerto Rico, Virgin Islands, Washington, Wisconsin and Wyoming.
Term of office is two years. For more details on the delegate elections, qualifications and procedures, consult the ACA Bylaws, Article VIII, Section C
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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