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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: December 8, 2003
This weeks report includes the following items:
- CLAIMS SOLUTIONS WORKGROUP IN CHICAGO
- NAII ASKS ACA TO CONDUCT TRAINING PROGRAM FOR CLAIMS ADJUSTERS
- LEGISLATIVE UPDATE
- DoD UPDATE
- VA UPDATE
- FCER DESERVES YOUR SUPPORT
- ACA's 2004 CHIROPRACTIC CODING SOLUTIONS MANUAL
- PARKER LAS VEGAS WILL BE THE PLACE TO BE IN JANUARY
- CAN’T ACCESS THESE LINKS?
1. CLAIMS SOLUTIONS WORKGROUP IN CHICAGO
For the sixth time in a short four-year period, officials from national insurance companies and ACA leadership met to study ways to improve billing and reimbursement issues involving chiropractic claims. On November 20, 2003, the National Association of Independent Insurers hosted this important meeting in Chicago at their headquarters. 13 insurers, some sending multiple representatives, met with ACA President Donald Krippendorf and other ACA board members and delegates, including Dr. John Gentile (Chairman of ACA's Insurance and Managed Care Committee), Dr. Mario Spoto (ACA’s Pennsylvania delegate) and Dr. Jim Rehberger (ACA’s Illinois delegate), as well as Pat Jackson, ACA’s vice president for professional development and research, to explore better ways to cre! ate alliances and speed the claim handling process.
Many of the group's concerns have been addressed in the previous 5 meetings, such as improvements in clinical documentation, anti-fraud initiatives, and attention to best practices. Sights are now being set on new priorities. A session was held to address 7 particular, often-mishandled codes. Correct reimbursement policy was also discussed, and ACA requested that insurers correct medical review software vendor edits as well. Insurers are solely responsible for the business partners they hire, and if the coding edits they purchase are flawed it reflects back on the insurer and can represent unfair claim handling--a serious regulatory infraction. The codes discussed were Extra-Spinal CMT, Neuromuscular Reeducation, Testi! ng and Measurement codes, Massage, Hot Packs, Manual Therapy (97140) and E/M codes with CMT. Insurers agreed to reassess their practices and those of their business partners.
Companies attending the meeting included:
 | NAII |
| Allstate |
| American Family Insurance |
| AAA |
| Blue Cross Blue Shield Illinois |
| National BCBS AssociationState Farm |
| Shelter |
| General Casualty |
| Erie |
| Metropolitan (Met Life) and |
| Farmers |
This is a mix of health, workers compensation and auto insurers.
The next meeting of the group is scheduled for March in conjunction with ACA’s National Chiropractic Legislative Conference (NCLC).
2. NAII ASKS ACA TO CONDUCT TRAINING PROGRAM FOR CLAIMS ADJUSTERS
The National Association of Independent Insurers (NAII), which includes over 700 insurance companies, has requested that ACA participate in a video teleconferencing program with its claims adjusters to provide training on chiropractic. It is anticipated that the chiropractic training manual for adjusters, which was a joint effort of the ACA and the insurance community including NAII, will be the text utilized during this program.
3. LEGISLATIVE UPDATE
I hope you don't mind if I gloat a little bit. Being declared among the 25 most effective lobbying organizations on health matters on Capitol Hill, ahead of the physical therapists (APTA) and the U.S. Chamber of Commerce, and having our demonstration project show up in articles in the Washington Post and the Washington Times all in one week, is pretty heady stuff. Our lobbyists have already noticed a significant change in attitude by many hill staffers who are impressed by strong grassroots/lobbying organizations. Thanks to our lobbyists, our aggressive PAC and close cooperation from our members, including students, and state associations for making this happen.
This has been a successful legislative year for a number of reasons:
The President signed the Medicare bill on Monday, and I am happy to report that Jon Hymes (ACA vice president for government relations), Kim Krocker (ACA PAC Manager) and I attended the ceremony. More on that in a later report. As you know, the demonstration project is part of the Medicare package. It not only pilots full scope of practice under Medicare Part B, but also will eliminate the physician gatekeeper requirement that exists in Medicare Part C managed care plan. Dynamic Chiropractic is running a great article on the legislation, including a timeline that outlines our ten-plus year struggle to make this happen. To view the! article and timeline, visit:
http://www.chiroweb.com/dynamic/temp/medicare.html.
4. DoD UPDATE
The Department of Defense (DoD) authorization bill recently signed by President Bush includes a chiropractic provision that not only accelerates the full implementation of the chiropractic benefit by one year, but also increases its annual funding. The bill also has strong report language that lets
DoD know that Congress isn't happy about the uneven implementation of the benefit in the armed services and urges the department to make better use of the chiropractic advisory committee. As of January 04 there will be 37 sites throughout the country that provide chiropractic care. There is a potential for there to be several hundred. There is a lot of room for improvement, and Congress realized that the medical bureaucrats would have to be dragged kicking and screamin! g to implement the provision.
Schrock/Evans Proposal: Legislation from Congressman Ed Schrock and Congressman Lane Evans is being circulated that would assure that current and former military services personnel and their families have the chiropractic benefit. While most of our attention has been on other areas, in a short period of time we have been able to get 27 members of Congress to sign on as cosponsors. This legislation will undoubtedly be one of our priorities for next year. We urge you to contact your member of Congress to sign on to this bill. This will not be easy, as
DoD will probably oppose the legislation because of cost. For more information, visit:
http://www.acatoday.com/government/dod/schrock.shtml.
5. VA UPDATE
The recommendations of the Chiropractic Advisory Committee of the Veterans Administration have been submitted to Secretary of Veterans Affairs Anthony Principi. We are continuing our discussion with him, but recognize that substantial opposition exists within the VA bureaucracy and organized medicine. None of this is surprising to any of us. Like the DOD, the implementation of the chiropractic benefit will require additional congressional pressure and pressure from veterans organizations. We will be organizing a campaign to be initiated at the beginning of the year and will urge your participation.
We were successful in including a provision in the Department of Veterans Affairs Long-Term Care and Personnel Authorities Enhancement Act of 2003 (S. 1156), that amends title 38 of the U.S. Code to provide the U.S. Department of Veterans Affairs with direct and immediate authority to hire and employ doctors of chiropractic to care for veterans in the VA health system.
6. FCER DESERVES YOUR SUPPORT
The Foundation for Chiropractic Education and Research (FCER) is celebrating 60 years, and we say "Thank you!" to all of you who are or have been friends of the foundation through being a member, making a donation, or purchasing a product. Sixty Dollars for Sixty Years -- In honor of the event, we are suggesting that doctors make a $60 tax-deductible* donation to FCER, less than the cost of going to dinner and the movies. Please see
http://www.fcer.org/Donate60.htm for more information on FCER’s "Sixty Dollars for Sixty Years" campaign. All who donate will receive a FREE static cling window sticker for your office th! at shows your support for chiropractic research.
* Please check with your tax advisor. FCER maintains a 501(c)(3) status as an independent foundation dedicated to education and research.
7. ACA's 2004 CHIROPRACTIC CODING SOLUTIONS MANUAL
ACA's 2004 Chiropractic Coding Solutions Manual has been completely revised this year into an even more user-friendly, comprehensive, chiropractic-specific coding resource, starting with a new smaller 6 x 9 desktop reference size. If there was ever a year to purchase the ACA coding manual, 2004 is the year! New this year – color-coded sectioned tabs, a glossary of terms, a new clinical example section, an index for quick referencing, and updated letters of appeal. Included with your purchase--a free CD-ROM with customizable template letters and essential claim forms, such as the CMS-1500 form. You will also receive a free yearly subscription to the popular quarterly newsletter, the ACA Practice Advisory.
Price: ACA Member: $75.95; Non-member: $115.00. For more information, go to www.shopaca.com or call 800-368-3083. Please mention this email when ordering item CPT04.
* Books will be available January 2004.
8. PARKER LAS VEGAS WILL BE THE PLACE TO BE IN JANUARY
The ACA Board of Governors will hold its mid-winter meeting at the Las Vegas Hilton Hotel during the week of the Parker Seminar next month. While at Parker, ACA will take the opportunity provided by Dr. Fabrizio Mancini to raise awareness of our two lawsuits. Last January we raised over $500,000, and this year Parker is giving us opportunities to increase on this total. We will be operating three booths and participating in some of the major events planned for the weekend. Plan to join us at Parker to help in raising funds and also to attend an excellent program focused on your patients. In one weekend, your patients can learn from the best of the best and gain insight on wh! at it takes to be healthy both mentally and physically. Nowhere else will they have the opportunity to hear from so many best-selling authors on the basics of nutrition, exercise, stress management and how to be successful both personally and professionally.
Throughout the weekend you and your patients will be captivated by dazzling celebrity guests who support chiropractic, as well as hear from Olympic and professional athletes who rely on their health for their livelihood. Tell your patients about Parker Las Vegas and help them take control of their lives and get healthy and well! If you have not registered yourself and your staff, be sure to register today! For more information call 1-888-727-5338 or visit us online at
www.ParkerSeminars.com
9. 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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