Fw: ACA EVP Weekly Report

[Guest guest]

ACA EVP Weekly Report

MEMORANDUM

ACA Board of Governors, House of Delegates and Other Interested Parties

From: Cuneo

Re: ACA EVP Weekly Report

May 20, 2001

IN THIS REPORT:

1. UPDATE ON LAWSUITS(MORE ON APTA)

2. ACA'S TWO LATEST NATIONAL NEWS RELEASES PUBLICIZE MAY ISSUE OF JACA

3. ACA PARTICIPATES IN COSCA-SPONSORED LEADERSHIP CONFERENCE

4. ANOTHER VETERANS GROUP CONTACTED

5. ACA ATTENDS AMERICAN RED CROSS PARTNERS MEETING

6. ACA PARTICIPATES AT URAC MEETING

7. SUMMIT 2001

8. IMPORTANT DEADLINES FOR 2001 HOD MEETING

9. INSURANCE PROGRAM ON THE ROAD

10. U.S. SENATOR AND OTHER LOCAL POLITICOS HELP A DELEGATE GET RE-ELECTED

11. OUT TO SEA

UPDATE ON LAWSUITS

There is nothing new to report from the courts regarding either lawsuit.

The

judge in the suit against the Blues is considering the motions for dismissal

filed by both Trigon and National Blue Cross/Shield.

The suit against HHS has been delayed until HCFA's new attorneys become

acquainted with the suit and the judge has had an opportunity to consider

the

intervention request from the American Physical Therapist Association

(APTA).

You will recall that the APTA was asking for intervention in part because

they didn't believe that their " right " to perform manipulation of the spine

would be appropriately defended in this suit. HCFA has changed since the

filing of our lawsuit their policy regarding the right of a PT to do manual

manipulation of the spine to correct a subluxation. Prior to the filling of

our law suit in November 1998, HCFA held the position that a PT could

perform

this procedure. But six months later, HCFA officials reassessed this

position and agreed to our stance, noting in a court brief that a PT could

not perform manual manipulation of the spine to correct a subluxation.

We have placed the APTA petition and our responses prepared by

Mcs on our Web Page. The direct link is:

http://www.acatoday.com/lawsuit_info/.

My report last week quoted from the APTA brief in which they claimed to

correct a

subluxation, although they acknowledged that they called the condition

something other than a subluxation.

This week I would like to take one quote from our legal response to the

courts that best summarizes the reasons we are opposed to APTA's petition:

" …If the APTA is claiming that now, in the year 2001, that its non-physician

members are prepared to illegally perform chiropractic manual manipulation

of

the spine to correct a subluxation of the spine, its remedy is to lobby

Congress, not the court, to (1) be declared " physicians " for this purpose

and

2) become licensed chiropractors. Therefore, the APTA's motion should be

dismissed. " Well said, Mr. Mcs.

We have succeeded in raising 2.5 million dollars since we initiated the

first

lawsuit in November 1998. But these lawsuits are expensive, as one should

expect, given the opposition that we face. Some months the bills run

$100,000. We need the financial support of the entire profession to sustain

this effort. Please make your contribution today. If you or the

organization that you represent wishes to make a contribution, or another

contribution, I have provided the contribution form at:

http://www.acatoday.com/pdf/legal_action.pdf.

ACA'S TWO LATEST NATIONAL NEWS RELEASES PUBLICIZE MAY ISSUE OF JACA

On Wednesday, May 9, the Communications department published two news

releases to promote the May 2001 issue of the Journal of the American

Chiropractic Association (JACA). One of the releases focuses on the May

2001

cover story, titled " Posturing for Wellness: Good Health Begins with Good

Posture, " while the other highlights " Chiropractic Hiccup Resolution: A Case

Study. " Both of these releases are available on ACA's Web site. Posture

release: http://www.acatoday.com/media/releases/050901.html

Hiccup release:

http://www.acatoday.com/members/publications/may2001_hiccups.html

ACA periodically distributes news releases to the public in order to

increase

appreciation and awareness for the chiropractic profession and to publicize

the efforts and victories of the ACA.

ACA's primary tool for the dissemination of news releases is PRNewswire, an

agency that offers unmatched news distribution to the general media,

industry

publications and feature news editors. Members of the press frequently

contact the Communications department for more information on interesting

releases we have put out, resulting in a multiplication of coverage for

ACA's

news and information.

To learn more about ACA's news releases, please contact Bernat in

the

Communications department at 800-986-4636, ext. 240 or at

pbernat@....

ACA PARTICIPATES IN COSCA-SPONSORED LEADERSHIP CONFERENCE

Drs. and Daryl Wills represented the ACA at the National

Chiropractic Leadership Forum in St. Louis, MO. Dr. McClelland was

also in attendance representing FCER. Sponsored by COCSA, the forum brought

together a cross-section of the profession's political and academic

community. Joining the ACA at this meeting were representatives from the

following groups: the Association of Chiropractic Colleges, the CCGPP, the

World Chiropractic Alliance, Dynamic Chiropractic, FCER, ICA, Leader

International, National Board, and FSCO. There was considerable discussion

about finding ways to work more closely together. The group agreed to a more

formal structure, a code of conduct, a declaration of chiropractic

responsibilities, conflict resolution protocols, a 'report card' system (to

insure follow through) and a revised original vision statement. The ACC

Paradigm seems to be the one document that all organizations are able to

unify around. The group agreed to redistribute this document to its members.

ANOTHER VETERANS GROUP CONTACTED

Continuing the effort reported earlier to contact the national offices of

veterans groups to gain their support for chiropractic inclusion into the

veterans' health care, representatives of the ACA met with representatives

of

the National Guard Association (NGA). The meeting was very positive and

productive. The NGA indicated that they are part of a board coalition of 33

organizations representing over 5 million military personnel and veterans.

They indicated that this coalition is very powerful and that it may want to

consider our issue. The NGA said they would work with us on this issue and

attempt to arrange a meeting with the broader coalition. The support and

contact continues to grow. Please don't miss the opportunity to contact your

local veterans group and get them involved in this effort. Our Web page

includes a lobby kit for contacting veterans groups.

ACA ATTENDS AMERICAN RED CROSS PARTNERS MEETING

Bernat of ACA's Communications Department attended the annual

American Red Cross partners meeting on Tuesday, May 8, at the Red Cross

national headquarters in Falls Church, Virginia.

In August of 1999, the ACA House of Delegates passed a resolution

establishing a formal relationship with the American Red Cross to

participate

in its disaster relief program. And in December 2000, the ACA signed a

five-year " Statement of Understanding " with the Red Cross. The Statement of

Understanding outlines the framework of the relationship.

One of our association's most important initiatives is to enhance the

visibility of doctors of chiropractic among the public, and ACA's program

with the American Red Cross serves to establish chiropractors as

professionals who care about their communities.

To learn more about the Red Cross Disaster Relief program, contact

Bernat at 800-986-4636, ext. 240, or pbernat@....

ACA PARTICIPATES AT URAC MEETING

Due to ACA's initiative involving meetings between ACA executive vice

president Cuneo and Garry Carneal, CEO of URAC, and the strong lobbying

of Pat , vice president of Professional Development and Research, ACA

was invited for the first time ever to participate in a national medical

directors meeting of managed health care plans. The medical directors forum

was held in Orlando, FL, and included some of the largest MCOs in the

country. ACA governor Dr. Krippendorf attended the meeting with Pat

. The purpose of the meeting was to challenge medical directors to

think about the impact medical review and managed care systems have on the

public and providers to develop better approaches in the future. Dr.

Krippendorf raised these issues for the chiropractic profession and the

patients they serve:

Our representatives emphasized the need for the chiropractic profession to

be

involved in medical review guidelines and reimbursement policy development

on

the front end; value in pursuing outpatient models of health care that

prevent disease and use a wellness approach; value to patients in measuring

outcomes vs. cost containment; value in integrated approaches at practice

and

association levels.

URAC officials and general agreement from the medical directors indicated

they would include the chiropractic profession in future talks and clinical

forums. The ACA was also invited to present to URAC staff on June 20th in

Washington, D.C.

SUMMIT 2001

Two weeks ago, I attended the 2nd annual Integrative Medicine Leadership

Summit. Organized by Weeks, the conference brought together

representatives from the political, academic, business, insurance and

governmental agencies all sharing information regarding complementary

medicine. Some of the sponsors of the program included Health Forum,

American Hospital Association, Health Business Partners, Triad and American

Specialty Health. There was an active presence by all the major

chiropractic

managed care groups in the country along with representatives of the White

House Commission on Alternative Medicine and medicine. Although CAM has

come

a long way, from a political standpoint most of their organizations are

where

we were twenty years ago.

IMPORTANT DEADLINES FOR 2001 HOD MEETING

ACA's annual House of Delegates meeting is scheduled for August 31-September

1, 2001, in St. sburg, FL. The Council of Delegates meeting will be

held on August 30th. The following are deadlines for submission to the

House

of Delegates for the following actions:

· Position Papers: Monday, June 4

· Bylaws Amendments: Monday, July 2

· Resolutions: Tuesday, July 17

All materials must be submitted to the ACA office c/o Cuneo at the

deadline prescribed.

INSURANCE PROGRAM ON THE ROAD

In the past month, both the Georgia and North Carolina associations have

hired the ACA to present coding/Medicare and documentation seminars for

their

membership. These classes were very well received. In Georgia, alternate

delegate Dr. Hayden gave an ACA update at the beginning of the seminar

together with a lawsuit update. In North Carolina, the doctors and staff

were together for the first hour of classes with Kathy Mills of Professional

Development and Research. Kathy updated the group on ACA initiatives and

the

lawsuit. Between the two seminars, 4 new members signed up on the spot and

purchased approximately $340.00 worth of ACA products.

The next three seminars scheduled are June 8-9 in Billings, MT, for the

Montana Chiropractic Assn; June 21 in Denver, CO, for the Colorado

Chiropractic Assn; and July 19 in Denver, CO, for ACA's Family Practice

Council.

U.S. SENATOR AND OTHER LOCAL POLITICOS HELP A DELEGATE GET RE-ELECTED

We received a news clipping from a Kentucky newspaper regarding the

fundraiser scheduled to support the reelection of Dr. Mark Schweitzer as

Coroner for

County. Dr Schweitzer is also the ACA delegate from Kentucky.

Included on the list as co-chairmen for this function are U.S. Senator Jim

Bunning and Kentucky Senate President . The column was

particularly impressed with the presence of Mr. , who seems to be a

rising political star in the state. The fundraiser anticipates raising over

$8,000. One has to be impressed by the level of support from prominent

legislators to this doctor's campaign efforts. We might have a future

Congressman.

OUT TO SEA

The weekly report will go on vacation for one week, while its author and

legal counsel join Dr. Krippendorf and one other on a 600-mile sail from the

Marsh Island in the Bahamas to St sburg, FL. Other than the fear of

sharks, seasickness, the curse of the Bermuda triangle, Castro and hurricane

season, we are looking forward to a real good time. Look for the next

report

on June 4th

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Board of Governors, House of Delegates and other

> interested parties

> From: Cuneo

> Re: EVP Weekly Report

> Date: September 5, 2001

>

> In this report:

>

> · UPDATE ON LAWSUITS

> · NON-MEMBERS BEGIN TO PARTICIPATE

> · 1ST SOLUTIONS CONFERENCE WITH CHIROPRACTIC NETWORK SCHEDULED

> · 4TH SOLUTIONS CONFERENCE SCHEDULED WITH INSURANCE CARRIERS

> · GOVERNMENT RELATIONS OPENS COMMUNICATION WITH THE NATIVE AMERICAN

> POPULATION

> · CHIROPRACTIC INTERNS AT BETHESDA HOSPITAL

> · APPROPRIATIONS COMMITTEE GAINS SUPPORT

> · MORE COMPARISONS WITH OTHER ORGANIZATIONS

> · DISTRICT OF COLUMBIA GOVERNMENT

> · SORRY FOR THE DELAY

>

> UPDATE ON LAWSUITS

>

> I have nothing new to report on our lawsuit against the Feds. The Trigon

> lawsuit is carrying on according to procedure. The attorneys for ACA and

> Trigon have met to discuss a schedule for briefs, depositions, etc. It is

> possible that the notices for the first depositions will go out in six

weeks.

>

> NON-MEMBERS BEGIN TO PARTICIPATE

>

> Since November of 1998, when we first began soliciting funds for the

National

> Chiropractic Legal Action Fund (NCLAF), we have raised $2.9 million. The

> vast majority of these contributions have come from members and certain

> chiropractic organizations. Over the last couple of months, however,

there

> has been a surge in contributions from non-members. During the months of

> July and August, the NCLAF received 73 contributions ($6,445) and 116

> contributions ($11,121) respectively from non-members. These two months

were

> the second and third highest totals received from non-members since we

began

> taking contributions for the NCLAF. The highest was in October 1999 when

we

> received 158 contributions totaling $13,145. While the recent wave of

> contributions from non-members is encouraging, the sum total of non-member

> contributions ($126,000) is dwarfed by the member contributions made

during

> the same time period ($1,118,012). When this lawsuit is successful, all

> doctors will benefit. With our legal expenses now averaging $100,000

> monthly, how much longer can our members be expected to carry the load of

> these lawsuits on their backs? There has been no other chiropractic

activity

> since the Wilk suit that has brought together so many diverse groups in

> support of the common goal. But we need to do more.

>

> 1ST CLAIMS SOLUTIONS CONFERENCE WITH CHIRORPACTIC NETWORK SCHEDULED

>

> ACA's Office of Professional Development and Research (PDR) has invited

> sixteen of the larger chiropractic networks to meet with the ACA on

September

> 28th to discuss current trends in managed care, how these trends are

> effecting the profession and the development of solutions to address these

> issues. So far, 14 companies have accepted the invitation to participate

in

> the conference. If you have any specific issues that you wish us to raise

> during this meeting, please let me know.

>

> 4TH CLAIMS SOLUTIONS CONFERENCE SCHEDULED WITH INSURANCE CARRIERS

>

> PDR has also sent out invitations to major insurance carriers inviting

them

> to the 4th claims solutions work group meeting scheduled for October in

> Chicago. At the request of past participants, the meeting will be held at

a

> chiropractic college, the National University of Health Sciences, where

the

> focus of discussion will be on chiropractic education. This will be a

great

> opportunity for leaders in the insurance industry to see first hand the

> educational experience of our doctors and to meet the faculty and students

of

> the institutions. Five years ago, a high level HCFA official, Grant

Bagley,

> MD, went through a similar experience and his positive findings resulted

in

> the beginning of significant discussions with HCFA. The meeting will

> continue the next day at the offices of the National Association of

> Independent Insurers (NAII), the largest Property and Casualty Trade

> Association. At their invitation, the meeting will be held at the same

time

> and location as their Medical Issues Committee meeting. The focus of the

> second day of the claims solutions work group meeting will be developing a

> chiropractic training program for claims adjusters. I don't even need to

> explain the significance of the ACA and the major insurance carriers

agreeing

> on such a program.

>

> This is the fourth meeting of the Claims Solutions Work Group. Initiated

and

> coordinate by Pat , ACA's Vice President of Professional

Development

> and Research, these meetings have already resulted in the following:

>

> 1. Open communication with national insurers on chiropractic

reimbursement

> concerns and establishment of inside contacts at high levels who are in

> decision-making capacities

> 2. Development of clinical documentation guidelines that will be accepted

by

> insurers

> 3. Development of a public anti-fraud position statement regarding

> activities that impact potential fraud by doctors and insurers alike

>

> GOVERNMENT RELATIONS OPENS COMMUNICATION WITH THE NATIVE AMERICAN

POPULATION

>

> One of the objectives of the ACA Legislative Commission is to make

> chiropractic care available to the Native American population. Recently

the

> ACA and ACC have been working with Indian Affairs staff on S212:

> Reauthorization Bill for Indian Health Care Improvement Act. While

> chiropractic is included in the bill, one specific problem is the use of

> differing definitions of " health care provider " . Of particular concern to

> the ACA was the use of the National Health Service Corps definition which

> does not include doctors of chiropractic. However, the recent victory and

> continuing movement in the NHSC program in the Senate relates directly to

> the current Indian Health Care bill before Congress. The ACA will

continue

> to work to ensure that doctors of chiropractic are eligible to participate

in

> the Native American health care system. The ACA has also been working

> closely with doctors in an attempt to do a presentation at the National

> Indian Health Board's conference in Denver in September.

>

> CHIROPRACTIC INTERNS AT BETHESDA HOSPITAL

>

> Dr. Bill , the chiropractic doctor who treats members of Congress at

> the U.S. Capitol building, reports that the Bethesda Hospital, which

treats

> the president and prominent members of Congress, has accepted its first

> chiropractic student for purposes of completing his internship

requirements.

> The New York Chiropractic College student will be enrolled in a program in

> which he will be able to perform rotations through some of the other

> specialties at the hospital as well as treat patients with chiropractic

care.

>

> Bethesda Hospital became one of facilities involved with the DOD

> demonstration projects when ACA passed legislation in 1998 adding it to

the

> list of project sites. Not only did this hospital's involvement in the

> project help develop positive chiropractic statistics which brought about

the

> successful passage of legislation mandating chiropractic care in the

> military, as well as help bring about the placing of a chiropractic doctor

at

> the capitol, but now is providing our chiropractic students with a great

> opportunity to operate in the setting of a prominent hospital.

>

> APPROPRIATIONS COMMITTEE GAINS SUPPORT

>

> Seven prominent members from both parties sent a letter to Congressman

> Murtha, ranking member of the Subcommittee on Defense and House Committee

on

> Appropriations urging that the subcommittee support ACA's efforts to

increase

> the appropriation for the implementation of chiropractic into the military

> from the current $6 million to $15 million. Signing the letter of support

> were Congressman Steve Buyer (R-IN), former chairman of the House Armed

> Services Subcommittee on Personnel and current chairman of the House VA

> Subcommittee on Oversight; Congressman Lane (D-IL), ranking Democrat

of

> the House VA committee and 5th ranking Democrat on the House Armed

Services

> Committee; Congressman Cliff Stearns (R-FL), former chairman of House VA

> Subcommittee on Health; Congressman Neil Abercrombie (D-HI), former

ranking

> Democrat on House Armed Services Subcommittee on Personnel and 7th ranking

> Democrat on the full Armed Services Committee; Congressman Jerry Moran

> (R-KS), chairman of the House VA Subcommittee on Health, Congressman Bob

> Filner (D-CA), ranking Democrat on the House VA Subcommittee on Health;

and

> Congressman Ciro (D-TX), member of the House Armed Services and

VA

> Committees.

>

> Think for a moment of the possibility ten years ago that the ACA would get

a

> letter of support to increase appropriations for a chiropractic project.

> Slim to none. Our profession has made significant progress.

>

> MORE COMPARISONS WITH OTHER ORGANIZATIONS

>

> The American Occupational Therapy Association

>

> Members: 55,000

> Employees: 140

> Annual Budget: $18 million

> Hard-dollar PAC contributions for 1999-2000: $326,600

>

> American Chiropractic Association

>

> Members: 18,000

> Employees: 40

> Annual Budget: $6.5 million

> Hard-dollar PAC Contributions for 1999-2000: $414,379

>

> A direct competitor? Not yet, but certainly a group that is seeking the

same

> slim health care dollar that all health care groups are competing for. It

is

> interesting to note that the Occupational Therapists, which I don't

believe

> are particularly active on the state level, have such presence in

Washington,

> D.C.

>

> DISTRICT OF COLUMBIA GOVERNMENT

>

> We recently sent a letter to Dr. Feseha Woldu, assitant deputy director

for

> operations, Washington, D.C. Department of Health expressing concern over

> what appeared to be the department's intent to do away with the board of

> chiropractic as part of a reengineering effort by the District of

Columbia.

> It was our understanding that a chiropractic advisory board would be

> established in its place under the auspices of the D.C. Board of Medicine.

I

> received a call from Dr. Woldu last week thanking the ACA for the letter

and

> for the insights that it provided. He assured me that the D.C. government

> would not be pursuing the recommendations to place the profession under

the

> Medical Board.

>

>

>

> SORRY FOR THE DELAY

>

> I apologize for the delay in getting this weekly report to you. I have

been

> in St. sburg, FL, all week participating in the ACA's annual meeting.

> Look to my upcoming weekly report and ACA Today for a summary of the

events

> at this meeting.

>

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Board of Governors, House of Delegates and other

> interested parties

> From: Garrett F. Cuneo

> Re: EVP weekly report

> Date: 9/24/01

>

> In this report:

>

> *BLUES UPDATE/ FEDERAL PLAN

> *BLUE CROSS/BLUE SHIELD MEDICAL DIRECTOR SPEAKS AT HOD

> *BLUE CROSS/BLUE SHIELD MEDICAL DIRECTOR INVITES ACA'S PARTICIPATION ON

> *MEDICAL ADVISORY PANEL

> *ACA HONORS ITS OUTSTANDING PRACTITIONERS

> *MARK YOUR CALENDAR FOR NCLC

> *MEDICARE REIMBURSEMENT AFFECTED BY ACA ACTION

> *ACA COMMENTS ON AFFINITY PROGRAMS

> *ACA WORKS TO IMPROVE SITUATION IN NEW JERSEY FOR OUR DOCTORS

> *SUPPORT FOOT LEVELERS

> *ACA MEMBERS IN SOUTHERN CALIFORNIA ELIGIBLE FOR MAJOR AUTO DISCOUNT

>

>

> BLUES UPDATE/FEDERAL PLAN

>

> As we have reported previously our Lawsuit against Trigon Blue

Cross/Shield

> continues. A court scheduling conference was held in Abingdon, VA on

> September 10, 2001. The trial will commence on November 11,2002. Both

sides

> are now identifying potential witnesses and collecting all documents that

may

> be subject to discovery.

>

> Our lawsuit against National Blue Cross/Shield was suspended while ACA

> continues its discussions with the national Blue Cross/Blue Shield

> Association through Dr Alan Korn, senior vice president of the clinical

> affairs and chief medical officer, to establish a new framework by which

> individual state problems can be addressed.

>

> The implementation of a new chiropractic benefit in the BC/BS Federal

> Employee Benefit Program was another factor in ACA's agreement to suspend

its

> action against the national Blue Cross/Blue Shield plan, which covers more

> than 4 million federal employees nationwide. We learned Friday that

effective

> January 1st a new chiropractic benefit would be included in a blue

> cross/shield federal plan available to federal employees. This is the good

> news; the bad news is, first and foremost, that the plan doesn't treat

> chiropractors as primary care doctors, contrary to what we had been lead

to

> believe; that the so-called benefit is available only under the " basic

plan "

> option and not the " Standard Plan " option; and that the coverage is

limited

> under that Basic Option plan to only twenty manipulations of the spine

with a

> co-payment of $20, a co payment that frequently wipes out the benefit all

> together. There is no payment for E and M services or physical therapy.

They

> only reimburse for initial x-rays. This coverage may vary to some degree

in

> individual states, and while no referral is necessary, no one can be

pleased

> with this development.

>

> We had attempted to learn of the benefit and lend our point of view to its

> development prior to Friday's meeting. National Blue Cross/Shield cited

> privacy concerns and resisted our inquiries, even though we cited legal

> precedent to them that their concerns were baseless. They did provide us

with

> an opportunity to suggest what we thought the plan should include.

Obviously,

> what came out wasn't what we recommended. We are doing a more

comprehensive

> review about the new chiropractic benefit and will be reporting this to

the

> profession.

>

> We need to decide what to do next. There has been some progress in our

> discussions with the Blues and their medical director continues to make an

> effort to improve our relationships, as noted in the stories below. But

talk

> is cheap and this federal plan appears to signal to us that the National

> Blues continue to have an anti chiropractic agenda, notwithstanding the

> medical directors actions. When we suspended the lawsuit we did it without

> prejudice, allowing us to reactivate it if we felt the need. We may be

close

> to that decision. The Board will be consulting with Mr. Mcs and

others

> and together with the other plaintiffs in the case will decide our future

> course of action.

>

>

>

> BLUE CROSS/BLUE SHIELD MEDICAL DIRECTOR SPEAKS AT HOD

>

> Dr. Allan Korn, chief medical officer of the national Blue Cross/Blue

Shield

> Association, spoke to the House of Delegates to assure them that his

> organization is taking ACA's concerns seriously. " There is a willingness

to

> put these issues on the table and talk through them, " Dr. Korn stated.

Some

> of the ways in which the national Blue Cross/Blue Shield Association will

> improve understanding and build trust with the ACA is by allowing

> chiropractic liaisons to work with local Blue Cross/Blue Shield plans to

> educate them about the chiropractic health care model. As Dr. Korn

> explained, local Blue Cross/ Blue Shield plans need help from

chiropractors

> to meet their business obligations. " We do care because our patients want

> access to your services "

>

> He did indicate that the discussions that he is holding with us are also

> going on with the AMA, Society of Internal Medicine, American Academy of

> Pediatrics, American Academy of Family Physicians, etc. He lumped us into

> the category of primary care doctors, a nice category to be in.

>

> BLUE CROSS/BLUE SHIELD MEDICAL DIRECTOR INVITES ACA'S PARTICIPATION ON

> MEDICAL ADVISORY PANEL

>

> Dr Korn invited ACA Governor Dr McClelland to attend a dinner at

his

> home along with members of the Medical Advisory Panel, and to attend their

> meeting the next day. MAP is the advisory council to Blue Cross/Blue

Shield

> and their 44 plans that evaluates new diagnostic or therapeutic

interventions

> based on their scientific merit, and advises Blue Cross as to their

> appropriateness for funding. The MAP is a consensus process that is made

up

> of approximately 20 MD, PHD, MS types. Additionally, it is supported by

an

> internal Blue Cross/Blue Shield technical evaluation center (TEC) that has

> both local and off site personnel.

>

> The TEC has the responsibility of gathering all the data on a new

> intervention, developing a report for presentation to the MAP along with

> recommendations to the MAP based on the established criteria that the TEC

and

> MAP have developed in order for an intervention to be acceptable.

>

> While we have established a technical assessment panel, Dr. McClelland

> recommends that some major changes be made. Dr. Korn is having his staff

> send us copies of their protocols, methodologies and criteria. While we

> won't necessarily use this information, it will be helpful in developing

our

> own guidelines.

>

> ACA HONORS ITS OUTSTANDING PRACTITIONERS

>

> At its annual meeting, the ACA presented its major awards to a number of

> doctors for their outstanding contributions to the profession. Included

were

> the following:

>

> · Chiropractor of the Year: Dr. Maurer

> · Humanitarian of the Year: Dr. Monte Greenawalt

> · Delegate of the Year: Dr. Spoto

> · Drs. Flynn- Lynch Memorial Award: Dr Fidler

> · Academic of the Year: Dr. Alan , vice presdient of professional

> affairs - Southern California University of Health Sciences (formerly the

Los

> Angeles College of Chiropractic)

> · ACA Research Award: Dr. Gert Bronfort, senior clinical researcher and

> professor at the Northwestern Health Sciences University

>

> MARK YOUR CALENDAR FOR NCLC

>

> Before you know it, the ACA's National Chiropractic Legislative Conference

> will be upon us. It is scheduled for March 6th, 7th, 8th and 9th at the

> Hyatt Regency Capitol Hill in Washington, D.C. Last year, four hundred

and

> sixty doctors and students converged on the capitol to promote the

> chiropractic agenda to members of Congress. Please make an effort to

attend

> this one and help us make the goal of six hundred attendees.

>

> MEDICARE REIMBURSEMENT AFFECTED BY ACA ACTION

>

> During a recent meeting with the HHS Inspector General's office, we were

> given some statistics regarding chiropractic usage in Medicare that were

> interesting.

>

> Year Allowed Services Percent of Services Allowed Allowed

> Dollars

> 1996 12,269,909 76%

> $294,691,461

> 1997 12,947,723 78%

> $328,831,199

> 1998 13,386,247 79.40%

> $374,191,291

> 1999 13,290,247 78.10%

> $379,275,897

> 2000 14,336,609 78.20%

> $430,367,416

>

> No one can be satisfied with the way this profession is treated under

> Medicare, further necessitating the passage of the Watkins Bill. The

actions

> that ACA has taken over the last few years have improved our reimbursement

> standing within the restricted parameters that our profession must

operate.

> In 1996 the ACA representatives on RUC/CPT were able to get a new set of

> codes adopted for chiropractic. And as a result of its survey of the

> profession, the codes were accepted by HCFA. The number of dollars

> reimbursed under Medicare increased by 40 million dollars in 1997 when

these

> codes became effective. The allowable services during this time also

> increased substantially, in my opinion, because of the availability of

more

> services to define what we do.

>

> Equally significant was the effect of our legislation eliminating the

x-ray

> requirement under Medicare that became effective in January 2000. Over 1

> million more services were authorized under Medicare from the previous

hours.

> Over 50 million dollars in expenditures over the previous year were

allowed.

> When we were pushing for the passage of this legislation, the

Congressional

> Budget Office was estimating that if passed and signed into law, it would

> cost the Medicare system over $100 million more per year, or $1.5 billion

> over ten years. Well, the projected costs didn't reach the estimates of

the

> Congressional Budget Office, but it wasn't bad.

>

> ACA COMMENTS ON AFFINITY PROGRAMS

>

> The White House Commission on Complementary and Alternative Medicine

Policy

> is scheduled to meet from October 4-6 to discuss the development of its

> report to Congress. The ACA will be attending this meeting. In addition

to

> attending the meeting, the ACA is drafting a letter of concern to the

> commission regarding its deliberation at the last meeting on the use of an

> affinity program. The ACA intends to send a strong message to the

commission

> about its strong opposition to affinity programs for CAM providers. The

> White House has a March 2002 deadline for developing recommendations on

the

> integration of CAM into the health care system. To date the ACA has

> presented oral and written testimony at 5 of the meetings. In addition,

the

> ACA, in response to an inquiry form the commission, provided in-depth

> recommendations on all of its major issues.

>

> ACA WORKS TO IMPROVE SITUATION IN NEW JERSEY FOR OUR DOCTORS

>

> ACA's delegate to New Jersey, Stiso, DC, held a heart-to-heart

meeting

> with Aetna officials in New Jersey on September 13 in which he laid out

the

> long-standing concerns about discriminatory reimbursement practices toward

> the profession. The picture he drew for them wasn't pretty, centering on

the

> ridiculous 200 limit on care within the state. The good news is that he

got

> the attention of not only the state medical director but the legal and

> chiropractic officials of Aetna's home office staff. Aetna is in the

process

> of evaluating a return to fee-for-service and hopes to have this plan in

> place by January 2002 in New Jersey. Several other strides were made as

> well. Aetna plans to drop homegrown codes, and was urged to go with the

CPT

> coding intent which will eliminate inappropriate global fees and bundling.

> ACA recommended clinical integration where a DC would be involved in

making

> Aetna reimbursement policies and guidelines that apply to doctors of

> chiropractic. In New Jersey, Dr. Stiso was invited to participate in this

> advisory committee. Further negotiations are scheduled for October.

>

> SUPPORT FOOT LEVELERS

>

> Earn CEUs and protect chiropractic with the new license renewal seminar

> series, " Seminars in Support, " sponsored by Foot Levelers, Inc. This new

> series was created to help fund the legal action taken against the Health

> Care Financing Administration (HCFA) and Trigon Blue Cross/ Blue Shield of

> Virginia. All registration funds collected from this series will go to

the

> National Chiropractic Legal Action Fund to support both lawsuits.

Register

> now by calling Foot Levelers at 800-553-4860, or visit

www.footlevelers.com.

>

>

> Speakers and Topics -

> · " Implementation of Outcomes Assessment Case Management in the

> Chiropractic Practice " - Kim D. Christensen, DC, CCSP, DACRB

> · " An Outcomes Based Approach To The Chiropractic Practice " - G.

> Yeomans,

> DC, FACO

> Dates and Locations:

> · Charlotte, NC - October 13 - 14

> · Baltimore, MD - November 3 - 4

>

> ACA MEMBERS IN SOUTHERN CALIFORNIA ELIGIBLE FOR MAJOR AUTO DISCOUNT

>

> The Automobile Club of Southern California notified us that they were

making

> available to our members an additional 14% discount on auto insurance

through

> the Auto Club. If you are a member in that area and are interested,

please

> call Grady Locklear, sales agent, Automobile Club of Southern California

> (310-914-2559).

>

[Guest guest]

Dear colleagues things are looking better and better for our landmark federal VA legislation. This will make for excellent legislative ammunition while you are contacting your local legislators as per a level playing field here in Oregon.

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates, and Other Interested Parties From: Garrett Cuneo Re: ACA Executive Vice President Report Date: December 17, 2001*

*Due to the holidays, next EVP report scheduled for January 9, 2002

In this report:

1. VA BILL TAKES A STEP CLOSER TO FRUITION 2. UPDATE ON THE HCFA LAWSUIT 3. UPDATE ON TRIGON BLUE CROSS/BLUE SHIELD LAWSUIT 4. CONGRATULATIONS TO NEBRASKA DOCTORS 5. HIPAA (REVISIONS) 6. SIGNIFICANT IMPROVEMENT ON CCI EDITS 7. ACA WORKS WITH PENNSYLVANIA ASSOCIATION IN DEALING WITH WCRI REPORT 8. KRIPPENDORF HONORED AT FLORIDA CONVENTION 9. ACA SPOKESPERSON MEETS THE MEDIA 10. SPECIAL MEMBERSHIP CATEGORY 11. ACA OFFICE CLOSED BETWEEN CHRISTMAS AND NEW YEAR'S; EVP REPORT TAKES A BREAK

VA BILL TAKES A STEP CLOSER TO FRUITION

The creation of a permanent chiropractic benefit within the Department of Veterans Affairs (DVA) health care system took a giant step forward this past week as negotiators representing the House and Senate Veterans Committees concluded informal negotiations regarding the details of a chiropractic benefit for veterans. The two sides hope to make the benefit law before Congress adjourns for the year. When the agreement was finalized on December 10, the House of Representatives moved quickly to include the agreed-upon legislative language in a veterans benefits bill that was voted on and approved by the full House of Representatives later that same day. The U.S. Senate must now pass a bill identical to the House measure before the legislation can be sent to President Bush. If and when this takes place, the president is expected to sign the measure into law. Although the Senate " calendar " is very busy with time for action running short, most observers believe the Senate will pass the necessary language before they adjourn because House and Senate negotiators were so successful in working out their differences in advance. We will keep you posted.

UPDATE ON THE HCFA LAWSUIT

Both ACA and the feds are waiting for the judge to complete his review of the documents and to make a ruling, which means one of the following: a) One side or the other wins and then determines whether an appeal is necessary, or neither side wins, meaning the case will go forward with normal discovery, allowing ACA to explore just how HHS (formerly HEW) worked with the medical community to thwart the congressional intent to bring chiropractic services to Medicare patients.

UPDATE ON TRIGON BLUE CROSS/BLUE SHIELD

Discovery is proceeding quickly with documentation being exchanged, questions being answered under oath and preparation for depositions beginning.

CONGRATULATIONS TO NEBRASKA DOCTORS

Congratulations to Daryl D. Wills, DC, and the other doctors of Nebraska on the recent ruling by the Nebraska Attorney General. Attorney General Don Stenberg issued an opinion indicating that the Nebraska Board of Chiropractic Examiners was in their right to identify doctors of chiropractic as chiropractic physicians.

A reporter from the Wall Street Journal became aware of the opinion and contacted the ACA for further information. We put the reporter in contact with Dr. Wills.

HIPAA (REVISIONS)

H.R. 3323, The Administrative Simplification Compliance Act, has been passed by the House and Senate and has been sent to the president. The bill would delay by one year the implementation of the electronic transaction standards mandated by HIPAA until October 16, 2003. In order to be eligible for this delay, a provider must submit to the Secretary of HHS an implementation plan. The plan must include: a) a summary of the reasons why the person is not in compliance, a budget, c) a schedule, d) a work plan and implementation strategy to achieve compliance, e) information on whether a person plans to use a contractor or vendor to assist in compliance and f) a timeframe for testing. HHS is required to develop a model form for submission of the plan no later than March 31, 2002. Those found to be in noncompliance would be excluded from participation in the Medicare program.

Also, the bill mandates that all Medicare claims be submitted electronically, effective October 16, 2003. There is a provision, however, that the secretary may waive the electronic submissions requirement if there is no method available for the submission of electronic claims, or if the entity submitting the claim is a small provider. A small provider is defined as a physician or practitioner with fewer than 10 full-time employees.

The doctors will still have to comply next year with the electronic standards and the medical records privacy aspects of HIPAA by preparing compliance plans.

SIGNIFICANT IMPROVEMENT ON CCI EDITS

The ACA gained a sweet victory around CCI edits as it continues its strategy to eliminate other edits that treat doctors of chiropractic unfairly in reimbursement for manual therapy procedures.

As mentioned in earlier reports, the CCI edits developed and used by the Center for Medicare Services (CMS) for Medicare coverage determinations are being used by third party carriers to reduce and deny reimbursement to the chiropractic profession. Dr. Hamm, Dr. McClelland and ACA staff have lobbied CMS in person in the last two weeks to disband edits that are totally unnecessary and which have a direct negative impact on all chiropractors. A concurrent strategy has been to directly attack the use of the CCI edits by private insurers. Dr. Jerilynn Kaibel and her coding committee have spearheaded this initiative with a large national vendor used by local Blues plans and others. This group, known as Claim Check, has notified the ACA that they will drop their edit for denial of Massage Code #97124 in their next release.

This reimbursement policy change with Claim Check is literally a reimbursement gain in the millions of dollars as it is a national change affecting all doctors of chiropractic on a frequently used code.

ACA WORKS WITH PENNSYLVANIA ASSOCIATION IN DEALING WITH WCRI REPORT

The Workers Compensation Research Institute (WCRI) is a national research group that produces much of the workers compensation research reports for workers' compensation in the country. WCRI was recently challenged by the Pennsylvania Chiropractic Association (PCA) and ACA over a negative report that was soon to be released in Pennsylvania. Both the ACA and PCA opposed the way the data was reported, as chiropractic data was included as an integral part of PT and other therapies. WCRI acknowledged the flaw and the study has been corrected. Instead of DC's representing 33% of total workers' comp costs, it is actually .9%. WCRI has published several other studies over the last few months where chiropractic data has been mentioned. The ACA will work with WCRI to determine if prior and future data identification is chiropractic specific. Also, special recognition needs to be given to Dr Tony Rosner from FCER who provided input on this project.

KRIPPENDORF HONORED AT FLORIDA CONVENTION

Last weekend, ACA vice president Don Krippendorf, DC, was honored by the Florida Chiropractic Association at its winter seminar. At a special ceremony, the seminar was dedicated to Dr. Krippendorf for his contributions to both the ACA and the FCA over the last twenty-plus years in practice. The FCA honors at each of their major programs a doctor who has contributed to the success of the profession in Florida.

ACA SPOKESPERSON MEETS THE MEDIA

Throughout November, ACA has had numerous contacts with members of the media regarding chiropractic issues. During that time, Dr. Jerome Mcs, ACA national spokesperson, spoke with a) Jay Green of American Medical News regarding VA legislation in Congress; Julius Karash of the Kansas City Star; c) of the Children's Press on the subject of " touch; " d) Colleen Moriarty of Self Magazine on the subject of handling multiple packages/bags in shopping malls; e) Kirk of Heart and Soul magazine concerning shooting pains down one's leg; f) O'Riley of Fortune Magazine; g) the Army Times on the recent veterans legislation; h) Avery Hurt of Life Health Magazine on the general topic of chiropractic; i) Katrina Waznicki of United Press International on back injuries. He also accepted an offer by the National Women's Health Resource Center of D.C. and New Brunswick to review the manuscript dealing with chiropractic.

A SPECIAL MEMBERSHIP CATEGORY

Please note that ACA Governors Advisory Cabinet (GAC) members may register to attend the March 2002 National Chiropractic Legislative Conference (NCLC) for free. ACA's newest membership classification, an enhancement of Full General DC membership, was launched this spring for leaders in the chiropractic profession who want to take a more active role in shaping the future of the chiropractic profession. Other GAC member benefits include special briefings on hot issues by leadership, free ACA products and/or audio teleconferences, a personalized plaque, membership pin, decal, and badge to denote the special contribution, a free Chiropractic Assistant membership, and much more.

Doctors already enrolled as GAC members include: J. Alpert, DC, L. Baldwin, DC, J. Bazakos, DC, A. Bohn, DC, Leo J. Bronston, DC, D. , DC, Terrance M. Eyerly, DC, Fidler, DC, J. Flynn, DC, W. Hamm, DC, M. Hendricks, DC, Warren T. Jahn, DC, J. Krippendorf, DC, L. Maurer, DC, D. McKenzie, DC, A. Nordstrom, DC, Harold Privette, DC, Viki S. Resler, DC, J. Triano, DC, J. Vendittelli, DC and Daryl D. Wills, DC.

If you are reading this report, you are probably participating in many of these ways already, so why not maximize your investment and get the recognition you deserve? For more information and a membership application, visit <www.acatoday.com/about_aca/membership_gac.html>.

ACA OFFICE CLOSES BETWEEN CHRISTMAS AND NEW YEAR'S; EVP REPORT TAKES A BREAK

The ACA office will be closed from 3:00 pm Eastern time on December 24th until 8:30 am Eastern time on Wednesday, January 2nd. During this time, we will be monitoring calls to the ACA office, and I will be checking my email account in case there are any problems that need to be resolved before we get back to work.

This will also be the last EVP report for the year. Expect the next report to be emailed to you on January 9th or 10th. I hope you have enjoyed these reports as much as I have in putting them together. This is a truly a NEW ACA, and each week I try to show how we are an active and aggressive organization with a single goal of assuring that our profession reaches its proper position in the health care community. If you believe this report would have value to others who aren't members, please feel free to share it with them.

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, ACA Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: January 14, 2002

In this report:

1. ACA RESPONDS TO TRIGON ALLEGATIONS 2. NATIONAL CHIROPRACTIC LEGISLATIVE CONFERENCE 2002 3. CMS CHANGES POSITION REGARDING UTILIZATION PARAMETERS 4. HHS SECRETARY WANTS TO ELIMINATE UNREASONABLE REGULATIONS 5. GIFT FROM THE HEART: FCER'S PATIENT APPRECIATION DAY 6. CONGRESSIONAL BATTLEGROUNDS FOR 2002 7. UPI AND MSNBC.COM COVER CHIRORPACTIC ISSUES 8. ACA MONITORS " ALLY MCBEAL " BROADCAST (PT. 1) 9. ACA MONITORS " ALLY MCBEAL " BROADCAST (PT. 2)

ACA RESPONDS TO TRIGON ALLEGATIONS

You will recall from my previous reports the startling admission made several weeks ago by Trigon Blue Cross/Blue Shield that it pays chiropractic doctors less for the same services provided by medical doctors because " the medical doctor has a higher degree of education, expertise, training, skill and medical knowledge. " ACA's legal team is zeroing in on that pivotal comment in a set of interrogatories filed with the court and delivered to Trigon on December 21. ACA first identifies a laundry list of studies and reports detailing the effectiveness of chiropractic care and the superiority of chiropractic education and training in a variety of areas. In interrogatory #10, the ACA directs Trigon to identify: (1) each CPT code and condition which

Trigon contends its " higher degree " admission applies, (2) the persons and sources consulted and relied upon by Trigon in making its decision regarding the relative qualifications for each of these CPT codes and conditions, (3) just what portion of a medical doctor's education, expertise, training, skill and medical knowledge better qualifies him or her to treat those identified conditions, (4) any study or other information that would lead to the conclusion that any of the reports identified by the ACA on chiropractic effectiveness and education are no longer accurate or otherwise in error.

The battle lines are being drawn on this central issue of reimbursement discrimination that cuts far beyond this one plan alone.

I noted in my report from last week the strong editorial by Dynamic Chiropractic to our lawsuit against Trigon. I understand that the link I cited to the full editorial was incorrect. Here is the correct link <http://www.chiroweb.com/archives/20/01/14.html>.

The editorial is really worth reading! NATIONAL CHIROPRACTIC LEGISLATIVE CONFERENCE 2002

Help push the legislative initiatives of the ACA and respond to the outlandish comments by our opposition by attending our annual legislative conference scheduled for March 6-9, 2002, at the Hyatt Regency Hotel Capitol Hill in Washington D.C. This is the opportunity for the profession to focus their D.C. power over a three-day period. Members of Congress do notice this level of participation as one of the measures of an organization's political strength and commitment. They recognize the cost and commitment that is required by members to attend and are particularly impressed when a member from their district comes by to discuss legislation. But NCLC is more than just an opportunity to promote our agenda and oppose the opposition's agenda. It also offers numerous programs that are useful to doctors back in their respective states. This year will be no exception, with seminars on hospital privileges and HIPPA, marketing, VA and DOD implementation and much more. For a tentative schedule for NCLC, click: <http://www.acatoday.com/about_aca/meetings.html>

CMS CHANGES POSITION REGARDING UTILIZATION PARAMETERS

In a major development, Medicare carriers will no longer be permitted to issue " blanket denials of services that exceed utilization parameters, under a new rules published by the Center for Medicare and Medicaid Services (formerly HCFA). Under the new rule that becomes effective on April 1st, Medicare carriers are prohibited from denying claims that reach a certain utilization review parameter unless: 1) clear policy serves as the basis for the denial; 2) the denial is based on medical impossibility; 3) the carrier sent an additional documentation request (ADR) letter and reviewed the ADR response, but the ADR response failed to support the coverage or coding of the claim, or 4) no timely response was received in response to an ADR letter.

In addition, the new rule allows carriers to release utilization guidelines which should be helpful to doctors of chiropractic in determining when a carrier will deem a service " not reasonable and necessary " .

While this new policy is a positive development for the chiropractic profession, it is now even more important for doctors of chiropractic to ensure that their documentation is strong enough to withstand a complex medical review. We will be providing additional information as this develops.

We have for years been pushing HCFA to require that their carriers be more open regarding their decision-making process. This is a step in the right direction, but with it comes some responsibility on our part.

HHS SECRETARY WANTS TO ELIMINATE UNREASONABLE REGULATIONS

As part of a Department of Health and Human Services-wide initiative to reduce regulatory burdens in health care, HHS Secretary Tommy has requested public input on ways to reduce current burdens imposed by existing HHS regulations. The comments are due to the Secretary by March 5, 2002. The ACA is preparing comments that address our overall concern that the Medicare Part B regulations are an overly strict interpretation of the Medicare statute.

GIFT FROM THE HEART: FCER'S PATIENT APPRECIATION DAY

This Valentine's Day, you can help raise funds for vital chiropractic research while building your patient base by participating in FCER's Patient Appreciation Day program. The ACA Board of Governors has endorsed the program and is urging doctors of chiropractic across the country to band together in support of this event on February 14, 2002. On Patient Appreciation Day, you contribute your services in exchange for patient contributions to FCER. Patients will make a contribution to FCER of either $15 or one-half your usual treatment fee. (Worker's compensation and insurance payments cannot be accepted on your Patient Appreciation Day.) For more information about the Patient Appreciation Day program - or to receive a free kit to help you plan and promote the program -- call FCER toll-free at 800-622-6309. The kit may also be downloaded from FCER's Web site at www.fcer.org <http://www.fcer.org>, but the posters and free brochures must still be ordered via telephone.

CONGRESSIONAL BATTLEGROUNDS FOR 2002

This is going to be an interesting year in politics as both parties try to regain control of their respective Houses without appearing to undermine the efforts to fight terrorism. The Democrats control the Senate by a razor-thin margin of one vote, while the Republicans control the House by a slim five votes. Anything can happen, and the outcome could shift the direction of this country. The stakes are high and we want to be part of the action.

From time to time in my report I will discuss some of the key races that the ACA-PAC is watching and may participate in. These articles will be non-partisan (yes, I can be non-partisan) and will not indicate which way the PAC is leaning on the race. If I did, this would be construed as an in-kind contribution.

It was made official last week - Reps. and Maloney will fight it out for Connecticut's 5th district. The compromise is that Maloney gets an additional 13,000 registered Democrats in the new district. But, 55% of the new district is in 's current district. This has set it up to be a very tight race, with both sides saying they have an advantage. The compromise was necessary when the results of the census report conducted in 2000 caused the state of Connecticut to lose one representative in the House. Two incumbents running in the same district is a nightmare for most political organizations, and this will be a particularly tough one for the ACA-PAC to decide on. Rep. Maloney has been a longtime friend of chiropractic, and recently received the

Connecticut Chiropractic Association's " Legislator of the Year " award. , who is Chair of the important Ways and Means Health subcommittee has said that " a campaign contribution for Jim Maloney is a contribution against . " She has also cosponsored some of our legislation. The PAC will continue to monitor this tight race.

UPI AND MSNBC.COM COVER CHIRORPACTIC ISSUES

ACA's media relations staff was successful in arranging interviews with MSNBC.com and United Press International (UPI) in December.

Dr. Conway, president of ACA's Council on Occupational Health, was interviewed for a story on computer ergonomics for children that was posted on MSNBC.com on December 5. Click here for a link to the story, titled " Keyboarding Kids: Generation at Risk? " <http://www.msnbc.com/news/610811.asp>

In addition, ACA's national spokesperson, Dr. Jerome Mcs, participated in two interviews with United Press International wire service in December. The first interview focused on a recent Ohio State University study on recurring back injury, and the story crossed the UPI wire on

December 1. Click here for a link to the story, titled " Misused Muscles Key to Repeat Back Injury. " <http://www.upi.com/view.cfm?StoryID=30112001-120202-5014r>

In late December, Dr. Mcs interviewed with UPI once again - this time on the topic of preventing winter-related injuries. This holiday feature was released December 26. Click here for a link to the story, titled, " Injury Prevention Makes Holidays Happier. " <http://www.upi.com/view.cfm?StoryID=19122001-125922-5483r>

ACA MONITORING ALLY MCBEAL BROADCAST (PT. 1)

The ACA sent the following message via email to its membership prior to the airing of the January 14 episode of " Ally McBeal. "

In response to a potential attack on the chiropractic profession by Fox Broadcasting Company's " Ally McBeal " television program, American Chiropractic Association (ACA) and Association of Chiropractic Colleges (ACC) staff members have discussed the episode of concern with officials from the program. Earlier this week, Fox aired a promotional piece for the upcoming episode, set to air at 9:00pm Eastern time on Monday, January 14, in which the lead character refers to chiropractors as " quacks. "

As a result of the discussions with Fox officials, ACC executive director O'Bryon learned from Fox's legal counsel that the slur against chiropractic is followed by the lead character receiving chiropractic care and having a beneficial experience. As a result, she refers several other characters to her doctor of chiropractic. In addition, another Fox official indicated to Bernat, ACA's public and media relations manager, that, " because of the quirky nature of the show, the situation could likely be spun into a positive " for chiropractic.

Obviously, there is no guarantee that what Fox considers to be positive for the chiropractic profession will agree with what we believe to be positive for the chiropractic profession. Thus, the ACA and ACC will be monitoring the program closely, poised to respond aggressively if deemed necessary. Should such action be deemed necessary, the ACA and ACC will consider any and all legal or public relations responses that may be appropriate.

ACA MONITORING ALLY MCBEAL BROADCAST (PT. 2)

After viewing the Monday, January 14 episode of the Fox Broadcasting Company's " Ally McBeal " television program, the ACA has decided it is unnecessary to respond aggressively to Fox regarding the episode's chiropractic theme. We had notified our membership via email that, because of a promo for the show that aired the previous week containing a negative reference to chiropractic, we would be monitoring the broadcast to determine whether or not any form of response would be appropriate.

True to the quirky and comedic nature of the show, the chiropractic scenario weaved into the episode's plot was so silly and absurd that ACA would likely come across as defensive and lacking a sense of humor if we responded too harshly. We will, however, be contacting the producers of the program to encourage them to continue to incorporate positive - and realistic - stories about chiropractic in future episodes - a topic on which the ACA would be pleased to provide reliable information.

Note: You are receiving this e-mail because of your affiliation with ACA. You are not receiving this message because you are subscribed to an electronic list. Your email address is not sold or given to other organizations by the ACA. If you have any input you would like to provide about mailings of this type, please e-mail ACA's member services department. (Mail to: MEMBERINFO@... <mailto:MEMBERINFO@...>)

[Guest guest]

ACA EVP Weekly Report

Memorandum to ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: EVP Weekly Report January 20,2002

1. BLUE CCHIP 2. SACA OFFICERS VISIT NATIONAL BOARD 3. ACA LEGISLATIVE INITIATIVES IN 2002: HOW DID WE DO? 4. DR WILLS AT PALMER CHIROPRACTIC COLLEGE 5. HIGHLIGHTS OF NCLC 6. ACA'S OFFICIAL CHIROPRACTIC CODING SOLUTIONS 2002

1. BLUE CCHIP

Since the initiation of Blue CCHIP in December 2001, the clinical integration program, a joint effort with the ACA and the National BC/BS Association, 25 out of 50 states have contacted the ACA with state-level concerns and progress points. Several states, such as Rhode Island, Montana, Nebraska, and

Missouri, already have an established and positive relationship with their local BCBS Plan and are sharing information that will help other states in this integration process.

Staff members in PDR spent the first week and a half after the holidays fielding calls from liaisons and state associations requesting advice and negotiating strategy assistance. Some of the topics and concerns were: coordinating initial meetings with the local BCBS Plan, strategizing upcoming meetings, inconsistent and poor reimbursement practices within the plan, FEHB questions, conversion factors, and inequity in RUVs.

The ACA is continuing to work with the National BCBS Association, local BCBS Plans, chiropractic liaisons, state associations, and state delegates on a daily basis to obtain equal reimbursement and fair treatment for all doctors of chiropractic. If you have any questions or concerns about Blue CCHIP, please contact the ACA's Office of PDR.

Like anything else, there is no guarantee that these discussions will resolve the problems facing doctors in individual states, but it's an important beginning. And ACA reserves the right to continue its suit against National

Blue Cross/Shield if we aren't satisfied with the results.

2. SACA OFFICERS VISIT NATIONAL BOARD

SACA National Officers will be meeting with the leaders of NBCE on February 1, 2002, to visit the facility and, more important, to learn of the National Board's plans and to discuss the concerns that students may have regarding its examination procedures and policy. SACA leaders are canvassing their student members about the issues to be raised. The National Board is showing a willingness to reach out to the student population in a way that we have not seen before to allow issues to be addressed, even the most sensitive ones. Both the ACA and the National board are financially supporting the student leaders.

You may not always like the answers you get, but at least you are getting an opportunity to ask them, which is a step in the right direction.

3. ACA LEGISLATIVE INITIATIVES IN 2002: HOW DID WE DO?

Veterans Administration - In late December, the U.S. Senate passed legislation mandating the establishment of a permanent chiropractic benefit within the Department of Veterans Affairs (DVA) health care system. The legislation (H.R. 3447), was passed by the Senate late in the evening of December 20 during one of the last actions of the 107th Congress before its adjournment for the year.

Because the U.S. House had previously passed the legislation on December 10, the bill has now been cleared for White House consideration. We learned on Friday, that the bill was presented to the President on January 11th. He has 10 days ,excluding Sundays, to sign it. All indications are that the President will sign the bill into law. I have seen one press release from a group of veterans' organizations praising the provisions in the bill and specifically mentioning the chiropractic provision. Stay tuned.

Student loans - As earlier reported, the Senate Health Education Loans and Pensions (HELP) Committee moved to include doctors of chiropractic in the NHSC program for a three-year period. This provision guarantees that doctors of chiropractic will receive loan reimbursement under the NHSC program. After the committee approved the legislation, it was cleared for consideration by the full Senate. The full Senate would have likely voted on the legislation in September, but because of the terrorist attacks on September 11, no further action has been taken on this issue. The House and Senate will likely continue action on this important legislation this year. The ACA and ACC will continue to work with key members of the Senate to ensure that the chiropractic provision remains in the bill when the NHSC legislation is considered on the floor of the Senate. The ACA and ACC will also work for the inclusion of a chiropractic provision in the House version of the legislation.

DoD appropriations - The ACA continues to work to expedite the integration of chiropractic care in the DoD health care system. To accomplish this, the ACA and ACC worked to increase the level of appropriations funds for the program. While Congress did not appropriate additional money, the House included language in the report that accompanied its version of the DoD appropriations bill that supports ACA's position. It states, "The Committee supports the provision of chiropractic care at designated military treatment facilities, and expects expansion of the service as appropriate." The ACA will continue to work on this issue this year.

Medicare - The ACA continues its effort to expand patients' access to chiropractic care and end the long discrimination against doctors of chiropractic in the Medicare program. To address this issue, Congressman

Wes Watkins, on behalf of the ACA, introduced "Chiropractic Patients' Freedom of Choice Act" H.R. 902 in the 107th Congress. This legislation would provide reimbursement to DCs for all Medicare services within their states' scope of practice. H.R. 902 has received strong bipartisan support in the House of Representatives. It already has 53 cosponsors.

As earlier reported, an issue has developed regarding the single conversion factor that is used to determine reimbursement rates for health care providers in the Medicare program. On November 1, 2001, the Centers for

Medicare and Medicaid Services (CMS), formerly known as the Health Care Financing Administration (HCFA) published in the Federal Register the FY 2002 Medicare Physician Fee Schedule. Due to new economic data from a slowing economy, the conversion factor used to calculate Medicare payments will decrease in FY 2002 by 5.4 percent. To remedy this problem, the ACA has been working with a large coalition of health care groups, including the AMA. This coalition is working to convince members of the Senate and House of Representatives to delay the implementation of the 2002 fee schedule until permanent changes can be made in the update formula and to develop a more appropriate long-term solution. In November, legislation was introduced into the House (H.R. 3351) and the Senate (S. 1707), designed to put a hold on the current flawed formula used to figure out the single conversion factor. Both bills contain a provision that disregards the formula for 2002 and sets the adjustment factor at the 2001 level, minus 0.9%. Each bill also states that the original provision passed in 1997 will be used again after the period of one year. Currently, H.R. 3351 has 287 cosponsors, while S. 1707 has 65 cosponsors. Another bill, designed to address the issue by freezing the conversion factor at 2001 levels for the first six months of 2001, has also been introduced. This bill, HR 3511, has 3 cosponsors. The ACA is working to get cosponsors and working for the ultimate passage of both bills. The ACA will continue to monitor the situation and alert the chiropractic profession when grassroots action is necessary.

The ACA Legislative Commission met this past week to review our legislative initiatives for the past year and to recommend to the BOG its legislative agenda for 2002. Look to my report next week for a summary of the Board's recommendations.

4. DR WILLS AT PALMER CHIROPRACTIC COLLEGE

At the invitation of Dr. Guy Riekeman, President of Palmer College of Chiropractic, Dr. Daryl Wills, ACA President, traveled to Davenport to address the college's students regarding the lawsuit filed by ACA against HHS and against the Blues. More than 900 students were in attendance and the presentation was well received. We understand that the students made contributions to the suit that may be matched by Dr. Riekeman.

Dr. Wills also had a chance to speak with the SACA Officers from Palmer including Olszewski, who also serves as the National Chair. Additionally, Dr. Wills had a chance to talk with Dr. Riekeman and tour the campus.

5. HIGHLIGHTS OF NCLC

You already know that NCLC is an annual event that focuses the political resources of the association during a three-day period to pressure members of Congress to support the chiropractic agenda. But NCLC is more than just legislation and this meeting is no exception. Over the next couple of reports, I will be focusing on specific events during NCLC week. Today, I want to highlight one program that will occur on Wednesday afternoon of NCLC.

From 1:00 pm to 3:00 pm on Wednesday afternoon, March 6, we will be presenting a "practice promotion" seminar designed to give doctors ideas on ways to successfully promote their care to the public, the media, and community groups. Immediately following this program will be a special presentation on the implementation of the Veterans and DOD legislation.

Dr. Bautch, immediate past president of ACA's Council on Occupational Health, has offered to conduct the entire seminar for us at no cost to the ACA. Dr. Bautch is chairman of the Board of Allied Health of Wisconsin, one of the largest chiropractic organizations of its kind providing the highest standards of care, a broad selection of specialized services, and consistent clinical and administrative practices at offices throughout Wisconsin. Dr.

Bautch and his associates have done a terrific job promoting chiropractic through media and community relations, and would provide tips and examples of

simple, low-cost ways to get the chiropractic message out in local areas.

For more information on NCLC or to register, visit our Web site at <http://www.acatoday.com/about_aca/meetings.html> or call ACA at 800-986-4636.

6. ACA'S OFFICIAL CHIROPRACTIC CODING SOLUTIONS 2002

ACA's Official Chiropractic Coding Solutions 2002 has been revised and expanded this year to include critical coverage of CCI edit relief, an expanded diagnosis section, an expanded HCPCS section, updated Medicare ABN, a free CD-Rom, and much more! It's also the only book on the market covering Federal Workers' Compensation.

NEW: Purchase the booklet and sign up for quarterly breaking news updates on coding, HIPAA, Medicare, and more. It's the most accurate and timely news you need to run your practice. For the book, four updates, and the CD-Rom, the price is only $49.95 for ACA Members, $79.95 for Non-members. Order Item CPT2002N. (Price for Book and CD-Rom only: ACA Members - $39.95, Non-Members - $65.95. Order Item CPT2002).

For more information, go to <http://www.acatoday.com/products/pm_products.html>. To order, call 800-368-3083 or go to <http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2 & pf%5Fid=136>.

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: February 4, 2002

In this report:

1. 50th ANNIVERSARY PARKER SEMINAR: AN HISTORICAL HAPPENING: NO KIDDING 2. ERISA DEVELOPMENTS 3. MEMBERS OF CONGRESS DEMAND MORE CHIROPRACTIC CARE 4. A RACE WORTH WATCHING 5. FIRST CHIROPRACTIC MANAGED CARE SUMMIT: MUCH WORK TO BE DONE 6. ACA IS PROACTIVE REGARDING POTENTIAL TERRORISM AT OLYMPIC GAMES 7. SACA STUDENTS WILL BE HIGHLY VISIBLE AT NCLC 8. NORTHWESTERN COLLEGE OF CHIROPRACTIC STUDENTS DOING THEIR PART 9. DEMYSTIFYING MEDICARE

LATE BREAKING NEWS: HHS ISSUES REVISED POLICY DIRECTIVE TO CARRIERS REGARDING PHYSICAL THERAPIST PROVIDING THE CHIROPRACTIC BENEFIT UNDER MEDICARE. IT'S TERRIFIC. MORE DETAILS WILL FOLLOW THIS REPORT.

1) 50th ANNIVERSARY PARKER SEMINAR: AN HISTORICAL HAPPENING

The 50th Anniversary Seminar was everything I thought it would be. Over seven thousand doctors, students and chiropractic assistants converged on the Rio Suites in Las Vegas for a four-day conference featuring some of the leading chiropractic and pro-chiropractic speakers in the country. It was also an opportunity for us to get the message out about our two lawsuits to an audience that we are seldom able to reach. The principle sponsors, Dr. Fabrizio Mancini, representing Seminars, and Dr. Kent Greenawalt of Foot Levelers, helped promote the lawsuits by providing us with multiple locations to display our materials, writing letters to the attendees in support of the suits, and by encouraging instructors to promote the issue in their classrooms. Mcs was given three different opportunities to address the attendees. Mark Victor Hansen, one of the major speakers at the program, proudly wore the Save Our Subluxation (S.O.S.) badge and told his audience of over 5,000 people about the importance of supporting the lawsuits. To me, the most significant moment occurred Friday evening when the leadership of the entire profession, with individuals who haven't been able to agree on a single issue since Wilk, came together to show their support for the lawsuits. Take a look at our Web site at: <http://www.acatoday.com/about/meetings.shtml> to see a portrait of solidarity. These pictures were taken immediately following the presentation by Goodman. What you do not see is that immediately before Mr. Goodman's presentation, Dr. Mancini and Mr. Greenawalt introduced the presidents of the ICA, ACA and WCA. All three indicated their support for the lawsuits. Even the most battle-hardened warrior from the philosophy wars would be impressed by this event.

You might want to make a copy of the picture and put it in your scrapbook. You can bet that when the history of the profession is written, this occasion will achieve prominence.

The Seminar was also successful from a financial standpoint, as we were able to raise a quarter of a million dollars for the National Chiropractic Legal Action Fund. More about that in my next report.

2) ERISA DEVELOPMENTS

You may have noticed in the news that the U.S. Supreme Court heard arguments in a landmark ERISA case this past Wednesday. The case, titled Rush v. Moran, deals with the central question of preemption of a state law established to assure proper external review of a HMO beneficiary's claim. The HMO is arguing that the state law is preempted by ERISA. There are over 40 similar state laws that currently hang in the balance with this decision. ACA aggressively lobbied last year for the inclusion of an external appeals provision in the Federal Patients

Bill of Rights that would have, among other things, assured that chiropractic services are reviewed by chiropractors. The eventual outcome of this case will have a strong impact not only on the various state external review laws but also upon the eventual shape of any federal external review protection. We are obviously watching this one closely.

In a somewhat related development, the U.S. Department of Labor has published a new set of standards for processing health benefit claims under ERISA. These new regulations are now in effect. Among other things, these new regulations require ERISA plans to identify and provide upon request to the patient a copy of the "internal rule, guideline or similar criteria" used as a basis for making a benefit determination. In addition, the new rules require ERISA plans to identify the medical experts consulted in the course of an adverse benefit claim determination. This approach is very much in line with the recent decision of CMS to provide greater information in connection with the release of utilization criteria related to chiropractic claims under Medicare.

3) MEMBERS OF CONGRESS DEMAND MORE CHIROPRACTIC CARE

Dr. Bill , with the assistance of Dr. Terence Kearney, has been providing chiropractic care one day a week at the Capitol to members of Congress. Both doctors practice out of Bethesda Naval Hospital in Washington, D.C. Located in the basement of the Capitol is a fully equipped health care facility, which only members of Congress can visit to receive treatment. All medical and dental services are made available to members of Congress. The demand for chiropractic care has been so great that prominent members of Congress recently wrote the Rear Admiral responsible to the clinic requesting that Dr. be authorized to spend additional time at the facility.

Quoting from the letter, "...the schedule of Congress does not afford opportunities for all to see Dr. on the day he is scheduled to visit. Many members of Congress have expressed great interest in expanding chiropractic care in the Office of the Attending Physician."

The letter is signed by the following: Speaker of the House Dennis Hastert, Senators Jim Inhofe, Strom Thurmond, Orrin Hatch and Rick Santorum, and Representatives Dana Rohrabacher, Manzullo, Dan Burton, Condit, n Berry, Neil Abercrombie, McCarthy, Alcee Hastings, Drier, Jim , Bono, Ackerman, Dennis Rehberg, Wes Watkins, Aderholt and Barbara Lee. I understand that this is only a partial list.

The letter is really something.

As you will recall, legislation initiated by the ACA and passed in 1998 established a chiropractic presence at the Bethesda and Walter Hospitals in Washington, D.C. It wasn't long after that when members of Congress took the opportunity to have our doctors present at the medical center in the Capitol building.

4) A RACE WORTH WATCHING

The ACA-PAC is currently tracking a number of close and important congressional races. One race of particular interest involves a strong chiropractic champion in Michigan. Congressman Fred Upton (R-MI) has been a strong supporter of chiropractic initiatives during his eight terms in Congress. It is the ACA-PAC's understanding that Rep. Upton faces a significant primary challenger. Michigan's 6th district is typically a Republican seat, however the boundaries have recently been withdrawn. Even so, the winner of the primary will most likely win in the general election. While he has not officially announced, term-limited state senator Dale Shugars is shaping up to be a formidable challenger. The ACA will continue to watch this race very closely and will alert the profession of any developments.

As I indicated previously, don't look to this report to indicate a preference in this race. I will let other periodicals provide that information. In a previous report, I discussed the difficult race between Congressman Jim Maloney and Congresswoman . According to a report from Congressman Maloney's office, Maloney has out-raised during a period of 7/1/01 to 12/31/01 $336,000 to $316,000. This information continues to confirm that this will be a close race and that a lot of money will be spent by both sides.

Look to future reports on the race between Senator Tom Harkin and Congressman Greg Ganske, MD. A report came out the other day which showed that Harkin had in the bank $2.2 million to Ganske's $1.1 million. This is going to be an interesting and expensive political year.

5) FIRST CHIROPRACTIC MANAGED CARE SUMMIT: MUCH WORK TO BE DONE

In early January, the ACA held its first Managed Care Summit with representatives from several national chiropractic managed care organizations. The main goals of the meeting were to discuss issues of concern between practitioners and MCOs, initiate an open forum on ways ACA can support practitioners while working with the networks, and to review a proposed MCO "code of conduct" drafted by ACA. Chiropractic MCOs represented at the summit included Access Managed Health Care, Alignis, Alternative Medicine, Inc., American Chiropractic Network, Inc., American Specialty Health Network, ChiroAlliance Corporation, Complementary Healthcare Plans, Landmark

Health Care, Inc., Managed Physician Network, Michigan Chiro/Net Corporation, Prism Health Networks, The Dominion Consulting Group and Triad Health Care, Inc.

Representing the ACA were Professional Development and Research vice president Pat , members of the ACA Insurance and Managed Care Committee including Don Krippendorf, DC, Gentile, DC, and Spoto, DC. Also participating were Mr. Tom Daly and myself.

It was a lively discussion (sometimes disappointing) covering a broad spectrum of subjects, with the needs of practitioners and patients often at the center of discussion. I made the open remarks, noting that ACA and the chiropractic networks were at a crossroads, needing to find a means of working together collaboratively. I indicated that if satisfactory results could not be achieved after all means of working together had been exhausted, the only alternative to assist practicing doctors of chiropractic is to take a more confrontational approach to the issues. We learned of the problems facing their industry and began the work of attempting to reach consensus on a code of conduct.

Look to future issues of my ACA EVP weekly report for further updates, including the status of the code of conduct.

6) ACA IS PROACTIVE REGARDING POTENTIAL TERRORISM AT OLYMPIC GAMES

As the 2002 Winter Olympics in Salt Lake City approach, the American Chiropractic Association (ACA) is urging doctors in Utah and surrounding states to be prepared to assist the Red Cross in the event of a crisis situation. The ACA has a formal relationship with the American Red Cross to provide assistance during times of disaster. As part of this relationship, ACA doctors of chiropractic need only complete a short orientation/training program in order to be authorized to serve as volunteers in the event of disasters.

This program, open to ACA members only, represents a great opportunity for the chiropractic profession. While participants do not provide chiropractic treatment, they are authorized to offer invaluable volunteer support that will not only assist disaster victims, but also increase the chiropractic profession's visibility and improve relationships with other health care professionals in our communities. It is possible that the volunteer role will eventually be expanded to include providing chiropractic services.

If you would like more information about ACA's statement of understanding with the Red Cross, contact Bernat at pbernat@... <mailto:pbernat@...>. In addition, call your local Red Cross for more information on dates, times and locations of local training programs.

7) SACA STUDENTS WILL BE HIGHLY VISIBLE AT NCLC

Once again, a large number of SACA students of chiropractic colleges from throughout the country will converge on the Capitol from March 6-9 in support of chiropractic legislation. Already, ten schools have reported the following numbers of attendees: Palmer College of Chiropractic: 20; Palmer College of Chiropractic-West: 6-8; College of Chiropractic: 8; National University of Health Sciences: 20; Texas Chiropractic College: 20; Western States Chiropractic College: 10; Los Angeles College of Chiropractic: 20.; NYCC 60; Logan 22; and Northwestern 38

It is important to note that the cost for travel and lodging is generally borne by the students themselves. They spend the entire year raising money for the opportunity to support this cause.

8) NORTHWESTERN COLLEGE OF CHIROPRACTIC STUDENTS DOING THEIR PART

Over twenty-five students from the Northwestern College of Chiropractic plan to work during a game of the Minnesota professional hockey team, hoping to earn up to $3,500 to be contributed at NCLC for the ACA-PAC and the Legal Action Fund.

9) DEMYSTIFYING MEDICARE

The ACA has developed a revised edition to help provide even greater understanding of Medicare regulations. ACA's Medicare Solutions Manual will guide you through the claims process, building accuracy and helping to ensure you receive the reimbursement you deserve! This revised edition also features: new, non-covered service modifiers for 2002, the new ABN form with clarification, an expanded documentation section, and a section on health professional shortage areas.

To order, call 800-986-4636 or visit us at: <http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2 & pf%5Fid=137>

We have placed my weekly EVP report on our Web site, where members and non-members can download the report in various formats. We will have the report available in Microsoft Word (.doc), Corel WordPerfect (.wpd), and standard text (.txt) formats.

This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to <kpark@...> and change the subject to read: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: February 18, 2002

In this week's report:

1. ACA FILES MOTION TO COMPEL TRIGON BLUE CROSS/ BLUE SHIELD TO ANSWER INTERROGATORIES: LAWSUIT HEATS UP 2. MCANDREWS LAW FIRM RECOGNIZED AGAIN 3. THE DOCTORS BEHIND DEREK PARRA 4. CANADIAN STROKE STUDY PROMPTS STRONG RESPONSE FROM ACA 5. STUDENT ACA MEETS WITH NATIONAL BOARD 6. LINK TO CONGRESSIONAL LETTER DEMANDING MORE SERVICE AT CAPITOL 7. LIST OF COSPONSORS SUPPORTING THE WATKINS BILL CONTINUES TO GROW 8. ACA COMMENTS ON ERRONEOUS INFORMATION GIVEN TO WHITE HOUSE COMMISSION ON ALTERNATIVE MEDICINE 9. ACA-PAC KEEPS AN EYE ON A CONGRESSIONAL RACE IN MICHIGAN 10. FOOT LEVELERS SEMINARS SUPPORT THE LAWSUITS 11. BLUE CCHIP UPDATE 12. ACA LONG-TERM CARE AVAILABLE IN A FEW STATES

1. ACA FILES MOTION TO COMPEL TRIGON BLUE CROSS/ BLUE SHIELD TO ANSWER INTERROGATORIES: LAWSUIT HEATS UP

As previously reported, ACA attorneys filed a set of follow-up interrogatories with Trigon centering on the contention that Trigon BC/BS often pays "limited-license providers [e.g. chiropractors] less than we pay medical doctors for the same procedure." In ACA's follow-up to that admission, we set forth studies and sworn testimony by medical authorities that contradict Trigon's implication that medical doctors have a higher degree of medical knowledge and skill than do doctors of chiropractic with respect to musculoskeletal conditions. We then asked Trigon to specify how these studies and testimony relate, if at all, to their discriminatory reimbursement policies, and to let us know which of the studies and sworn testimony do they view as not being credible, along with the reasons for that belief. Since Trigon has resisted responding to these follow-up inquiries, we have filed a motion with the court to order Trigon to answer these questions.

2. MCANDREWS LAW FIRM RECOGNIZED AGAIN

There is no question about our lead counsel's loyalty to the chiropractic profession. Mcs' father was a doctor of chiropractic, his brother and sister are doctors of chiropractic, and he encouraged his daughter to become a doctor of chiropractic. While commitment is important, so is competency. Mr. Mcs and his firm are known as one of the outstanding operations in the country. His firm was recently recognized in the Global Counsel 3000, a worldwide publication listing the recommendations of corporate in-house counsel for engaging outside counsel. Mr. Mcs' firm was designated as one of six "highly recommended firms" in Chicago for intellectual property law, while Mr. Mcs was designated as one of only four "highly recommended individuals." Although commitment and skill are a difficult combination to find in an attorney, we have one as our lead attorney in the lawsuits against the federal government and Trigon Blue Cross/ Blue Shield.

3. THE DOCTOR BEHIND DEREK PARRA

Hopefully you saw Parra win the Olympic silver medal in an event (the 5,000 meters) that is not even considered his best , on February 9th. His best event is the 1,500 meters competition, which is scheduled for Tuesday, February 19th, at 1:00 pm Mountain time. Look for him again on Friday, February 22nd, in the 10,000 meters competition at 12:00 noon Mountain time.

When he was interviewed immediately after winning the silver medal, he thanked his psychologists and his "doctors." So we have specifically requested that when he wins the gold medal in the 1,500 meters to explicitly mention his chiropractic doctors. is a strong chiropractic patient, and his doctor and the unofficial doctor of the American speedskating team for the last three years has been ACA delegate to Connecticut, Dr. Overland. He is credentialed to treat athletes at the Olympics in an area called the "high performance center." It was Dr. Overland who suggested to the ACA and ACAuxiliary to become sponsors of over a year ago.

I would be remiss if I didn't also recognize Dr. Robin Hunter, the first chiropractic doctor to serve on staff of the USOC Winter Olympics committee. Dr. Hunter has been in Salt Lake City for over a month.

Another chiropractic success story...

On Tuesday, February 13, Takeshi Honda, a member of the Japanese men's skating team had just finished a perfect performance in the Short Program. As he was leaving the ice, the commentator mentioned that, "he sees his chiropractor and acupuncturist twice a week."

The Olympics really is a great place to demonstrate the effectiveness of chiropractic care.

4. CANADIAN STROKE STUDY PROMPTS STRONG RESPONSE FROM ACA

The ACA is denouncing as "junk science" a recent paper by Canadian neurologists regarding chiropractic and the risk of stroke. The study, which is extremely limited and seriously flawed, has needlessly alarmed patients about one of the safest and most effective treatments in health care today, according to the ACA. The Canadian neurologists' study, presented by Dr. W. Norris and colleagues at the American Stroke Association's 27th International Stroke Conference, contained no control group; it was essentially a random opinion survey based on the whims of doctors who themselves decided to participate. This outrageous paper is being falsely portrayed as legitimate science and leaves many basic questions unanswered.

A February 11 Reuters Health wire story on the study stated that the results were "prompting some Canadian neurologists to campaign against neck manipulation by chiropractors." Unfortunately, the Reuters story contained no chiropractic perspective and incorrectly stated that the ACA had not responded to requests for comment by press time. ACA's spokesperson on this issue, Dr. Bill Lauretti, had indeed responded to Reuters' call by deadline, but due to a mix-up on their end, his phone call was not returned before the story was released. Upset by the unfair treatment of chiropractic in the article, ACA's media relations staff contacted the Reuters reporter and urged a follow-up story containing ACA's take on the study. Yesterday, that story was released by Reuters, and it can be found here: <http://story.news./news?tmpl=story & u=/nm/20020214/hl_nm/chiro_1>.

ACA's full response to this extremely flawed study can be found on ACA's Web site in the "Hot Topics" section, at: <http://www.acatoday.com/hot_topics/021402.shtml>.

5. STUDENT ACA MEETS WITH NATIONAL BOARD

The four national officers of SACA (Student ACA) met with the leadership of the National Board of Chiropractic Examiners at NBCE facilities in Greeley, Colorado, February 1, 2002. Representing SACA were: Olszewski, national chair, Palmer College of Chiropractic;

Craig Caviness, vice chair, New York Chiropractic College; Nick Mellum, legislative chair, Northwestern Chiropractic College; and Dana Weissman, vice legislative chair, New York Chiropractic College.

The agenda for the day included a tour of the facilities and presentations about NBCE test design and development, Part IV Practical examination process, application processing, exam scoring and reporting, and current projects including the possibility of computerized testing. The four student leaders discussed concerns with NBCE that they received from chiropractic colleges throughout the nation regarding NBCE policies and procedures for the examinations. The visit proved to be very informative and "eye-opening" for the students, who feel that they now have a greater appreciation for the operations of the National Board. The SACA officers will be discussing their visit with the leadership of the SACA chapters in the upcoming weeks, as well as working to effectively communicate their learning experience with chiropractic students throughout the United States.

6. LINK TO CONGRESSIONAL LETTER DEMANDING MORE SERVICE AT CAPITOL

For those of you interested in viewing the letter signed by numerous members of Congress to the Admiral who oversees the medical center at the Capitol requesting the additional days for our chiropractic doctor to treat members of Congress, go to: <http://www.acatoday.com/pdf/feb04.pdf>.

7. LIST OF COSPONSORS SUPPORTING THE WATKINS BILL CONTINUES TO GROW

The bill introduced by Congressman Wes Watkins that would expand the services reimbursable under Medicare continues to gain support in Congress.

With VA and DOD wins under our belt, the Government Relations department is turning its attention to getting the chiropractic provision inserted into a Medicare vehicle, which is in the early stage of formation. This will take a major effort as we must demonstrate through co-sponsorship the broad, bipartisan support for this provision in order to be included in the major vehicle. This measure will be one of the primary focuses at NCLC when the conference is held in March.

For a listing of the current sponsors and other pertinent information, please go to: <http://thomas.loc.gov/cgi-bin/bdquery/z?d107:HR00902:@@@P>.

If your member of Congress has agreed to cosponsor the bill, send him or her a thank you letter. If not, ask him/her to cosponsor this important measure.

8. ACA COMMENTS ON ERRONEOUS INFORMATION GIVEN TO WHITE HOUSE COMMISSION ON ALTERNATIVE MEDICINE

The ACA wrote a letter to the White House Commission stating that the comments made by the chiropractic doctor on the commission that we weren't trained to provide nutritional counseling were grossly incorrect. We pointed to the training our doctors receive in chiropractic college and noted that the scope of practice for our doctors included nutrition. We also pointed out that our doctors are qualified to serve as primary health care providers. For a complete text of our letter, visit the following section of the ACA Web site: <http://www.acatoday.com/government/white_house/0202_testimony.shtml>

9. ACA-PAC KEEPS AN EYE ON A CONGRESSIONAL RACE IN MICHIGAN

Once every ten years the federal government conducts a census of the American population. The results have a profound effect on how and where federal dollars are spent, and equally important, can determine the political survival of members of congress and of state legislators. Naturally, this aspect of the process is highly political. The number of congressional seats in each state can increase or decrease based on the fluctuation of the population in the state. This year is no exception, as some states with increased population increased their number of representatives, while other decreased. Since Michigan lost population, in redrawing the congressional lines some incumbents landed in the same district as one another. In a state like Connecticut, where two congressmen ended up in the same district, at least each was from different parties. But in Michigan, thanks to the Republicans who control the redrawing process, two incumbents from the same party ended up in the same district. Unless the congressional redistricting lines are thrown out by the court, which is not expected to happen, 24-term Rep. Dingell (D-MI, ranking member on Energy and Commerce) will face a tough primary against fellow Democrat incumbent Rep. Lynn Rivers. This has naturally caused a split within the Democratic party in Michigan, and has caused repercussions within the Democratic caucus. Recently, Congresswoman Pelosi, the third most powerful democratic woman in Congress, had to explain a contribution she had made earlier in the year to Representative Rivers. The court decision is expected in April. This will be a very interesting race to watch.

10. FOOT LEVELERS SEMINARS SUPPORT THE LAWSUITS

In conjunction with the 50th anniversary of Foot Levelers, the company is sponsoring a series of 18-hour seminars throughout the country, including some of the most prominent speakers in chiropractic. Included in the programs are Drs. Mark Charrette, Austin, Gentempo, Kim Christensen, Danchik, Kirk Lee, Terry Yochum, , K.S.J. Murkowski, Olsen and Hyland. Continuing education hours have been requested.

Fifty percent of the registration fee goes to the National Chiropractic Legal Action Fund, which supports our lawsuits against Trigon and the federal government, with the balance going to your school of choice.

The programs are being offered at the following locations and times: March 22-24 in San , California April 26-28 in Newark, New Jersey May 17-19, in Minneapolis, Minnesota

To register, contact Foot Levelers at 800-553-4860, or visit <http://www.footlevelers.com>.

11. BLUE CCHIP UPDATE

Blue CCHIP Trends...

· 29 states have called or written to their local plans requesting a meeting · 18 states had meetings with their local BC/BS plan or have one scheduled · Network plan contacts are being responsive in the majority of the states · In longstanding talks with their local Blues, Vermont and Rhode Island have had their yearly visits increased · DCs in Tennessee are now able to bill for 146 diagnoses, up from 25, can use numerous procedure codes that they were not able to in the past, and are able to bill for any appropriate diagnosis on the first visit for diagnosis and referral.

· In New York, Excellus BC/BS has established a chiropractic advisory panel, and the plan will start a chiropractic column that will be included in their monthly newsletter to all providers to help educate them on chiropractic care. Dr. Herd, liaison for this plan, will be meeting with Excellus officials on the campus of the New York Chiropractic College in April to show them what kind of training a DC receives and their level of education.

· Mississippi and Alabama have engaged in talks with their local BC/BS plans after a long hiatus. · Plan contacts in Hawaii and North Carolina were unaware of the Blue CCHIP initiative when contacted by the liaisons. The National Blue Cross/Blue Shield association feels this is a matter of semantics, since many of the plan contacts are not familiar with the Blue CCHIP language, as it is a term the ACA adopted internally to identify the project for the chiropractic liaisons. It is known as a communications program within the Blues.

* In an early program move, the BC/BS plan in South Dakota has recommended to its medical policy-making board the inclusion of Dr. Tom Ivey, Blue CCHIP state chiropractic liaison in the state. Following the lead of the Blue CCHIP process, Dr. Ivey has been in dialog with the Blues medical director and has lobbied for an important seat on their reimbursement committee. It's one of those things that won't happen unless you ask. It comes on the heels of an announcement by ACA that the Blue CCHIP program is working.

12. ACA LONG-TERM CARE AVAILABLE IN A FEW STATES

As the nation's population ages, long-term care insurance is becoming increasingly popular. This month, JLT Services, Inc., will begin offering ACA long-term care insurance to members in Michigan, Indiana, Illinois, Pennsylvania and Missouri. To learn more about this new ACA benefit, call 800-544-2672, ext. 1108.

For some valuable information on long-term care insurance, including when and how much to buy, visit: <http://www.kiplinger.com/magazine/archives/2001/March/managing/ltcare.html>

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: Feb. 25, 2002

In this week's report:

1. SENATE MAJORITY LEADER TOM DASCHLE COMMENTS ON VA BILL 2. JUST SPELL MY NAME RIGHT (APTA and AOA SPIN THEIR STORIES) 3. PARRA WINS GOLD MEDAL 4. CORRECTION 5. ACA-PAC: HOW WE STACK UP TO OTHERS (UPDATE) 6. REDISTRICTING WILL CLAIM ANOTHER VICTIM 7. ACA COMMENTS TO INSURANCE COMMISSIONERS REGARDING APPROPRIATE REVIEW 8. COMEDY IS NOT FUNNY: ACA RESPONDS TO DAVID SPADE 9. ACA COMMENTS TO HHS 10. FREE OFFER FROM FCER 11. SEMINARS AT NCLC HELP BUILD AND PROTECT YOUR PRACTICE

1. SENATE MAJORITY LEADER TOM DASCHLE COMMENTS ON VA BILL

What is that old expression...success has many fathers and failure is an orphan. I have commented in amusement about the number of organizations taking credit for the passage of the VA bill. I guess I would expect each group to spin the results to suit their audience. So where is the truth? Well, as an ole political hack I believe a strong fulltime lobbying team, a strong

PAC and an effective grassroots organization are the ingredients for success. We are the only national organization with these three ingredients. But you don't have to believe this spin doctor, get it from someone with credibility, like the Senate Majority Leader. Even the most ardent zealot would have to recognize his word. In a letter from Senator Daschle to Dr. Kerwin Winkler, he stated in part, "...Because of the leadership and determination from you and the American

Chiropractic Association, chiropractic care will soon be extended to both military personnel an our veterans...I appreciate your counsel on this issue and am proud of what we have accomplished together."

For the complete letter, go to: <http://www.acatoday.com/hot_topics/>

2. JUST SPELL MY NAME RIGHT (APTA and AOA SPIN THEIR STORIES)

You know that you have arrived as an organization when your opposition starts to use your name in their membership recruitment letters. Over the last couple of weeks, two of our "friends" have done so:

The American Osteopathic Association membership recruitment letter chirped about how "hundreds of osteopaths" had successfully stopped our attempts to be designated as primary care providers in the veterans administration bill...Quoting the letter, "We hate to say it, but this was a close one. What's worse? The issue may soon return. And, when it does, we'll need twice the help. Without your active participation, we may not be so lucky next time." What they fail to note is that chiropractic did become a permanent part of the Veterans Administration and that the legislation includes language on the establishment of protocols for direct access to chiropractic care, one of the reasons that primary care inclusion was important.

The APTA has also been using us as their poster boy. In a January 10th membership letter, on the top right hand, they quote an ACA alert that stated, "The physical therapists now make the outlandish claim that they perform spinal manipulation to correct a subluxation." This was referring to their brief to the court, which among other things, stated that they have been correcting a subluxation for years.

The opening paragraph of the recruitment letter refers to the quote and states, "I am sure you'll agree that the ACA statement above is outrageous." It then goes on for the next five paragraphs discussing their battles against ACA in the court and the thousands of dollars they have spent in the litigation attempting to intervene in our suit against the federal government.

Needless to say, the revised Operational Policy Letter #23 issued by the feds that physical therapists could not be reimbursed for correcting a subluxation has put a damper on the PT's enthusiasm. In fact, in their second statement since the OPL letter was released, they seem to be saying that the policy statement doesn't change anything, which tells me that they have been spending thousands of dollars on a position they care nothing about. See the entire statement at:

<https://www.apta.org/news/chiro_challenge/cms_update>

The back hoe seems to be working overtime at the APTA.

3. PARRA WINS GOLD MEDAL

Last week, ACA-sponsored speedskater Parra won a gold medal by winning the 1,500-meter race and breaking the world record in the process. The previous week, he won the silver medal in the 5,000-meter race, making him the first double medallist for speedskating this year. His final event was the 10,000-meters this past Friday. He placed 12th.

This Olympic star is a regular chiropractic patient, and the ACA along with the ACA Auxiliary have been a sponsor of Mr. Parra since last February. We are naturally proud of our sponsorship.

4. CORRECTION

Last week, I noted that Dr. Robin Hunter was a member of the 2002 U.S. Olympic medical staff and in fact had been treating over the last couple of weeks. I also indicated that she was the first doctor to serve on a Winter Olympics medical staff. Well, I was corrected by a number of doctors regarding the latter issue , pointing out that in fact Dr. Goodhart was the first doctor of chiropractic to "officially" serve at a Winter Olympics with Team USA in 1980, and the first doctor of chiropractic to officially serve at the Olympics. Thanks for the information.

5. ACA-PAC: HOW WE STACK UP TO OTHERS (UPDATE)

2001 was a non-election year, but most PACs were still active. The following are the "hard dollar" contributions made by the ACA and its competitors during the past year, and their balance for January 2002. It should be noted that this doesn't include "soft money" contributions, which are not tracked by the Federal Election Commission. For more details about the contributions and who got the money, go to the Federal Election Commission Web site at: <http://www.fec.gov/>

· ACA-PAC: $177,370.85 Opening balance for January 2002: $81,877.10 · ICA PAC: $ 6,064.50 Opening balance for January 2002: $11,222.14

(No other national federal PAC is registered)

· AOTA PAC: $250,904.01 Opening balance for January 2002: $49.134.95 · APTA PAC: $294,380.60 Opening balance for January 2002: $223,417.39 · AMA PAC: $2,151,886.87 · Opening balance for Janaury 2002: $2,601,597.70

6. REDISTRICTING WILL CLAIM ANOTHER VICTIM

I mentioned in my report last week a Republican-dominated legislature and governorship in Michigan were responsible for redrawing district lines and putting two incumbent democratic congressmen, including Dingell, into the same district. Just to let you know that this activity happens with both parties, the upcoming primary in Georgia features a face-off between two Republican Congressmen, with Linder and Barr running in the same district. Thanks to the redistricting done by the democratically controlled legislature and governorship. If you are a political junkie, you will appreciate the high drama that occurs when party leaders and special interest groups have to make a choice between two members from the same party. The story in the Washington Post about this race indicated that the National Rifle Association was facing this problem, since both candidates have been strong supporters of the NRA. Politics is a tough business, even more so the first election after redistricting is completed.

7. ACA COMMENTS TO INSURANCE COMMISSIONERS REGARDING APPROPRIATE REVIEW

Over the past two decades, insurers and managed care organizations have implemented a wide range of medical review activities that they believe will contain costs. While little has been published on the cost impact of medical review activities, their practices have continued to proliferate. While the ACA believes certain activities may be needed to avert fraud and abuse by a small percentage of providers and/or policyholders, we do not feel the chiropractic profession should be targeted for review activities. We also feel payers should be accountable for review activities so these intervention activities do not intimidate the patient or the provider into averting or entirely forgoing necessary care. The ACA Insurance and Managed Care Committee, which fields national insurance concerns by members, drafted a position paper called Medical Review Benchmarks. Medical Review Benchmarks outlines what constitutes fair medical review practice as it applies to the chiropractic profession. This document comments on a wide range of topics, including the selection of a chiropractic consultant and IME to having a doctor of chiropractic determine guidelines that apply to the profession, as opposed to those who are not knowledgeable in the field. In addition, the benchmarks were reviewed by over 15 national insurers who had input into the process, assuring their reasonable buy-in to the intent of the benchmarks. ACA went one step further and has now placed the document into the hands of each commissioner of insurance in every state in the country, including a letter from ACA president Daryl D. Wills, DC, to lobby for local regulatory changes. For the entire document, please refer to this ACA Web link: <http://www.acatoday.com/insurance/policy/benchmarks.shtml>

8. COMEDY IS NOT FUNNY: ACA RESPONDS TO DAVID SPADE

ACA has once again "set the record" straight on chiropractic. During a recent "Tonight Show" appearance, actor/comedian Spade jokingly equated being a meteorologist to being a chiropractor. "It's like three weeks of school," he said.

While Spade might have been joking, the chiropractic profession certainly wasn't laughing. The ACA has responded to Spade, pointing out the extensive education doctors of chiropractic receive. A copy of our response can be found on the Web site at:

<http://www.acatoday.com/media/record/bwr.shtml>.

9. ACA COMMENTS TO HHS

Taking advantage of the directive by Secretary Tommy to CMS (formerly HCFA) to conduct a review of its regulations with an eye toward modifying and/or eliminating those that are unreasonable or not supported by statute, the ACA submitted an analysis of the discriminating sections in Medicare Part B as they relate to this profession. This included a history of the collaboration between the AMA and the department that resulted in the erroneous position taken by HCFA twenty years ago, including the stance that x-rays, even though required by statute for treatment, would not be reimbursable. For the complete text, go to the Web site at:

<http://www.acatoday.com/government/medicare/020502.shtml>

10. FREE OFFER FROM FCER

"The Week in Chiropractic" is FCER's Monday morning news and research bulletin for the busy doctor of chiropractic. And now it's FREE via e-mail, simply for asking! Sign up using the link below, and let FCER be your source of information. Every Monday in your e-mail inbox you will find the latest on topics that affect you, your patients, and your profession, such as:

· Health News in Brief · Inside Chiropractic · Capsule Abstracts on Current Research · FCER Update on Activities and Resources

In part, the Mission of FCER is "to provide information needed to document and improve chiropractic health care capacity worldwide." With this in mind, FCER has decided to take this weekly publication and make it FREE to everyone. To receive it, or to see a sample copy, just use the following link and sign up today: <http://www.fcer.org/html/Products/subscribe.htm>

11. SEMINARS AT NCLC HELP BUILD AND PROTECT YOUR PRACTICE

On Saturday, March 9, 2002, from 9:00 am - 4 pm, the ACA will present two special seminars discounted almost 50% for ACA members. ACA members attend for only $69, non-members for $129 and SACA members for $25

The Nuts and Bolts of Hospital Protocol - Presented by Dr. Jon Buriak, chairman of ACA's Hospital Relations Committee, and staff DC at Walter Medical Center in Washington, D.C., this seminar will offer invaluable information about the critical steps you need to take to request formal staff privileges and to educate hospital staff about chiropractic. ACA's newest hospital privileges resource will be deeply discounted for seminar attendees. Can't make the seminar but need the material? Click here: <http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2 & pf%5Fid=141>

HIPAA: What You Need to Know Now - Put an end to the guessing game - get accurate and timely information about HIPAA compliance from these expert speakers: Stanley Nachison, from Information Services at the Centers for Medicare and Medicaid Services, and Mark Cohen, Esq., attorney, Ober, Kaler, Grimes & Schriver. We'll focus on the administrative simplification aspects of the Health Insurance Accountability and Portability Act (HIPAA), with a primary emphasis on electronic code sets and medical records privacy. We will also discuss the impacts of the recent law that extends the electronic standards deadlines by one year, the requirements of this statute, and medical records privacy. Free 11-page HIPAA summary for seminar attendees. If you're unable to join us but want the information, click here:

<http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=2 & pf%5Fid=138>

Call 1-800-986-4636 to register today -- space is limited.

[Guest guest]

ACA EVP Weekly Report

Memorandum to ACA Members, Board of Governors, House of Delegates and Other Interested Parties From Cuneo Re: ACA EVP Weekly Report March 19, 2002

This week's report includes the following items:

1.ACA, NCMIC, FCER AND PENNYSLVANIA CHIROPRACTIC ASSOCIATION REACT TO AN INSURANCE COMPANY'S USE OF THE STROKE ISSUE

2. NCLC WAS MORE THAN A LEGISLATIVE SUCCESS 3. PAC ALSO SCORES AT NCLC 3. LEADER TABLE CONTRIBUTES TO THE CAUSE 4. ACA RECOGNIZES PARKER AND FOOTLEVELERS 5. TEXAS PRIMARY UPSET 6. ACA HONORS ITS VOLUNTEERS 7. ACA ENDORSES EZYPAD

ACA, NCMIC, FCER AND PENNSYLVANIA CHIROPRACTIC ASSOCIATION REACT TO AN INSURANCE COMPANY'S USE OF THE STROKE ISSUE It goes without saying that the recent study by a group of neurologists regarding the frequency of stroke was meant to hurt this profession. As you may know, after the study, a group of about 60 Canadian neurologists issued a news release warning of the dangers of neck manipulation. It is interesting to note that one of these 60 neurologists, a Dr , was reported in the media to have claimed that the news release was more directed toward medical doctors than chiropractors. If this is true, why does the study refer to chiropractic procedures without distinguishing one practitioner from another? It would be tough to convince me that there wasn't clear intent here. But we have to deal with the cards that are dealt and be vigilant about this issue popping up again in the media. Hopefully, the material we have provided the state associations and colleges, which was included in my report last week, will help us maintain a unified message. It appears that we also have to be vigilant about how this issue may be used by insurance companies looking for ways to improve their bottom line. We had such an experience in Pennsylvania. The Health Guard Medical Group, an HMO in Pennsylvania with 100,000 subscribers, took action at its Medical Policy Board Meeting in January and voted to restrict Cervical Manipulation as a carrier benefit, effective immediately. The Pennsylvania Chiropractic Association (PCA) heard of this decision and promptly contacted the HMO to confirm that this was, in fact, an official decision. When PCA learned that this was accurate, PCA provided to Health Guard Medical Review Board members with extensive literature on the Practice of Chiropractic and its safe and effective care--especially when treatment is provided to the cervical spine. PCA also called on others to provide the research necessary to bring into serious question the group's decision. ACA , FCER and NCMCI all weighed in to bolster the arguments being presented by the Pennsylvania Association. Dr Louis Sportelli was designated to represent the profession before the group The Pennsylvania Association reported that at the March 5, 2002 meeting of the Health Guard Medical Review Committee, the committee voted unanimously to make the change to its Benefit Package and allow Cervical Manipulation to once again be offered to its 100,000 subscribers. NCLC WAS MORE THAN A LEGISLATIVE SUCCESS Over 350 doctors and students converged on the capitol to promote the profession's legislative agenda. The members of Congress heard the chiropractic message. But NCLC was more than a legislative success, it was also a financial success for the legal action fund. A total of $285,000 was raised in cash and pledges during this period of time. Next week, I will provide a link to our Web site so that everyone who has contributed to the law suit since 1998 can be recognized, including those who contributed at this meeting. Below are the organizations that contributed and, next to their contribution, the total. Organizations Nebraska Chiro Physic. Assoc 10,000.00 40,001.00 Eastern Ohio Chiro Society (OH-Dist. 4) 10,000.00 10,000.00 North East. OH Academy of Chiro (OH-Dist.3) 10,000.00 10,000.00 North Central Academy of Chiro (OH-Dist. 14) 10,000.00 10,000.00 Tri-County Chiropractic (OH-Dist. 5) 10,000.00 10,000.00 Georgia Chiropractic Association 8,500.00 11,500 Allied Health of Wisconsin 5,000.00 32,625.00 Kansas Chiropractic Assoc 5,000.00 20,000.00 Missouri State Chiro Assoc 5,000.00 6,000.00 North Carolina Chiro Assn 2,000.00 13,400.00 Northwest Coll - SACA 2,000.00 3,300.00 Mid-Ohio Chiropractic Assoc 1,500.00 1,500.00 Florida Chiro Assn 1,250.00 17,500.00 Logan College-SACA Chapter 1,025.00 1,025.00 Amer. Chiro Coll of Radiology 1,000.00 5,885.00 Counc on Chiro. Orthopedics 1,000.00 1,500.00 Kentucky Assoc. of Chiro. 1,000.00 4,000.00 Tennessee Chiro Assn 1,000.00 2,000.00 Tennessee Valley Chiro Assn 1,000.00 1,500.00 Upper Cumberland Chiro Assn (TN) 500.00 700.00 Washington State Chiro Assoc 500.00 500.00 PAC ALSO SCORES AT NCLC There was also support for the PAC during the weekend. Over $10,000 was raised, including $1500 from the SACA chapter at Northwestern, $500 from the SACA Chapter of Cleveland Kansas City, and $500 from the SACA chapter of Texas College. LEADER TABLES CONTRIBUTES TO THE CAUSE

Rick Flaherty, President of Leader Table, served as facilitator while contributions were being raised for the lawsuits. He did an excellent job in motivating the doctors and students to contribute to the cause. He personally contributed an adjusting table

earlier. Then at NCLC, he made a personal contribution of $1000 and a second table.

The total value of the tables and his personal contribution is over $15,000. Rick was a major contributor during the Centennial and is stepping up to the plate again. The major part of his business no longer comes from this profession, but he appreciates the importance of this lawsuit and is willing to make the contribution. I am sorry to say that very few vendors have come forward to show the same level of commitment. May I ask that the next time you purchase products from a vendor, ask about their commitment to the Legal Action Fund. Next week I will provide a link to the Web site listing the contributions by the vendor community since 1998.

ACA RECOGNIZES PARKER AND FOOTLEVERS AT NCLC; CONTINUES TO SUPPORT THEIR 50TH ANNIVERSARY PROGRAMS At NCLC, Drs Wills and presented special proclamations to both Dr Fabrizio Mancini and Kent Greenawalt in commemoration of the 50th Anniversary of Seminars and Footlevelers. It was also in appreciation for their unbelievable assistance at their program in Las Vegas to help us raise $250,000 for the legal action fund and to expose our material on the lawsuit to a group of doctors that we wouldn't have been able to reach. They plan to continue to show this support in the four programs that they have scheduled for the year and we intend to show our appreciation, as well, by maintaining a presence at the program and by encouraging our members to attend. The program at is first rate and deserves our support. The ACA will be staffing a National Chiropractic Legal Action Fund booth at the Seminars in Dallas, April 11-14, 2002. Please join us to get the latest updates from ACA leadership and staff and learn how these lawsuits affect your practice. And don't miss the fresh, substantive seminars by 's expert teachers. For more information on 's 50th Anniversary Seminar Series, go to: http://www.parkerseminars.com/seminar/Dallas02special.asp TEXAS PRIMARY UPSET!

Four-term Congressman Ken Bentsen was dealt a surprising blow to his career on Tuesday. Rep. Bentsen took third place in the Democratic Primary for the Texas Senate seat being vacated by retiring Senator Phil Gramm. The two democratic contenders, Ron Kirk and Victor Morales, each got 33% of the vote. They will face each other in a run-off for their party nomination on April 9th. The democratic nominee will face state Attorney General Cornyn in the general election. Reports show Cornyn, who was nominated with 77% of his party's vote, already leading both democratic hopefuls in the polls. The ACA-PAC will monitor this important Senate race in the President's home state. ACA HONORS ITS VOLUNTEERS I have talked in past reports regarding the resources of this organization, which makes it a player in the political world of health. I have bragged about our PAC, our lobbying team, and other financial resources. All of these are important, but this is still a volunteer organization, run by volunteers. And their contributions to the profession are as important--if not more so--than a PAC contribution to a legislator. At NCLC, the ACA President honored five of them. Dr Spoto, delegate from Pennsylvania, for his work with other chiropractic organizations in bringing about unanimous support for our lawsuits against the federal government and Blue Cross/Shield and for coordinating efforts with Kent Greenawalt and Dr. Mancini in spearheading the successful fundraising drive at the Seminars that brought in over $250,000 in pledges and checks. Dr Ken Luedkte, former PAC Chair and ACA President , whose personal relationship with Secretary going back 15 years provided us with the access to make our case regarding the physical therapists and led to the directive by HHS that physical therapists should not be reimbursed for providing manual manipulation of the spine to correct a subluxation. Dr Overland, delegate from Connecticut, in appreciation for his work in treating over the last few years the U.S. Skating team and, in particular, Parra, the gold and silver medalist. Dr Overland persuaded the ACA and the Auxilary to sponsor Mr Parra over a year ago when he was a virtual unknown outside the skating community. Perra recently cut a pro-chiropractic spot for us. Dr R.J. "Duke" Short. Dr Short is a graduate of Palmer. He has also been chief of staff of Senator Strom Thurmond for over a decade, serving this important role while the Senator served as chairman of the Armed Services Committee. I commented in an early report about the importance of Senator Daschle in getting our VA bill through the Congress. Senator Thurmond and Duke Short were very important in getting the DOD provisions and previous legislative successes through the U.S. Senate and were instrumental in bringing a chiropractor to the nation's capitol to treat members of Congress. Duke Short is not an ACA volunteer, but clearly he and the senator are valuable supporters to the cause and deserved this recognition. Dr for his great contributions to the Legal Action Fund. Dr was a former PAC officer who was appointed to the National Chiropractic Legal Action Fund five months ago. During this time, he has spearheaded an effort in Ohio that increased the contributions from the state by over $90,000 This included a personal check for $5,000.. Dr Malcom Mc, delegate from the Virgin Island. For fifty years of service for this profession. I am sure that Dr Mc has done many things for this profession. I think the most important contribution is that first in Massachusetts, and later in the Virgin Islands, he pushed the doctors to be involved politically in these areas so that today both Mass and VI are political strongholds for this profession. Thanks, Dr Mc, for your commitment.

A bust of the late Gerald Brassard D.C. , who was a founding member of ACA and served in several positions within the association including ACA President and the ACA Executive Vice President, was presented to Dr Brassard's family and ACA members. The bust, which commemorates Dr Brassard's important work and advocacy on behalf of the chiropractic profession and ACA, will be displayed at ACA headquarters in Arlington, VA.

ACA ENDORSES EZYPAD The ACA is pleased to announce our recent endorsement of Ezypad. Developed by Grandom PTY Ltd., Ezypad is an ergonomic mouse pad designed to reduce repetitive motion injuries associated with frequent computer use. According to estimates, 75 million Americans use a computer everyday. The more hours per day spent at the computer, the greater the risk of wrist and arm discomfort, and repetitive motion injuries (RMIs), such as carpal tunnel syndrome. Ezypad's unique 360-degree rotational cushion is designed to help reduce the risk of RMIs often associated with the use of the traditional horizontal computer mouse by supporting the wrist and decreasing shoulder and neck strain, and maintaining the natural movement of the arm. To learn more about EZYPAD, visit http://www.ezypad@.../ezypad/ezypad.html or call 949-361-1158. The ACA is always seeking to identify the highest quality products and services available, especially those designed to minimize spinal pain and injury. We would like to be able to better serve the public, doctors of chiropractic, the media, and others. If you would like to recommend specific products for ACA endorsement, please contact Leigh-Anne Perialas at lperialas@...

[Guest guest]

What your only viable national trade organization is doing for ya lately!

Enjoy: Vern Saboe, DC ACA Delegate (Oregon)

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: EVP Weekly Report Date: April 1, 2002

In this week's report:

1. PRACTICE EXPENSE: IT DOES DETERMINE WHAT YOU ARE PAID:THE PROCESS BEGINS 2. PAC TRACKS ANOTHER TARGETED RACE 3. ACA REPRESENTED AT PARKER PROGRAM 4. FEBRUARY ISSUE OF THE ANNALS OF INTERNAL MEDICINE CONTAINS BALANCED ARTICLE ON CHIROPRACTIC 5. LOCAL AMERICAN LEGION POST SENDS STRONG MESSAGE TO CONGRESS 6. MISSISSIPPI KNOWS HOW TO TAKE ON THE PHYSICAL THERAPISTS 7. PENNSYLVANIA ALSO SCORES ON THE ISSUE 8. MEDICARE REIMBURSEMENT AFFECTED BY ACA ACTION: EVER WONDER WHY YOU PAY YOUR DUES? 9. SPECIAL ACCESS FOR ACA MEMBERS 10. CAN'T ACCESS THESE LINKS?

1. PRACTICE EXPENSE: IT DOES DETERMINE WHAT YOU ARE PAID:THE PROCESS BEGINS

One of the activities of the ACA that doesn't get much publicity is our participation on the AMA's RUC and CPT HCPAC Committees. The CPT committee is responsible for updating AMA's CPT codes, while the RUC, or Relative Value Update Committee, is responsible for assigning relative values for each CPT code and suggesting relative value to CMS (formerly HCFA) under a contract with the federal government. While the RUC decisions are advisory, they are generally followed by CMS (HCFA) regarding Medicare, and their impact trickles down to the private pay areas as well. Later in this report you will see the benefits that have accrued for the profession as a result of the new CMT codes that were developed by these committees in 1995.

Part of the benefit from our new codes is the relative values that are used to determine the fee that can be charged for a particular procedure. Every five years the values are up for review. Ours were up this year and for the first time values would be developed based on specific chiropractic data. The formula to develop relative values for CMT codes is determined by a survey of the profession in three areas, including practice expense, hour survey and malpractice survey. Earlier in the year we conducted a survey of doctors in the field and came up with data for the practice expense portion of the

relative value. Practice expense is the general overhead costs for running a practice, including rent, value of adjustment tables and equipment, average time office staff spends for a given procedure, headrest paper, etc. The ACA team presented our results to the Practice Expense Advisory Committee (PEAC), a group of physicians, AMA staffers and CMS individuals who get the figures and determine if the survey was scientifically sound and the results conclusive. The ACA team included Drs. Daryl Wills, Joe , Tony Hamm, Goertz and Mrs. McClelland.

One of the participants on the PEAC, a nephrologist, made the following comment about our data: "This society (ACA) has their ducks in a row. This is their first time to the PEAC process. They were well organized, did a great job of their presentation. They stuck by their survey data and I think we should invite them back regularly."

The presentation of the survey data went far better than we could have imagined as all our data was approved with, in some cases, beneficial edits. This translates into a success, as the first phase is complete to establish CMT relative values, and if the next two go as planned, the profession will have justly favorable relative values for the first time in history. But as you know, nothing is easy in this business, and we must continue to pursue this process in a methodical manner until the formula is complete. Later in the year we will be conducting a survey of doctors in the field with a larger sampling to determine the third part of the formula, the work hour survey. This is an important part of the outcome and we urge those of you who receive the survey to complete it and return it to the ACA. When the survey is complete and our numbers are accepted, only than can we celebrate a victory..

2. PAC TRACKS ANOTHER TARGETED RACE

A democratic redistricting plan in Indiana has paired two Republican Congressmen, Representative Buyer and Representative Kearns against each other in the new 4th district in west-central Indiana. Buyer is considered the stronger candidate, however Kearns has a distinct advantage. Rep. Kearns currently represents nearly 70% of the new district, versus Buyer's 3% representation. Buyer, who is in his 5th term, has a proven record of support for the ACA and pro-chiropractic initiatives in general. Rep. Kearns had help gaining support in an eight-way 2000 primary from his father-in-law, former GOP Rep. Myers. As of the January 1 FEC deadline, Buyer had $324,987 on hand, versus Kearns' $70,883.

3. ACA REPRESENTED AT PARKER PROGRAM

ACA Chairman , DC, along with members of the ACA staff, will be manning the SOS booths at the Seminar in Dallas, TX, April 11-14, promoting the lawsuits against Trigon and the federal government. Dr. will have an opportunity to address the attendees and will be given other speaking opportunities. The seminar looks really good, including motivational speakers such as Dr. Hunter "Patch" , Charlie "Tremendous" and Ed Foreman, former member of Congress from two states. To learn more about the Programs, go to:

<http://www.parkerseminars.com/seminar/Dallas02special.asp> 4. FEBRUARY ISSUE OF THE ANNALS OF INTERNAL MEDICINE CONTAINS BALANCED ARTICLE ON CHIROPRACTIC

The February issue of the ls of Internal Medicine contains an excellent article authored by Drs. Bill Meeker and Haldeman titled "Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine." It presents the profession fairly and objectively, addressing its development, education, scientific support, philosophy diagnostics, practice characteristics, etc. It is important as it is published in the third largest medical scientific journal in the world.

5. LOCAL AMERICAN LEGION POST SENDS STRONG MESSAGE TO CONGRESS

A bulletin of the Highland Park American Legion Post 374 of Des Moines, Iowa included the following statement regarding chiropractic in the Veterans Administration: "I have recently learned the use of chiropractic treatment has been approved for the VA medical centers. Don't plan on going and getting a treatment very soon because the VA has been dragging its feet for a long time. Please take time and contact your senator or representative and urge them to push the VA to get their regulations in place."

What a great statement and the kind of pressure that will force the VA to implement chiropractic responsibly. ACA's Iowa delegate, Dr. F. Dow Bates, whose office is a few blocks from this American Legion Post, was helpful in bringing this about. If you are a veteran and member of the local

chapter, whether American Legion or any other veteran group, contact the chapter to see if they would do the same thing. If you are successful, please let me know. 6. MISSISSIPPI KNOWS HOW TO TAKE ON THE PHYSICAL THERAPISTS

ACA's Mississippi delegate, Al Norville, DC, provided me with copies of recent legislation passed by his legislator. It clearly permits only doctors of chiropractic to perform the chiropractic adjustment/manipulation. The specific language reads as follows: "It shall be unlawful for any person, corporation or association to, in any manner, make claim, verbally, in writing or by way of advertising, that they perform chiropractic or chiropractic-like adjustments/manipulation to the articulations of the human

spine, unless they hold a valid license to practice chiropractic in the State of Mississippi."

To add salt to the physical therapists' wound, the newly created Physical Therapy Examining Board must include a doctor of chiropractic. Did I mention that the governor of Mississippi is the father-in-law of the president of the Mississippi Chiropractic Association, or that the lieutenant governor is a close friend of Dr. Norville and his wife Bess? Relationships don't guarantee votes, but they sure help with access.

7. PENNSYLVANIA ALSO SCORES ON THE ISSUE

Congratulations to Dr. Spoto, Pennsylvania Chiropractic Association (PCA) legislative chairman, Gene Veno, PCA executive director, and the other doctors in Pennsylvania for their successful passage of legislation that defines manipulation/adjustment. Legislation was also passed by the physical therapists defining mobilization. In my former life as executive secretary of the California Board of Examiners, we were always having a difficult time prosecuting a physical therapist who was clearly doing the adjustment, as there was no clear distinction in the law between mobilization and adjustment/manipulation. The governor has indicated his intention to sign the legislation.

8. MEDICARE REIMBURSEMENT AFFECTED BY ACA ACTION: EVER WONDER WHY YOU PAY YOUR DUES?

A few months ago when ACA staff met with the HHS Inspector General's office, we were given some statistics regarding chiropractic usage in Medicare that were interesting:

Year: 1996 Allowed Services: 12,269,909 Percent of Services Allowed: 76% Allowed Dollars: $294,691,461

Year: 1997 Allowed Services: 12,947,723 Percent of Services Allowed: 78.40% Allowed Dollars: $328,831,199

Year: 1998 Allowed Services: 13,486,247 Percent of Services Allowed: 79.40% Allowed Dollars: $374,191,291

Year: 1999 Allowed Services: 13,290,247 Percent of Services Allowed: 78.10% Allowed Dollars: $379,275,897

Year: 2000 Allowed Services: 14,336,609 Percent of Services Allowed: 78.20% Allowed Dollars: $430,367,416

No one can be satisfied with the way this profession is treated under Medicare, further necessitating the passage of the Watkins Bill. The actions that ACA has taken over the last few years have improved our reimbursement standing within the restricted parameters that our profession must operate.

In 1996, the ACA representatives on RUC/CPT were able to get a new set of codes adopted for chiropractic. And as a result of its survey of the profession, the codes were accepted by HCFA. The number of dollars reimbursed under Medicare increased by 40 million dollars in 1997 when these codes became effective. The allowable services during this time also increased substantially, in my opinion, because of the availability of more services to define what we do. Equally significant was the effect of our legislation eliminating the x-ray requirement under Medicare that became effective in January 2000. Over 1 million more services were authorized under Medicare from the previous hours. Over $50 million in expenditures over the previous year were allowed. When we were pushing for the passage of this legislation, the Congressional

Budget Office was estimating that if passed and were signed into law, it would cost the Medicare system over $100 million more per year, or $1.5 billion over ten years. Well, the projected costs didn't reach the estimates of the Congressional Budget Office, but it wasn't bad. Do you still have doctors who won't join the ACA because they don't think we do anything? Share with them these statistics.

9. SPECIAL ACCESS FOR ACA MEMBERS We continue to receive great feedback on ACA's recently revamped Web site. If you're an ACA member, don't forget that you can access even more tools and information via password-protected sections, like master artwork for "For Your Health" patient fact sheets that you can customize with your own contact information, sample HIPPA and other forms, complete recent issues of JACA and CA Chronicles, and more. For access information, call your ACA Member Information Specialists at 1 (800) 986-4636, or email memberinfo@....

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 email me at gcuneo@... <mailto:gcuneo@...>."

We have placed my weekly EVP report on our Web site, where members and non-members can download the report in various formats. We will have the report available in "Publications", "EVP Report." The report is available in .html and .txt formats.

This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to <kpark@...> and change the subject to read: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: April 8, 2002

1. ACA VIDEO NEWS RELEASE FEATURING DEREK PARRA AND CHIROPRACTIC TO BE DISTRIBUTED NATIONALLY...AND YOU CAN VIEW IT HERE

2. TRIGON BALKS AT PROVIDING MORE CRITICAL INFORMATION: ACA FORCED TO FILE SECOND MOTION TO COMPEL 3. CONTRIBUTE 'TIL IT HURTS 4. CONFERENCE CALL ON ACA LAWSUITS FOR CHIROPRACTIC MEDIA, MAJOR CONTRIBUTORS, HOUSE OF DELEGATES AND STATE ASSOCIATIONS

5. POWERPOINT PRESENTATION ON LAWSUITS: PLEASE HELP SPREAD THE WORD 6. ACA EVP ADVISORY COMMITTEE HOLDS ITS MONTHLY CALL 7. STUDENT LOAN BILL HUNG UP IN THE HOUSE 8. CODING SOURCE YOU CAN TRUST 9. MAY IS CORRECT POSTURE MONTH 10. MEDICINE, MONOPOLIES AND MALICE: AN ETHICAL PRACTICE BUILDER 11. CAN'T ACCESS THESE LINKS?

1. ACA VIDEO NEWS RELEASE FEATURING DEREK PARRA AND CHIROPRACTIC TO BE DISTRIBUTED NATIONALLY...AND YOU CAN VIEW IT HERE In a video news release (VNR) which was distributed nationally on Friday, April 5th, Olympic speedskating gold and silver medalist Parra talks about the

important role chiropractic care played in his medal-winning performances. The VNR, which will be released via satellite to more than 800 media outlets across the United States, explains that doctors of chiropractic have been a part of the Olympic Medal Staff since 1980 and have helped many world-class athletes reach their peak. Also featured in the VNR is ACA Connecticut Delegate Dr. Overland, chiropractic consultant to the U.S. Speedskating Team, who explains that weekend warriors are prone to the same types of repetitive and overuse injuries as Olympic athletes. The footage for the VNR was shot during an interview in Salt Lake City just days after Parra's Olympic victories. At the same time, Parra was also filmed for a public service announcement (PSA) about chiropractic care as well as a television commercial spot that ACA members can air in their local communities. The PSA will be available in 60, 30 and 15-second lengths, and promotes chiropractic care as an integral part of the health care team. PSAs are designed to be placed for free by local TV and radio stations as a service to the viewing public. ACA members will soon be able to order the PSA at cost and present it to their local stations for possible free placement. For ACA members who want to advertise either chiropractic in general - or their own local practice - with guaranteed, paid air-time, we are also producing a 60-second advertising spot that can be aired "as is" or personalized with a doctor's name and clinic information. Pricing and ordering information for the PSA spots and the advertising piece will be available soon. Keep watching my weekly report for updates. In the meantime, click here to view the Video News Release: <http://64.224.5.139/westglen.com/Hot_Topics/12594.wmv>. IMPORTANT: To view the VNR, you must have Windows Media Player installed on your computer, which can be downloaded for free at the following site: <http://www.microsoft.com/windows/windowsmedia/download/>. Even with Windows Media Player, some computers may not have the capacity to play the video - due to system requirements and/or firewalls that are in place at your organization. For those of you who are able to view the VNR, we hope you enjoy it.

2. TRIGON BALKS AT PROVIDING MORE CRITICAL INFORMATION: ACA FORCED TO FILE SECOND MOTION TO COMPEL

Last week I reported on the favorable court ruling in our Trigon litigation concerning information we seek from Trigon pertaining to how it established its chiropractic reimbursement policy. This week, we are again forced to return to the court to obtain more critical information that Trigon is trying very hard not to provide. The amount of money Trigon pays other providers and more specific information on the other providers that receive less for the same service than medical doctors is at issue. This information is sought in order to obtain the full picture of how other providers are treated so that we may contrast that with the particular discrimination suffered by chiropractors. This issue is central to the litigation and is an all to common problem in plans across the country. (Note: this information was requested in a separate and later set of interrogatories and therefore was not included in the first motion to compel)

3. CONTRIBUTE 'TIL IT HURTS

While making calls to the top 300 contributors to the National Chiropractic Legal Action Fund (NCLAF), ACA president Daryl D. Wills, DC, had an opportunity to speak to a 50-year old doctor from Colorado who has retired from practice due to a spinal stenosis and bilateral leg

numbness. The doctor has been a strong contributor to the NCLAF, and in the course of the conversation, after explaining that he was having difficulty obtaining disability reimbursement from his insurance, he made the following statement: "Our cash flow is rather tight right now, we are having difficulties, but as soon as things start coming in I want to continue to contribute to the NCLAF and continue to do my part."

Here is an individual with strong priorities and commitment and a belief in what we are doing. This doctor will give even past the point of hurting. Dr. Wills thought this was a story worth relating. If you are tired of being harassed by the managed care barons, then you need to contribute to these lawsuits...yes, contribute until it hurts. Because if we fail, it will really hurt.

4. CONFERENCE CALL ON ACA LAWSUITS FOR CHIROPRACTIC MEDIA, MAJOR CONTRIBUTORS, HOUSE OF DELEGATES AND STATE ASSOCIATIONS

Just a reminder that we have scheduled a special conference call with Mcs and Tom Daly on Thursday, April 11th at 1:00 pm ET to learn the latest on the ACA's lawsuits against Trigon and the federal government.

In a March 18 opinion, Judge of the federal district court in Abingdon, Virginia, ordered Trigon Blue Cross/Blue Shield to answer ACA's questions, or interrogatories, regarding Trigon's reasons for paying doctors of chiropractic less than medical doctors for the same services. Mcs and Daly will discuss this development and provide an update on ACA's lawsuit against the federal government, including the recent directive prohibiting physical therapists from providing chiropractic services under Medicare.

5. POWERPOINT PRESENTATION ON LAWSUITS: PLEASE HELP SPREAD THE WORD

If you are interested in spreading the word about these lawsuits, ACA chairman , DC, has prepared a power point presentation that provides a comprehensive review of the purpose and status of each of our lawsuits. It will take ten minutes to present and may be converted to overheads. If you are interested, please click either here (for the PDF file): <http://www.acatoday.com/pdf/NCLAFHOD021.pdf> or here (for the Power Point file):

<http://www.acatoday.com/legal/NCLAFHOD021.ppt>

6. ACA EVP ADVISORY COMMITTEE HOLDS ITS MONTHLY CALL

The executive directors and/or leadership from ten chiropractic state associations participated with legal counsel, staff vice presidents and me in our monthly call to discuss issues of mutual concern. Included on this call were representatives from Texas, Kentucky, Iowa, Arizona, COCSA, Rhode Island, Pennsylvania, Louisiana and Colorado. Dr. Wills also participated on the call. We discussed the recently issued letter on CCI edits from AdminaStar Federal and gave updates on chiropractic legislation, the Blue CCHIP Program and HIPAA. The next conference call of the committee is scheduled for Tuesday, April 23, at 1:00 pm ET.

7. STUDENT LOAN BILL HUNG UP IN THE HOUSE

ACA and ACC continue to push the amendment, which would include a chiropractic provision, to the National Health Service Corp reauthorization bill. Under the amendment, chiropractic graduates would be eligible to participate in a program in which

student loans can be forgiven in return for service in underserved areas. As you know, we were successful in including a chiropractic provision on the Senate side, while podiatrists and optometrists were eliminated from the program. The senate has passed its provision and we are awaiting House action. This reauthorization should have been passed last

year, but some members of the House attempted to include controversial provisions which had no connection with the bill. We suspect this issue will be resolved shortly. Once it is and the House bill is introduced we will be sending out an alert. It will not be easy to include a chiropractic provision in the House version, and you can be sure that the podiatrists and optometrists will be out in force trying to get themselves returned to the provision.

8. CODING SOURCE YOU CAN TRUST

Up to 30% of the calls received by ACA's Professional Development and Research department are from doctors who have received inaccurate coding advice or made troublesome coding errors. In attempt to address this growing problem, Dr. Hamm has written an article titled "Coding: Information is Power When it Comes to Getting Paid," which appears in the April issue of Chiropractic Economics. The article provides a comprehensive coding overview, including the important role of ACA's Coding and Reimbursement Committee in the coding process, and addresses some of the most common coding problems. Dr. Hamm is the ACA's North Carolina delegate and chairman of the ACA Coding and Reimbursement Committee. Please read this article, and recommend ACA's Coding Solutions 2002 resource to your colleagues (available at <www.shopaca.com>). It is the most accurate book on the market, and the only coding resource approved by the ACA Coding and Reimbursement Committee.

9. MAY IS CORRECT POSTURE MONTH

Turn your expertise into news your community can use. May is Correct Posture Month. Use this observance to promote yourself and your practice. First, order the "How to Market Your Practice: Media Relations" phone conference audiocassette. You'll learn how to write

effective news releases, get media coverage without spending money on advertising, and much more. Go to: <http://www.lighthousemarket.net/acastore/product.asp?dept%5Fid=13 & pf%5Fid=130> Then, watch this space for an announcement on how to get the May is Correct Posture Month Kit, free for ACA members. The kit will feature sample news releases and easy, step-by-step instructions for maximizing this important observance.

10. MEDICINE, MONOPOLIES AND MALICE: AN ETHICAL PRACTICE BUILDER

The ACA and Dr. Chester Wilk, one of the most influential individuals in chiropractic history, have teamed up to provide doctors of chiropractic and patients with Medicine, Monopolies and Malice, an educational book written by Dr. Wilk to help minimize the misconceptions of chiropractic training, history, treatment, safety and efficacy. Many chiropractors were not in practice during the Wilk vs. AMA lawsuit and may not understand the magnitude of the stigma that medical doctors placed on the profession. Medicine, Monopolies and Malice serves as a history book by

highlighting the basic concept of chiropractic, its safety, scientific evidence, therapeutic superiority, cost effectiveness, training and scientific evidence supporting chiropractic. "This book will help doctors of chiropractic become better communicators to patients, thus more successful practitioners...It enhances

self-esteem and confidence of the chiropractic doctor and provides an excellent training manual for all chiropractors to communicate with better knowledge, authority, research and history when speaking to patients," said Dr. Wilk.

80% of all net profits will be donated to the activities of the ACA. For more information, call 773-725-4878.

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 email me at gcuneo@....

We have placed my weekly EVP report on our Web site, where members and non-members can download the report in various formats. We will have the report available in "Publications," "EVP Report." The report is available in .html and .txt formats.

This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... and change the subject to read: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Members, Board of Governors, House of Delegates and

Other

> Interested Parties

> From: Cuneo

> Re: ACA EVP Weekly Report

> Date: April 22, 2002

>

> In this week's report:

>

> 1. ACA TARGETS OFFENDING HMO; APTA WITHDRAWS FROM LAWSUITS

> 2. CHIROPRACTIC ORGANIZATIONS CONTINUE TO SUPPORT LAWSUITS

> 3. ACA LONG RANGE PLAN

> 4. U.S. SENATE COMPETITIVE RACES AND CASH POSITIONING

> 5. WFC HOLDS CONFERENCE ON CLINICAL EDUCATION

> 6. NEW BACKPACK SAFETY PROGRAM FORMING: MEMBERS ONLY

> 7. USE YOUR COMMUTE TO BUILD YOUR PRACTICE

> 8. CAN'T ACCESS THESE LINKS?

>

> ACA TARGETS OFFENDING HMO; APTA WITHDRAWS FROM LAWSUITS

>

> While we continue to await the federal court's ruling on our motion for

> summary judgment in our Medicare lawsuit, the ACA is moving to take the

> gains we have made so far and apply them on a practical level. We have

> identified a Medicare HMO that has refused to provide chiropractic

services

> to a Medicare patient. The HMO later stated that even if coverage is

allowed

> for the patient, it would require the patient to be monitored by a medical

> doctor and that the

> medical doctor would have to identify the patient's subluxation. The

> recently released

> Operational Policy Letter (OPL) #23, resulting from our court action, has

> made clear

> that " As a standard Medicare Part B benefit, manual manipulation of the

> spine to correct a subluxation must be made available to enrollees in all

> Medicare+Choice plans. " Mr. Mcs is now preparing a letter to

> the HMO

> informing it of its legal responsibility to make the service available in

an

> appropriate manner. The ACA will also provide Mr. Mcs' letter, or

> portions

> thereof, to all Medicare Managed Care organizations as well as to NCQA,

which

>

> now serves to certify HMO compliance for the Medicare+Choice program. Mr.

> Mcs, as you may know, has a special knack for getting his point

across,

> legal and otherwise. In a related development, the APTA has withdrawn

its

> motion

> to intervene in our lawsuit, claiming victory as it retreats. Maybe they

> should read OPL #23 again - especially the part that states, " They

> (Medicare+Choice organizations) may not use non-physician physical

therapists

>

> for manual manipulation of the spine to correct a subluxation. "

>

> CHIROPRACTIC ORGANIZATIONS CONTINUE TO SUPPORT LAWSUITS

>

> Last week the National Chiropractic Legal Action Fund received support

from

> the following organizations: Pinellas County Chiropractic Society (FL):

> $1,422, bringing its total to $1,422; North Carolina Chiropractic

> Association: $2,000, bringing its total to $15,400; Allied Health of

> Wisconsin: $50, bringing its total to $32,675; Unified Chiropractic

> Association of Oklahoma: $5,000, bringing its total to $11,000;

Chiropractic

> Association of Louisiana: $2,500; bringing its total to $7,000.

>

> ACA LONG RANGE PLAN(IF YOU DON'T KNOW WHERE YOU ARE GOING, ANY ROAD WILL

GET

> YOU THERE)

>

> Participating in a long-range planning meeting can be equated to getting a

> root canal. However, in both cases, the end result justifies the pain.

Last

> weekend, ACA's vice presidents and I joined Dr. Rick Mc and the

other

> members of the Long Range Planning Committee to conduct a comprehensive

view

> of our existing plan. For those of you who have benefited from Dr.

> (Sergeant) Rick Mc in his role as a facilitator, and there are

many,

> you will appreciate it when I tell you that Dr. Mc is a taskmaster

who

> is very good at what he does. The other members of the committee who

> participated in this exercise include: Drs. Terrance Freitag from

Wisconsin,

> Herd from New York, Blair Bauer from North Dakota,

from

> Oklahoma, Glenn Manceaux from Louisiana, ph Morelli from Hawaii, and

Da

> ryl Wills, ACA

> President. Also joining the meeting was Olszewski, SACA chair.

> I asked Dr. Mc to summarize what he felt had been accomplished at

the

> meeting. Here is his assessment: The ACA Long Range Planning Committee,

> including key leadership and staff personnel, met for two days to review,

> revise, update and prioritize the ACA's Strategic Long Range Plan. The

group

> was energized by the long list of recent ACA successes and ongoing ACA

> initiatives. The conference participants

> continued to set aggressive goals for the ACA, as strategic reorganization

> was

> completed to create a more streamlined and focused Long Range Plan. The

> revised plan will move doctors of chiropractic forward into decision

makers

> in health

> care and experts in health and wellness. ACA holds the vision of a bright

> future

> for doctors of chiropractic and the increasing number of patients who

benefit

> from

> our safe, efficacious and cost-saving care. The revised ACA Long Range

Plan

> was created to move us aggressively toward that vision. Together, our

> vision-in-action will continue to transform health care in the United

States

> and the world.

>

> U.S. SENATE COMPETITIVE RACES AND CASH POSITIONING

>

> There will be a major push this year by both parties to change the

> composition of the Senate. As of now, the Democrats control the Senate by

a

> razor-thin margin of one vote. Control of the Senate will depend on the

> outcome of six or seven competitive Senate races, where either an

incumbent

> is facing a major challenger or there is an open seat. Here are the races

> which

> right now are considered competitive, with the respective cash positions

of

> the

> candidates as of the first quarter reports for the year. Most observers

will

>

> note the definite financial edge that incumbents have going into the

> election, although I noticed a couple of races where the margin is not

very

> significant. Additionally, you can be assured that both parties will spend

> whatever is necessary to be competitive.

>

> · Georgia: Sen. Max Cleland (Inc): $3.7 million; Rep. C. Saxby

Chambliss:

> $1.7 million

> · Missouri: Sen. Carnahan (Inc): $3.4 million; Talent: $2.12

> million

> · Arkansas: Sen. Tim Hutchinson (Inc): 1.82 million; Mark Pryor $1.02

> million

> · Minnesota: Sen. Wellstone (Inc): $2.6 million; Norman

$1.6

> million

> · Iowa: Sen. Tom Harkin (Inc): $2.5 million; Rep. Greg Ganske $1.3

million

>

> In New Hampshire, incumbent Senator faces a tough primary

> contest

> with Representative Sununu. And the winner must face popular

democratic

>

> governor Jeanne Shaheen. In North Carolina, there is an open seat for the

> retiring Senator Jessie Helms. Dole, former cabinet member in

both

> the Reagan and Bush Administrations, faces Erskine Bowles, former chief of

> staff to Clinton. Dole

> currently has $2.6 million and Bowles $1.6 million. South Carolina has an

> open seat for the retiring Senator Strom Thurmond. Representative

> Graham has $2.8 million in the bank, compared to , who has

$1.6

> million. As one of the floor managers in the Clinton impeachment

hearings,

> you know the Democrats would love to knock this guy off.

>

> WFC HOLDS CONFERENCE ON CLINICAL EDUCATION

>

> The World Federation of Chiropractic and the Association of Chiropractic

> Colleges are sponsoring a conference on clinical education in Sao o,

> Brazil, from October 26-29, 2002. The goal of the conference is to bring

> together leaders from chiropractic education and practice around the world

to

> discuss current innovations and challenges in chiropractic clinical

> education, with a view toward: a) improving and integrating

> pre-clinical and clinical education; defining the core common clinical

> skills for tomorrow's chiropractors internationally, and how to achieve

these

>

> in today's chiropractic education; and c) promoting a consistent, clinical

> approach to chiropractic practice internationally, both at established and

> newer chiropractic colleges. If you are interest in attending and

> participating in this program, visit

http://www.wfc.org/english/congress.html

> and scroll down to the second meeting listed for further information.

>

> NEW BACKPACK SAFETY PROGRAM FORMING: MEMBERS ONLY

>

> We are pleased to announce that the ACA has endorsed the Chiropak

backpack.

> During the ACA's recent National Chiropractic Legislative Conference

(NCLC),

> many of you visited with representatives from Chiropak and Samsonite, the

> U.S.

> distributor for Chiropak. Some of you expressed interest in a backpack

> safety

> program to present to your local school systems, PTAs, and other groups in

> critical need of your expertise on this subject. In conjunction with Dr.

> Bautch, past president of ACA's Council on Occupational Health, as

well

>

> as Chiropak and Samsonite, the ACA will begin offering materials and

backpack

>

> safety training for this purpose. If you are interested in participating

or

> would like to learn more, please email Leigh-Anne Perialas, ACA vice

> president of business development, at lperialas@....

>

> USE YOUR COMMUTE TO BUILD YOUR PRACTICE

>

> If it's difficult to get out of the office to attend workshops and

seminars,

> try ACA's phone conference audiotapes. These 90-minute seminars feature

> expert presenters and cover a variety of topics including: practice

> management, CA training, fraud and abuse, practice marketing, managed

care,

> coding, and more (CEUs may be available - contact your state delegate).

> Listen to the seminar in your office, at home, or in the car. Build a

> library of audiocassettes to serve as ongoing training for your staff.

> Whether you're looking for basic information or creative new ideas, these

> seminar tapes are a convenient business development tool. Order five or

more

>

> and take 20% off. Go to:

> http://www.lighthousemarket.net/acastore/dept.asp?dept%5Fid=8

>

> 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 email me at gcuneo@....

>

> We have placed my weekly EVP report on our Web site, where members and

> non-members can download the report in various formats. We will have the

> report available in " Publications, " " EVP Report. " The report is available

in

>

> .html and .txt formats.

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to kpark@... and

> change the subject to read: " REMOVE - EVP Report. "

>

>

[Guest guest]

ACA EVP Weekly Report

Memorandum to: ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: May 6, 2002

In this week's report:

1. MCANDREWS DEPOSES FORMER TRIGON MEDICAL DIRECTOR 2. TRIGON IS PURCHASED BY ANTHEM 3. STROKE CONTROVERSY CONTINUES (CANADIAN INQUEST) 4. SOUTH DAKOTA DOCTORS STEP UP FOR THE LAWSUITS 5. MC/NC: ONE CHIROPRACTIC NETWORK SHOWS ITS SUPPORT 6. ACA REPRESENTATIVE MEETS WITH PRESIDENT'S POLITICAL ADVISOR 7. SCHOLARSHIP AVAILABLE TO STUDENT ACA (SACA) MEMBERS 8. CORRECTION REGARDING APHA STORY 9. 2nd ANNUAL MEDICAL FICTION WRITING COMPETITION FOR PHYSICIANS 10. FOOT LEVELERS SEMINAR IN MINNESOTA HELPS SUPPORT LEGAL ACTION 11. CAN'T ACCESS THESE LINKS?

1. MCANDREWS DEPOSES FORMER TRIGON MEDICAL DIRECTOR

In June of 2000, Dr. McClelland, and Tom Daly joined representatives of the Virginia Chiropractic Association (VCA) to meet with officials from Trigon Blue Cross/Blue Shield to discuss their discriminatory practices toward this profession. One of the more prominent Trigon representatives was their medical director, Dr. Larry Colley. Three statements made by the Trigon reps during the meeting summarized their attitudes: 1) they pay chiropractors less because the doctors are willing to accept it, 2) they pay our doctors less for the same service because they consider us limited practitioners, and 3) that they had no intention of changing their policies or trying to accommodate our concerns. A few months later, we filed suit against Trigon. Colley left Trigon shortly thereafter.

Mcs' deposition of Colley was the first opportunity to probe a Trigon official regarding this matter. The deposition started around 9:15 in the morning and continued until 5:00pm an hour lunch break. The attorneys for Trigon asked that the deposition be kept confidential. Mr. Mcs agreed to a thirty-day confidentiality seal, during which time Trigon's attorneys would be required to justify why all or parts of the proceedings should be kept confidential. Because of the confidentiality seal, comments about the deposition are restricted to the following statement, which has been approved for consumption by Mr. Mcs:

"The purpose of the deposition was to further explore with Dr. Larry Colley the manner in which Trigon uses medical physicians to determine what all providers get paid under Trigon policies, even when the studies in refereed medical journals indicate that medical physicians are substantially uneducated in and incompetent to deliver the most cost-effective and beneficial care for musculolskeletal problems that represent (possibly with the exception of respiratory problems) the most common problem reported to health care providers in the United States. The ACA lawyers intended to question Dr. Colley closely on his knowledge, background, education and training in problems involving the musculoskeletal system and his knowledge or lack of knowledge of studies that reference the training that chiropractic manipulation requires and that it is the preferred mode, or treatment, for caring for back pain and related problems. The lawyers also expected to inquire about the substantial lack of documentation produced by Trigon, to date, supporting the medical physicians' decisions to reduce reimbursement rates for chiropractors and their patients for chiropractic care. At the time of this writing it is known that Dr. Colley's deposition took approximately 7½ hours. Details of this deposition are currently under confidential seal at the request of Trigon. Within 30 days of receiving the full transcript of the deposition, the matter of confidentiality will be revisited.

2. TRIGON IS PURCHASED BY ANTHEM

You may have seen recent press reports that Trigon will be purchased by Anthem. The deal would add 2.2 million Trigon members to Anthem and increase enrollment to more than 10 million lives, making it the second largest Blue Cross/Blue Shield business in the nation. Anthem operates Blue Cross/Blue Shield plans in 8 other states including Colorado, Connecticut, Indiana (its home base), Maine, Nevada, New Hampshire and Ohio. Four of those states have reported problems with chiropractic coverage, and a recent front-page article in the Indianapolis Star has detailed the general "ill will" providers have with Anthem. On the other hand, Rob Sherman, General Counsel for the Ohio State Chiropractic Association, has reported that while problems remain with Anthem, it has shown cooperation in its dealings with the state association.

As for ACA's litigation, Anthem will be purchasing not only Trigon's assets but will also purchase its liabilities, including the potential liability resulting from our litigation. What is also clear is that this purchase raises the importance of ACA's efforts to reform Trigon policies, since those policies will soon become part of the nation's 2nd largest Blue Cross/Blue Shield plan (spread into 9 different states). A successful outcome would have an immediate effect within Anthem and an undoubted ripple effect on other insurers across the nation.

In the and Goliath struggle the ACA is engaged in, Goliath just became about 4 times larger.

3. STROKE CONTROVERSY CONTINUES (CANADIAN INQUEST)

As you've probably heard, two high-profile stories are in the news allegedly linking chiropractic manipulation to stroke - Sharon Stone and the Lana Dale inquest in Canada. As a result, DCs across the nation might receive inquiries from patients concerned about the safety of chiropractic cervical adjustments. The ACA recently developed talking points on the safety of chiropractic that we believe will help you respond to patients concerned about these recent news reports. While the information was originally developed in response to an extremely flawed Canadian study - and not the inquest in particular -- we believe the general information regarding the safety of chiropractic treatment will still be helpful. You can find it on our Web site at <http://www.acatoday.com/hot_topics/memo_stroke.shtml>.

In addition, the ACA has been in contact with the Canadian Chiropractic Association (CCA) regarding the inquest, and reports from Canada are that things are going as well as can be expected. According to the CCA, news reports in Canada on the inquest have been relatively balanced - pointing out the chiropractic profession's contention that Ms. was predisposed to stroke because of smoking, elevated cholesterol levels, high blood pressure and a family risk of heart disease, among other things. In addition, the CCA is confident that its team of experts will clearly point out the chiropractic profession's impressive safety record and history of positive outcomes. According to a May 2 story in the Toronto Star, Dr. Haldeman testified that the "stroke was almost certainly a natural consequence of advanced artherosclerotic disease" and "that the suggestion that trauma from manipulation caused bleeding (inside the skull) is without scientific validity." You can follow media coverage of the inquest on the Toronto Star's Web site at www.thestar.com <http://www.thestar.com>.

We will continue to forward updates on the Canadian inquest as they become available. We are making this information available to our state associations as well.

4. SOUTH DAKOTA DOCTORS STEP UP FOR THE LAWSUITS

This past week the South Dakota Chiropractic Association contributed another $10,000 to the National Chiropractic Legal Action Fund (NCLAF), bringing its total contribution to $60,000. What is most remarkable about their contribution is not only that it is the second highest amount from a state, second only to Ohio, but that the total number of chiropractic licentiates in the state is under 400. When you consider that we have 55 thousand-plus DCs in the country, South Dakota shines brightly.

5. MC/NC: ONE CHIROPRACTIC NETWORK SHOWS ITS SUPPORT

The Michigan Chiro/Net Corporation (MC/NC), the largest non-profit chiropractic IPA in Michigan, contributed $5,000 this week to the NCLAF, bringing its total contribution to $19,000. Since the inception of ACA's legal activity against CMS (formerly HCFA) and Trigon, the MC/NC was one of the first, if not the first, chiropractic IPA to support the effort with annual corporate contributions. They have also promoted this effort in their newsletter, which generated further contributions by their members. With the exception of Triad, whose contribution of $100,000-plus through NCMIC is the largest ever, the majority of the chiropractic networks have either been silent or their contributions have been relatively small. Here is what the record shows: (I will fill in)

6. ACA REPRESENTATIVE MEETS WITH PRESIDENT'S POLITICAL ADVISOR

Dr. Luedkte, past president of the ACA and PAC chairman, met with Karl Rove, political advisor to President Bush in a private gathering attended by no more than nine other contributors. The ACA PAC, together with Dr. Luedtke's personal contribution, helped support Dr. Luedtke's participation in the event. He had some one-on-one face time with Rove, and learned that Rove had just seen his chiropractor. Rove invited our doctor to call him the next time he is in Washington, D.C..

Dr. Luedtke brought many things to this meeting - not just a check. He represented the ACA, which is considered a player in the political arena. Equally important, he is chairman of the Republican Party of Dane County, Wisconsin. Involvement in political matters has always been one of our profession's strengths. Doctors like Dr. Luedtke, who labored in the political vineyards for years, are the bulwarks of our successes.

7. SCHOLARSHIP AVAILABLE TO STUDENT ACA (SACA) MEMBERS Once again the American Chiropractic Foundation and the ACAuxiliary are offering a number of scholarships to SACA members. Eligibility requirements include SACA membership, a minimum GPA of 3.0, full-time student status, and enrollment in the student's second year of chiropractic college. Up to fourteen scholarships will be awarded each year. Typically the ACF will grant ten to twelve $1,000 scholarships, and the ACAuxiliary will award two $2,500 scholarships. Scholarships are to be used toward tuition, books or other school supplies. The determination of the number of scholarships granted will be made by the ACF and ACAuxiliary. The deadline for 2002 scholarship applications is July 12th. Awards will be announced at the ACA's Annual Business Meeting on August 31st. Additional information regarding the scholarships, including the application, can be found at the ACA Web site at <http://www.acatoday.com/about/saca/scholarship.shtml>, at college student financial centers, or through the campus SACA chapter.

8. CORRECTION REGARDING APHA STORY

My report last week included a story about the accomplishments of the chiropractic section in the American Public Health Association. Some of the information I received was from doctors who participate in the chiropractic section. If I were smart, I would have included only their information. However, I thought I would show everyone how smart I really was by adding my own spin and information to the story, when I noted that the APHA "...for years refused to even accept the membership of our doctors in its organization. This changed in the early 1990s when chiropractic membership began to be accepted." Apparently, this is not true. Fortunately, there were some people reading this newsletter, including Dr. Rand Baird, who caught my errors. Dr. Baird commented that, "This is patently untrue. APHA recognized chiropractic as safe and effective for certain neuromusculoskeletal conditions and low back disorders in 1982, not 'the early 1990s.' And while APHA had an official anti-chiropractic care policy from 1969 thru 1982, it never refused individual membership at any time in its history. Think about it for a second: if APHA didn't allow DC memberships until the 1990s, how could I have been a member since 1975? How could we have gotten the anti-chiropractic policy superceded in 1982? How could we have established The Chiropractic Forum - SPIG in 1981? The fact is we had over 500 individual members plus several agency members before the early 1990s!"

If anyone would know the history of chiropractic in the APHA, it is Dr. Rand Baird. He was one of the first chiropractic doctors who fought the early years of recognitions with the APHA.

9. 2nd ANNUAL MEDICAL FICTION WRITING COMPETITION FOR PHYSICIANS

We received notice from SEAK, Inc., a legal and medical information system, that they are seeking fictional short stories not to exceed $2,500 words. The purpose of the competition is to encourage physicians to become more interested in and adept at writing medical fiction. There are cash awards of $1,000 for first prize, $500 second prize and $250 third prize. Deadline for submission is September 13th. There is no charge for entering the contest. If you are interested, let me know and I will forward you the pertinent information.

10. FOOT LEVELERS SEMINAR IN MINNESOTA HELPS SUPPORT LEGAL ACTION

Foot Levelers' 50TH ANNIVERSARY CELEBRATION CONFERENCE in Minneapolis (May 17-19, 2002) helps support the lawsuits.

18 Hours of License-Renewal Credits -- ONLY $99!

The right price, the best speakers and lots of fun festivities - all for a good cause! What more could you ask for from a Foot Levelers 50TH ANNIVERSARY CELEBRATION CONFERENCE?

Held at the Millennium Hotel in Minneapolis, Minnesota, this special three-day extravaganza (May 17-19, 2002) focuses on key practice-building aspects, such as:

· Philosophy - Understand how to make the chiropractic paradigm work for you! · Technique - Learn new treatment protocols of practical and immediate value! · Motivation - Discover invigorating approaches for growing your practice!

Engage in lively discussions with chiropractic's most popular and entertaining speakers, including favorites such as Drs. Mark Charrette, Kim Christensen, Danchik, Hyland, , K.S.J. Murkowski, Jeff Olsen, and Terry Yochum. Also, enjoy a slate of planned festivities and plenty of refreshments, including a large ornate anniversary cake and lavish hors d'oeuvres.

Doctors of chiropractic pay ONLY $99 when they sign up at least 5 days in advance. With early registration, chiropractic assistants and students can attend for JUST $49. Half of all proceeds from this special event will go to the colleges of the attendees' choice, with the other half benefiting the American Chiropractic Association's (www.acatoday.com <http://www.acatoday.com>) National Chiropractic Legal Action Fund (NCLAF).

Please call us toll-free at 1-800-553-4860 (Canada: 1-800-344-4860) or click here: (<https://www.footlevelers.com/doctors/spring_conferences.cfm?pg=157>) for more details. Hurry, early registration ends May 12, 2002! Don't miss this special opportunity to unlock your practice's potential at Foot Levelers' 50TH ANNIVERSARY CELEBRATION CONFERENCE.

Foot Levelers, Inc. U.S.: (800) 553-4860 Canada: (800) 344-4860 International: (540) 345-0008 FAX: (540) 345-0202 E-mail: service@... Address: P.O. Box 12611 Roanoke, VA 24027-2611

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 <http://www.adobe.com>. If you need further assistance viewing anything referred to in this report, please email me at gcuneo@... <mailto:gcuneo@...>.

We have placed my weekly EVP report on our Web site, where members and non-members can download the report in various formats. We will have the report available in "Publications," "EVP Report." The report is available in .html and .txt formats.

This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... <mailto:kpark@...> with a subject of: "REMOVE - EVP Report."

[Guest guest]

ACA Update. I will be putting a National Legislative Alert together for all

of you relative to contacting our Oregon Congressmen and Women and having

our Medicare patients do the say relative to the ACA's Federal Bill (Watkins

Amendment).

This amendment will mandate that Medicare cover all of your charges/services

which are within your scope of practice! We must phone and Fax the folks in

Washington DC. I spoke at length with Congresswomen Hooley on our way from

Portland to Washington (I was sitting next to her on the plane, poor thing!)

anyway she told me they are still not getting their snail mail and they get

so many E-mails that faxing and phoning are the keys to her heart!!

I be getting up early tomorrow and will get a post out to all of you

colleagues which will have all the contact numbers.

Vern Saboe, DC

ACA Delegate (Oregon)

CAO Executive Board

Albany

ACA EVP Weekly Report

> Memorandum to: ACA Members, Board of Governors, House of Delegates and

Other

> Interested Parties

> From: Cuneo

> Re: ACA EVP Weekly Report

> Date: May 6, 2002

>

> In this week's report:

>

> 1. MCANDREWS DEPOSES FORMER TRIGON MEDICAL DIRECTOR

> 2. TRIGON IS PURCHASED BY ANTHEM

> 3. STROKE CONTROVERSY CONTINUES (CANADIAN INQUEST)

> 4. SOUTH DAKOTA DOCTORS STEP UP FOR THE LAWSUITS

> 5. MC/NC: ONE CHIROPRACTIC NETWORK SHOWS ITS SUPPORT

> 6. ACA REPRESENTATIVE MEETS WITH PRESIDENT'S POLITICAL ADVISOR

> 7. SCHOLARSHIP AVAILABLE TO STUDENT ACA (SACA) MEMBERS

> 8. CORRECTION REGARDING APHA STORY

> 9. 2nd ANNUAL MEDICAL FICTION WRITING COMPETITION FOR PHYSICIANS

> 10. FOOT LEVELERS SEMINAR IN MINNESOTA HELPS SUPPORT LEGAL ACTION

> 11. CAN'T ACCESS THESE LINKS?

>

> 1. MCANDREWS DEPOSES FORMER TRIGON MEDICAL DIRECTOR

>

> In June of 2000, Dr. McClelland, and Tom Daly

joined

> representatives of the Virginia Chiropractic Association (VCA) to meet

with

> officials from Trigon Blue Cross/Blue Shield to discuss their

discriminatory

> practices toward this profession. One of the more prominent Trigon

> representatives was their medical director, Dr. Larry Colley. Three

> statements made by the Trigon reps during the meeting summarized their

> attitudes: 1) they pay chiropractors less because the doctors are willing

to

> accept it, 2) they pay our doctors less for the same service because they

> consider us limited practitioners, and 3) that they had no intention of

> changing their policies or trying to accommodate our concerns. A few

months

> later, we filed suit against Trigon. Colley left Trigon shortly

thereafter.

>

> Mcs' deposition of Colley was the first opportunity to probe

a

> Trigon official regarding this matter. The deposition started around 9:15

in

> the morning and continued until 5:00pm an hour lunch break. The attorneys

> for Trigon asked that the deposition be kept confidential. Mr. Mcs

> agreed to a thirty-day confidentiality seal, during which time Trigon's

> attorneys would be required to justify why all or parts of the proceedings

> should be kept confidential. Because of the confidentiality seal,

comments

> about the deposition are restricted to the following statement, which has

> been approved for consumption by Mr. Mcs:

> " The purpose of the deposition was to further explore with Dr. Larry

Colley

> the manner in which Trigon uses medical physicians to determine what all

> providers get paid under Trigon policies, even when the studies in

refereed

> medical journals indicate that medical physicians are substantially

> uneducated in and incompetent to deliver the most cost-effective and

> beneficial care for musculolskeletal problems that represent (possibly

with

> the exception of respiratory problems) the most common problem reported to

> health care providers in the United States. The ACA lawyers intended to

> question Dr. Colley closely on his knowledge, background, education and

> training in problems involving the musculoskeletal system and his

knowledge

> or lack of knowledge of studies that reference the training that

chiropractic

> manipulation requires and that it is the preferred mode, or treatment, for

> caring for back pain and related problems. The lawyers also expected to

> inquire about the substantial lack of documentation produced by Trigon, to

> date, supporting the medical physicians' decisions to reduce reimbursement

> rates for chiropractors and their patients for chiropractic care. At the

> time of this writing it is known that Dr. Colley's deposition took

> approximately 7½ hours. Details of this deposition are currently under

> confidential seal at the request of Trigon. Within 30 days of receiving

the

> full transcript of the deposition, the matter of confidentiality will be

> revisited.

>

> 2. TRIGON IS PURCHASED BY ANTHEM

>

> You may have seen recent press reports that Trigon will be purchased by

> Anthem. The deal would add 2.2 million Trigon members to Anthem and

increase

> enrollment to more than 10 million lives, making it the second largest

Blue

> Cross/Blue Shield business in the nation. Anthem operates Blue Cross/Blue

> Shield plans in 8 other states including Colorado, Connecticut, Indiana

(its

> home base), Maine, Nevada, New Hampshire and Ohio. Four of those states

have

> reported problems with chiropractic coverage, and a recent front-page

article

> in the Indianapolis Star has detailed the general " ill will " providers

have

> with Anthem. On the other hand, Rob Sherman, General Counsel for the Ohio

> State Chiropractic Association, has reported that while problems remain

with

> Anthem, it has shown cooperation in its dealings with the state

association.

>

> As for ACA's litigation, Anthem will be purchasing not only Trigon's

assets

> but will also purchase its liabilities, including the potential liability

> resulting from our litigation. What is also clear is that this purchase

> raises the importance of ACA's efforts to reform Trigon policies, since

those

> policies will soon become part of the nation's 2nd largest Blue Cross/Blue

> Shield plan (spread into 9 different states). A successful outcome would

> have an immediate effect within Anthem and an undoubted ripple effect on

> other insurers across the nation.

>

> In the and Goliath struggle the ACA is engaged in, Goliath just

became

> about 4 times larger.

>

> 3. STROKE CONTROVERSY CONTINUES (CANADIAN INQUEST)

>

> As you've probably heard, two high-profile stories are in the news

allegedly

> linking chiropractic manipulation to stroke - Sharon Stone and the Lana

Dale

> inquest in Canada. As a result, DCs across the nation might receive

> inquiries from patients concerned about the safety of chiropractic

cervical

> adjustments. The ACA recently developed talking points on the safety of

> chiropractic that we believe will help you respond to patients concerned

> about these recent news reports. While the information was originally

> developed in response to an extremely flawed Canadian study - and not the

> inquest in particular -- we believe the general information regarding the

> safety of chiropractic treatment will still be helpful. You can find it

on

> our Web site at http://www.acatoday.com/hot_topics/memo_stroke.shtml.

>

> In addition, the ACA has been in contact with the Canadian Chiropractic

> Association (CCA) regarding the inquest, and reports from Canada are

> that things are going as well as can be expected. According to the CCA,

news

> reports in Canada on the inquest have been relatively balanced - pointing

out

> the chiropractic profession's contention that Ms. was predisposed to

> stroke because of smoking, elevated cholesterol levels, high blood

pressure

> and a family risk of heart disease, among other things. In addition, the

CCA

> is confident that its team of experts will clearly point out the

chiropractic

> profession's impressive safety record and history of positive outcomes.

> According to a May 2 story in the Toronto Star, Dr. Haldeman

testified

> that the " stroke was almost certainly a natural consequence of advanced

> artherosclerotic disease " and " that the suggestion that trauma from

> manipulation caused bleeding (inside the skull) is without scientific

> validity. " You can follow media coverage of the inquest on the Toronto

> Star's Web site at www.thestar.com.

>

> We will continue to forward updates on the Canadian inquest as they become

> available. We are making this information available to our state

> associations as well.

>

> 4. SOUTH DAKOTA DOCTORS STEP UP FOR THE LAWSUITS

>

> This past week the South Dakota Chiropractic Association contributed

another

> $10,000 to the National Chiropractic Legal Action Fund (NCLAF), bringing

its

> total contribution to $60,000. What is most remarkable about their

> contribution is not only that it is the second highest amount from a

state,

> second only to Ohio, but that the total number of chiropractic licentiates

in

> the state is under 400. When you consider that we have 55 thousand-plus

DCs

> in the country, South Dakota shines brightly.

>

> 5. MC/NC: ONE CHIROPRACTIC NETWORK SHOWS ITS SUPPORT

>

> The Michigan Chiro/Net Corporation (MC/NC), the largest non-profit

> chiropractic IPA in Michigan, contributed $5,000 this week to the NCLAF,

> bringing its total contribution to $19,000. Since the inception of ACA's

> legal activity against CMS (formerly HCFA) and Trigon, the MC/NC was one

of

> the first, if not the first, chiropractic IPA to support the effort with

> annual corporate contributions. They have also promoted this effort in

their

> newsletter, which generated further contributions by their members. With

the

> exception of Triad, whose contribution of $100,000-plus through NCMIC is

the

> largest ever, the majority of the chiropractic networks have either been

> silent or their contributions have been relatively small. Here is what

the

> record shows: (I will fill in)

>

> 6. ACA REPRESENTATIVE MEETS WITH PRESIDENT'S POLITICAL ADVISOR

>

> Dr. Luedkte, past president of the ACA and PAC chairman, met with

> Karl Rove, political advisor to President Bush in a private gathering

> attended by no more than nine other contributors. The ACA PAC, together

with

> Dr. Luedtke's personal contribution, helped support Dr. Luedtke's

> participation in the event. He had some one-on-one face time with Rove,

and

> learned that Rove had just seen his chiropractor. Rove invited our

doctor

> to call him the next time he is in Washington, D.C..

>

> Dr. Luedtke brought many things to this meeting - not just a check. He

> represented the ACA, which is considered a player in the political arena.

> Equally important, he is chairman of the Republican Party of Dane County,

> Wisconsin. Involvement in political matters has always been one of our

> profession's strengths. Doctors like Dr. Luedtke, who labored in the

> political vineyards for years, are the bulwarks of our successes.

>

> 7. SCHOLARSHIP AVAILABLE TO STUDENT ACA (SACA) MEMBERS

>

> Once again the American Chiropractic Foundation and the ACAuxiliary are

> offering a number of scholarships to SACA members. Eligibility

requirements

> include SACA membership, a minimum GPA of 3.0, full-time student status,

and

> enrollment in the student's second year of chiropractic college. Up to

> fourteen scholarships will be awarded each year. Typically the ACF will

> grant ten to twelve $1,000 scholarships, and the ACAuxiliary will award

two

> $2,500 scholarships. Scholarships are to be used toward tuition, books or

> other school supplies. The determination of the number of scholarships

> granted will be made by the ACF and ACAuxiliary. The deadline for 2002

> scholarship applications is July 12th. Awards will be announced at the

ACA's

> Annual Business Meeting on August 31st. Additional information regarding

the

> scholarships, including the application, can be found at the ACA Web site

at

> http://www.acatoday.com/about/saca/scholarship.shtml, at college student

> financial centers, or through the campus SACA chapter.

>

> 8. CORRECTION REGARDING APHA STORY

>

> My report last week included a story about the accomplishments of the

> chiropractic section in the American Public Health Association. Some of

the

> information I received was from doctors who participate in the

chiropractic

> section. If I were smart, I would have included only their information.

> However, I thought I would show everyone how smart I really was by adding

my

> own spin and information to the story, when I noted that the APHA " ...for

> years refused to even accept the membership of our doctors in its

> organization. This changed in the early 1990s when chiropractic

membership

> began to be accepted. " Apparently, this is not true. Fortunately, there

> were some people reading this newsletter, including Dr. Rand Baird, who

> caught my errors. Dr. Baird commented that, " This is patently untrue.

APHA

> recognized chiropractic as safe and effective for certain

> neuromusculoskeletal conditions and low back disorders in 1982, not 'the

> early 1990s.' And while APHA had an official anti-chiropractic care

policy

> from 1969 thru 1982, it never refused individual membership at any time in

> its history. Think about it for a second: if APHA didn't allow DC

> memberships until the 1990s, how could I have been a member since 1975?

How

> could we have gotten the anti-chiropractic policy superceded in 1982? How

> could we have established The Chiropractic Forum - SPIG in 1981? The fact

is

> we had over 500 individual members plus several agency members before the

> early 1990s! "

>

> If anyone would know the history of chiropractic in the APHA, it is Dr.

Rand

> Baird. He was one of the first chiropractic doctors who fought the early

> years of recognitions with the APHA.

>

> 9. 2nd ANNUAL MEDICAL FICTION WRITING COMPETITION FOR PHYSICIANS

>

> We received notice from SEAK, Inc., a legal and medical information

system,

> that they are seeking fictional short stories not to exceed $2,500 words.

> The purpose of the competition is to encourage physicians to become more

> interested in and adept at writing medical fiction. There are cash awards

of

> $1,000 for first prize, $500 second prize and $250 third prize. Deadline

for

> submission is September 13th. There is no charge for entering the

contest.

> If you are interested, let me know and I will forward you the pertinent

> information.

>

> 10. FOOT LEVELERS SEMINAR IN MINNESOTA HELPS SUPPORT LEGAL ACTION

>

> Foot Levelers' 50TH ANNIVERSARY CELEBRATION CONFERENCE in Minneapolis (May

> 17-19, 2002) helps support the lawsuits.

>

> 18 Hours of License-Renewal Credits -- ONLY $99!

>

> The right price, the best speakers and lots of fun festivities - all for a

> good cause! What more could you ask for from a Foot Levelers 50TH

> ANNIVERSARY CELEBRATION CONFERENCE?

>

> Held at the Millennium Hotel in Minneapolis, Minnesota, this special

> three-day extravaganza (May 17-19, 2002) focuses on key practice-building

> aspects, such as:

>

> · Philosophy - Understand how to make the chiropractic paradigm work for

> you!

> · Technique - Learn new treatment protocols of practical and immediate

> value!

> · Motivation - Discover invigorating approaches for growing your

practice!

>

> Engage in lively discussions with chiropractic's most popular and

> entertaining speakers, including favorites such as Drs. Mark Charrette,

Kim

> Christensen, Danchik, Hyland, , K.S.J. Murkowski,

Jeff

> Olsen, and Terry Yochum. Also, enjoy a slate of planned festivities and

> plenty of refreshments, including a large ornate anniversary cake and

lavish

> hors d'oeuvres.

>

> Doctors of chiropractic pay ONLY $99 when they sign up at least 5 days in

> advance. With early registration, chiropractic assistants and students

can

> attend for JUST $49. Half of all proceeds from this special event will go

to

> the colleges of the attendees' choice, with the other half benefiting the

> American Chiropractic Association's (www.acatoday.com) National

Chiropractic

> Legal Action Fund (NCLAF).

>

> Please call us toll-free at 1-800-553-4860 (Canada: 1-800-344-4860) or

click

> here:

> (https://www.footlevelers.com/doctors/spring_conferences.cfm?pg=157) for

more

> details. Hurry, early registration ends May 12, 2002! Don't miss this

> special opportunity to unlock your practice's potential at Foot Levelers'

> 50TH ANNIVERSARY CELEBRATION CONFERENCE.

>

> Foot Levelers, Inc.

> U.S.: (800) 553-4860

> Canada: (800) 344-4860

> International: (540) 345-0008

> FAX: (540) 345-0202

> E-mail: service@...

> Address: P.O. Box 12611

> Roanoke, VA 24027-2611

>

> 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 email me at gcuneo@....

>

>

> We have placed my weekly EVP report on our Web site, where members and

> non-members can download the report in various formats. We will have the

> report available in " Publications, " " EVP Report. " The report is available

in

> .html and .txt formats.

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to kpark@... with

a

> subject of: " REMOVE - EVP Report. "

>

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Members, Board of Governors, House of Delegates and

Other

> Interested Parties

> From: Cuneo

> Re: ACA EVP Weekly Report

> Date: May 13, 2002

>

> In this week's report:

>

> 1. MEDICARE LEGISLATION IN FINAL STAGES: IT'S TIME TO CALL YOUR HOUSE

MEMBER

> 2. CANADIAN INQUEST: WEEKLY UPDATE

> 3. LEGAL UPDATE

> 4. IOWA SEES TRIGON-LIKE PROBLEMS WITH LOCAL BLUES AND TAKES ACTION

> 5. COCSA SUPPORTS THE LEGAL ACTION FUND

> 6. DEREK PARRA VNR TO AIR ON HEALTH NEWS PROGRAM: BE SURE TO TUNE IN

> 7. CORRECTION ON CONTRIBUTIONS BY CHIROPRACTIC MANAGED CARE NETWORKS

> 8. EVP ADVISORY COMMITTEE CALL IN APRIL

> 9. TALENT VS. CARNAHAN: A SENATE RACE WORTH WATCHING

> 10. ORDER YOUR ACA-ENDORSED BACKPACK

> 11. CAN'T ACCESS THESE LINKS?

>

> 1. MEDICARE LEGISLATION IN FINAL STAGES: IT'S TIME TO CALL YOUR HOUSE

MEMBER

>

> The House Ways and Means Committee and the House Energy and Commerce

> Committees are currently working to produce a joint Medicare reform bill

that

> could be brought to the floor of the House for a vote in the near future,

> perhaps as early as the end of this month. As this bill is expected to be

> the only Medicare reform bill that will be voted on by the House this

year,

> it is critical that we are successful in our efforts to include a

> chiropractic provision in the bill. The provision would expand

reimbursable

> chiropractic services in Medicare. We are pushing to include the

> chiropractic provision contained in the Watkins bill, which currently has

72

> cosponsors.

>

> The joint committee bill being developed remains " a work in progress, " and

> while the bill has not been finalized, we have obtained a " draft " copy of

the

> legislation. Thus far the draft bill does not contain any chiropractic

> pressure. If we have not successfully included a provision in the bill by

> the time it is publicly unveiled, it will be very difficult to win

inclusion

> during the balance of the legislative process. It is important that

doctors,

> patients, students and state associations act now to exercise its DC

power.

> For further information, please visit our Web site at

> http://www.acatoday.com/government/medicare/041602.shtml or contact the

> Government Relations Department.

>

> 2. CANADIAN INQUEST: WEEKLY UPDATE

>

> The Canadian inquest into the case of a 45-year-old woman whose death has

> been blamed by some on chiropractic cervical manipulation seems to be

going

> fairly well for the chiropractic profession. Last week, Dr. Deck,

the

> coroner's pathologist who attributed the woman's death to chiropractic

> adjustment, faced days of hard-hitting cross-examination by attorneys for

the

> chiropractic profession, who have characterized his work as unscientific

and

> biased. According to media reports, Dr. Deck came to his initial

conclusion i

> n 1996 about the cause of death before he even looked at the pathological

> evidence through a microscope. In fact, he based his first opinion on the

> conclusion of his protégé, Dr. Pollanen, who at the time believed

> spinal manipulation was to blame for the death. Now, however, Dr.

Pollanen

> has changed his mind, saying that he now believes atherosclerotic disease

> caused the woman's death. " We were wrong, " Dr. Pollanen testified at the

> inquest. Dr. Pollanen changed his mind after extensively reviewing

> additional evidence that he and Dr. Deck missed the first time around.

You

> can follow media coverage of the inquest on the Toronto Star's Web site at

> www.thestar.com.

>

> 3. LEGAL UPDATE

>

> There is nothing of major significance to report on either lawsuit.

>

> As you know, the judge in our lawsuit against HHS has had under

consideration

> for some time the summary judgments filed by both HHS and ACA. This issue

> concerns who can provide the chiropractic benefit under Medicare Part C.

> Already, HHS has reversed its policy that had allowed physical therapists

to

> provide the chiropractic-specific benefit of " manual manipulation of the

> spine to correct a subluxation. The department still maintains, however,

> that medical and osteopathic doctors would still qualify for reimbursement

of

> the chiropractic benefit, contrary to what we believe was the intent of

> Congress.

>

> Depositions continue in the Trigon case, and the usual battle for

> documentation continues with the Medical Society of Virginia. Thanks to

the

> Minnesota Chiropractic Association for its contribution of $3,000,

bringing

> its total contribution to $5,500.

>

> 4. IOWA SEES TRIGON-LIKE PROBLEMS WITH LOCAL BLUES AND TAKES ACTION

>

> ACA's delegate to Iowa, Dr. F. Dow Bates, reported great success from the

> Iowa Chiropractic Society convention two weeks ago. This story is

important

> not only because of the money raised ($27,000) but also because of the

> message that generated this support. At Dr. Bates' suggestion, I

contacted

> Dr. Steve Kraus, alternate delegate to Iowa, who spearheaded the effort.

Dr.

> Kraus confirmed the amount that was raised (and subsequently sent it to

ACA).

> He indicated that on both days of the convention he was given the

> opportunity to promote the lawsuit against

> Trigon, and his message to the attendees was simple: The problems facing

Iowa

> doctors from the Wallmark Blue Cross/Blue Shield plan are nearly identical

to

> the problems being litigated by ACA with Trigon, including the argument

that

> they pay us less for the same service because we are " limited

practitioners. "

> He continued by stating that the Iowa doctors can attempt to litigate

this

> issue locally at the cost of hundreds of thousands of dollars, or

participate

> in ACA's lawsuit, which if successful will impact their doctors locally.

>

> As an aside, it is curious (or perhaps not so curious) that Iowa is now

the

> third state (Montana and Virginia the others) where the local plans are

> acknowledging that they are paying us less for the same services because

they

> consider us limited practitioners. Sounds like a lot of plans are

watching

> what is happening in the Trigon suit.

>

> If this wasn't significant enough, two weeks earlier, Dr. Bates and Dr.

> Krause helped organize a fundraiser for Senator Harkin, who is up for

> reelection against Republican challenger Congressman Greg Ganske. They

> brought together over 125 attendees representing a cross-section of the

> community, including 40 doctors of chiropractic, and raised $15,000. The

> event was held at the home of Dr. Krause.

>

> 5. COCSA SUPPORTS THE LEGAL ACTION FUND

>

> As an illustration of the broad support for ACA's lawsuits, the Congress

of

> Chiropractic State Associations, a non-partisan coalition of chiropractic

> state associations, representing all philosophies, agreed to contribute

> another $2,000 to the National Chiropractic Legal Action Fund. This brings

> COCSA's total contributions to $3,000.

>

> The March 2001 issue of Florida Chiropractic News, a publication of the

> ICA-affiliated Florida Chiropractic Society, had a front-page story titled

> " Wilk II: The New Legal Battle to " Save our Subluxation, " giving strong

> support for both of our lawsuits. Until the inception of these lawsuits,

> there clearly has been no other issue since the Wilk case that has so

unified

> this profession.

> 6. DEREK PARRA VNR TO AIR ON HEALTH NEWS PROGRAM: BE SURE TO TUNE IN

>

> ACA's video news release (VNR) featuring Olympic gold and silver medalist

> Parra will be airing throughout the country during the month of May

on

> a news magazine called " Health & Home Report. " The program - which

features

> topics related to consumer health, fitness, nutrition and lifestyle - airs

on

> both broadcast and cable TV, and is watched by an estimated 10 to 12

million

> viewers each month.

>

> Stations that regularly air " Health & Home Report " are listed on ACA's Web

> site at http://www.acatoday.com/hot_topics/parra_news.shtml. If you live

in

> the viewing area of one of these stations, check your local listings for

> information on when the program will air. Most of the stations air the

> program multiple times throughout the month, so if you've already missed

one

> broadcast, it's likely you'll have a chance to see it again.

>

> In the VNR, Parra discusses the important role chiropractic care played in

> his medal-winning performances. And Dr. Overland, ACA's Connecticut

> delegate and chiropractic consultant to the U.S. Speed Skating Team,

explains

> that it's not just the Olympic athlete who can benefit from chiropractic

> care. As Dr. Overland points out, even common, everyday activities like

> gardening or housework can lead to overuse injuries that could require

> treatment. You can view the VNR on ACA's Web site at

> http://www.acatoday.com/hot_topics/parra_video.shtml.

>

> Also, watch my weekly report next week for information on how you can

order

> ACA's new TV public service announcements (PSAs) and TV ad spots featuring

> Parra.

>

> 7. CORRECTION ON CONTRIBUTIONS BY CHIROPRACTIC MANAGED CARE NETWORKS

>

> Last week's EVP report included an article that focused on the

contributions

> by chiropractic networks to the National Chiropractic Legal Action Fund.

> While I specifically mentioned the contributions of the Michigan Chiro/Net

> Corporation, I did not include a list of other chiropractic networks that

> have contributed. So in the interest of good journalism, here is the list

of

> chiropractic managed care networks that have contributed to our lawsuits

> against HHS and Trigon, along with the amount of contribution since our

> lawsuits were filed in 1998:

>

> · Michigan Chiro/Net Corporation (MC/NC): $19,000

> · Preferred Chiropractic: $5,000

> · Spinal Care Group: $4,000

> · Chiropractic Care of Minnesota, Inc.: $2,500

> · Chiropractic Health Plan, Inc.: $2,000

> · Academy for the General Practice of Chiro.: $1,000

> · American Chiropractic Network: $1,000

> · Atlantic Physicians Network: $1,000

> · Connecticut Chiropractic Network: $1,000

> · Quality Managed Health Care, Inc.: $1,000

>

> 8. EVP ADVISORY COMMITTEE CALL IN APRIL

>

> The monthly call of the state association leadership and ACA staff was

held

> on April 23rd. Since I was attending the deposition of Dr. Colley in

> Virginia, Dr. Wills chaired the meeting. Representatives from Louisiana,

> Kentucky, Colorado, Pennsylvania, Iowa, Michigan and Minnesota, as well as

> Janet Jordan of COCSA, plus staff members Wanda, Rick , Tom

Daly

> and Stavenjord participated on the call. The topics discussed

included

> our strategy for being part of the Medicare proposal being considered in

> Congress, budgeting by projects,

> NCLF program, the new antitrust legislation containing a Wilk amendment

and

> an update on HIPAA. The next meeting of the committee is scheduled for

May

> 21st at 1:00 pm Eastern.

> 9. TALENT VS. CARNAHAN: A SENATE RACE WORTH WATCHING

>

> A couple of weeks ago I printed the story from the Washington Post that

> listed some of the key Senate races this year and how the major contenders

> were doing with contributions. Not surprisingly, all the incumbents had a

> substantial fundraising edge over their opponents. One race in which the

> financial margin was closer was in Missouri, where the incumbent Senator

Jean

>

> Carnahan was being challenged by former Congressman Jim Talent. A recent

> poll sponsored by Republicans shows how close a race this will be: Former

> Rep. JimTalent ® led Sen. Carnahan (D) by four points. Talent took

48

> percent to 44 percent for Carnahan in the survey, which was done by

> GOP-polling firm American Viewpoint for Talent and the National Republican

> Senatorial Committee. The poll tested 600 registered voters from April 22

to

> 24 and had a 4 percent margin of error. Both Talent and Carnahan had

solid

> favorable ratings in the survey. Carnahan was viewed favorably by 56

percent

> of the sample and unfavorably by 33 percent. Talent had a 51 percent

> favorable score and a 21 percent unfavorable rating. Again, this is a

> Republican-sponsored poll, so the sampling could be skewed. However, this

is

> one of those races where control over the U.S. Senate will be determined.

> You know that both parties will be spending a ton.

>

> 10. ORDER YOUR ACA-ENDORSED BACKPACK

>

> The Consumer Product Safety Commission estimates that, in 1999,

approximately

> 6174 emergency room visits were a result of spinal injuries stemming form

> heavy backpacks. Now, you can help make backpack safety a reality for

your

> patients and your community. First, order the ACA-endorsed Chiropak.

Some

> specific features of this high-quality pack include:

>

> · load close to the wearer's center of gravity

> · anchored load

> · comfortable body contact surfaces

> · waist belt to position load on top of hips

> · sternum strap

> · shoulder strap adjustment to fine-tune weight distribution

>

> To order, call 1-800-547-BAGS, then dial X7951. Three sizes and two

colors

> are available. Backpacks will ship in August. Doctors receive a special

30%

> discount off the suggested retail price.

>

> To sign up for ACA's members-only backpack safety program, email

Leigh-Anne

> Perialas, ACA vice president of business development at

> lperialas@...

>

> 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 email me at gcuneo@....

>

>

> We have placed my weekly EVP report on our Web site, where members and

> non-members can download the report in various formats. We will have the

> report available in " Publications, " " EVP Report. " The report is available

in

> .html and .txt formats.

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to kpark@... with

a

> subject of: " REMOVE - EVP Report. "

>

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Members, House of Delegates and Board of Governors

> From: Cuneo

> Re: ACA EVP Weekly Report

> Date: May 28, 2002

>

>

>

> In this report:

>

> 1. NEW ERISA REGULATION COULD HURT THE MANAGED CARE INDUSTRY

> 2. CANADIAN INQUEST UPDATE

> 3. THE FASCINATING POLITICS OF THE MEDICARE REFORM BILL

> 4. SUMMARY OF DEVELOPMENTS SINCE JANUARY IN TRIGON, HHS LAWSUITS IS ON

OUR

> WEB SITE

> 5. DR. JEROME MCANDREWS BECOMES TOP LEGAL ACTION FUND CONTRIBUTOR - BY

FAR

> 6. DEE CEE LABS SHOWS ITS COMMITMENT TO THE LEGAL ACTION FUND

> 7. DEADLINES APPROACHING FOR ANNUAL MEETING

> 8. CORRECTION: MISSISSIPPI DOES IT AGAIN

> 9. ACA AT PARKER SEMINAR

> 10. CAN'T ACCESS THESE LINKS?

>

> 1. NEW ERISA REGULATION COULD HURT THE MANAGED CARE INDUSTRY

>

> A new regulation prepared during the closing days of the Clinton

> administration, that deals with ERISA and becomes effective in July, will

> provide a useful weapon to patients and doctors who are fighting managed

care

> companies and others. The regulation has so much potential that the major

> managed care and business interests along with their allies in the House

of

> Representatives are making a major push to have the Department of Labor,

> which would be responsible for implementation, delay or water down its

> provisions. In a letter from Republican Congressional leader Boehner

to

> his supporters, he indicates that these regulations go further than the

> Patient's Bill of Rights bill and should be opposed. Recognizing this

fact,

> the Democrats are pushing for immediate implementation. We are joining

other

> groups in an attempt to have this fully implemented, and will be

discussing

> this provision with the PARCA coalition to get these groups involved as

well.

>

> The new ERISA rules require a) greater disclosure of claim procedures,

> including the specific reasons for any claim denial with all relevant

> information and guidelines used in the denial along with the

identification

> of any claims reviewer; more procedures intended to assure full and

fair

> review of claims from plan participants; and c) more definite timeframes

and

> procedures to assure timely reviews of initial claims and appeals of

denied

> claims. If properly followed, the new rules would give doctors a new tool

to

> appeal denied ERISA plan claims that are too often not appealed. It will

> also give doctors the ability to find out why a claim is being denied, the

> policies and protocols used in the review of claims and the identity of

the

> experts used in the review of a denied claim. It's not a silver bullet,

but

> it can be a powerful tool in challenging a benefit denial.

> We will keep you apprised of what develops. In the meantime, if you are a

> state association, you should be asking your legal counsel to review this

> opportunity.

>

> At press time, the Internet link to the text of the ERISA regulation was

> down. If you'd like to receive a copy of the text, Please email me at

> gcuneo@....

>

> 2. CANADIAN INQUEST WEEKLY UPDATE

>

> Proceedings in the Canadian inquest continue to turn up information that

> appears helpful to the chiropractic profession. Last Wednesday, May 22,

the

> family physician of 45-year-old Lana Dale -- whose death is being

> blamed by her family on chiropractic cervical manipulation -- testified

that

> Ms. suffered from a variety of medical problems during the 12 years

he

> served as her family physician. Dr. Harvey Knapp testified that Ms.

> had a history of smoking, that she was not compliant with her blood

pressure

> medication and that she experienced a great deal of stress in her life,

among

> other things.

>

> Also last week, Dr. Hamilton Hall, an expert witness in orthopaedic

surgery,

> testified that he believes the most reasonable figure citing the relative

> risk of stroke after cervical manipulation is about 1 in 1 million. Dr.

> Hamilton also discussed the limitations of studies presented by the

counsel

> for the family that have been used to demonstrate the dangers of

> chiropractic cervical manipulation. Dr. Hamilton testified that studies

> based on surveys of practitioners - as opposed to clinical trials - could

> create bias in the phrasing of the questions.

>

> And on Monday, May 27, a widely respected Canadian neurosurgeon testified

> that Ms. died of natural causes and rejected claims that

chiropractic

> manipulation had anything to do with her death. Dr. Moulton, head

of

> neurosurgery at St. 's Hospital in Toronto, agreed with earlier

> testimony by such experts as Dr. Haldeman that Ms. ' stroke was

> caused by advanced hardening of the arteries.

>

> 3. THE FASCINATING POLITICS OF THE MEDICARE REFORM BILL

>

> Hopefully you have received the alert from Jay Witter, ACA Vice President

of

> Government Relations, requesting that you contact members of the House

Energy

> and Commerce Committee and the House Ways and Means Committee and urge

them

> to include a chiropractic provision in the Medicare Reform bill currently

> being drafted. This continues to be a time-sensitive issue, as our latest

> intelligence indicates that the decisions on who is in and who is out of

the

> Medicare reform bill will be determined this week.

>

> For those of who are intrigued by the politics of Washington, D.C., this

> evolving story is fascinating. The House Republican leadership has made

it

> known that they want a Medicare bill this year and that they have the

votes

> to do it (at least they think they do). Unless things break down, this

will

> be the best opportunity for the passage of a comprehensive Medicare bill

in

> the

> House. And all the health care and senior citizens groups are attempting

to

> get their provision included. The basic part of this bill will be a drug

> provision for seniors, as no one wants to face the senior citizen voters

this

> November without trying to deal with this expensive issue. To make things

> more interesting, health care groups are lobbying Congress heavily to

correct

> the current formula for determining reimbursement for Medicare fees.

These

> fees will be 5% lower than they were last year. Called the " Single

> Conversion Factor, " the formula for reimbursement is tied to the Gross

> National Product (GNP), which this year happens to be down by 5%. Next

year,

> the GNP is anticipated to be down by another 5%. The price tag to correct

> this problem is tremendous. To complicate the situation even further, the

> hospitals, already claiming to be suffering because of cuts of 1997, are

> demanding that their fees be increased, even at the expense of the health

> care providers. So you now have a battle between the hospitals and the

> health care providers. Finally, every health care group including us is

> trying to get a piece of the bill. Right now, the word is that the

physical

> therapists' efforts to get a provision giving them direct access has been

> sidelined in favor of a simple study.

>

> Because of the complexity and controversy of the issues, you have two

> Congressional committees attempting to reach consensus and come up with a

> single bill. The typical jealousies that exist between committees will

not

> make this easy. In addition, the conflicting positions of groups that

> generally support the same members complicate the situation. And finally,

> there is only so much money available. We have learned that the physical

> therapists have been told that the best they can expect is a study on

direct

> access. If the best the physical therapists (not a small lobbying group)

can

> get is a study, then you know we will have to fight like heck to get a

> significant chiropractic provision.

>

> All the action is on the House side, with the Senate watching and holding

> fire until they see what the House plans to do. One thing that is fairly

> certain at this point is that the House will pass out a Medicare reform

bill.

> We need to make sure it includes a chiropractic provision.

>

> 4. SUMMARY OF DEVELOPMENTS SINCE JANUARY IN TRIGON, HHS LAWSUITS IS ON OUR

> WEB SITE

>

> If you interested in seeing the significant events surrounding our two

> lawsuits since January of this year, or have a non-member colleague

> interested in the issue, I have included a summary on our Web site

describing

> the events from January 10 to the present at

> http://www.acatoday.com/legal/mid_year_review.shtml.

>

> 5. DR. JEROME MCANDREWS BECOMES TOP LEGAL ACTION FUND CONTRIBUTOR - BY FAR

>

> ACA spokesperson Dr. Jerome Mcs became the top individual

contributor

> to the National Chiropractic Legal Action Fund this week by personally

> contributing $20,000. Putting his money where his mouth is, he has long

felt

> that these lawsuits will have a significant impact on the future of the

> profession. And this is not his first contribution to the lawsuits. In

> fact, this contribution brings his total contribution to the fund to

$26,000

> - more than double any other single contributor. Over the years, Dr.

> Mcs has made many great contributions to the chiropractic

profession.

> This contribution is yet another. He has nothing personally to gain by

this

> effort, except to once again demonstrate his commitment to the profession.

I

> think everyone needs to congratulate Dr. Mcs for this commitment.

Dare

> I ask…would anyone out there like to match this effort?

>

> 6. DEE CEE LABS SHOWS ITS COMMITMENT TO THE LEGAL ACTION FUND

>

> We received a $5,000 contribution this week from Dee Cee Labs, bringing

its

> total contribution to $15,000. Dee Cee Laboratories provides nutritional

and

> orthopedic items, and is the exclusive source of famous Formula 303, Kool

> Comfort, Formula 75, Mark V, Formula 512, and Beta-25. They are the

> fourth-highest vendor contributor to the legal action fund. Please show

your

> appreciation for those vendors who support our efforts.

>

> Other contributions we received this week from chiropractic organizations

> included:

> · Hillsborough County Chiropractic Society - Florida: $500 (first

> contribution)

> · Natural Care Products: $100 (first contribution)

>

> 7. DEADLINES APPROACHING FOR ANNUAL MEETING

>

> Deadlines are approaching for submission of amendments to bylaws,

> resolutions, position papers and awards. Mark your calendars for the

> following:

>

> · Position Papers: June 1

> · Proposed bylaws: July 1

> · Resolutions: July 16

> · Awards: July 16

> (Chiropractor of the Year, Humanitarian of the Year, Delegate of the Year,

> Researcher of the Year, Academic of the Year)

>

> For further details regarding the criteria for the selection of award

winners

> or for the submission of resolutions and bylaws, please send me an email

> (gcuneo@...).

>

>

> 8.. CORRECTION: MISSISSIPPI DOES IT AGAIN

>

> Last week I reported that Dr. Foxworth had been appointed by the

> Governor as Director of the Mississippi State Board of Health. Actually,

he

> was reappointed to the State Board of Health and elected as chairman by

his

> fellow board members after serving as vice chairman for 2 years. Very

> impressive.

>

> 9.. ACA AT PARKER SEMINAR

>

> Seminars is coming to San Diego June 27th to 30th at the Sheraton

San

> Diego Hotel and Marina. The ACA will again be given the opportunity to

> promote the lawsuits to the attendees.

>

> For further details or to register for the upcoming seminar, contact

> at 888-727-5338 or visit their Web site at www.parkerseminars.com.

>

> 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 email me at gcuneo@....

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to kpark@... with

a

> subject of: " REMOVE - EVP Report. "

>

[Guest guest]

ACA EVP Weekly Report

> Memorandum to: ACA Members, Board of Governors and House of Delegates

> From: Cuneo

> Re: ACA EVP Weekly Report

> Date: 6/10/02

>

>

> In this report:

> 1. VIRGINIA STUDY CONFIRMS CHIROPRACTIC EFFICACY

> 2. MEDICARE REFORM LEGISLATION UPDATE: STILL NO CIGAR

> 3. REPORT ON CANADIAN INQUEST BY OUR PAST CHAIRMAN

> 4. HATCHET JOB BY PBS

> 5. PDR HELPS MICHIGAN

> 6. GOOD NEWS FROM CIGNA HEALTH PLAN OF HOUSTON, TX

> 7. STUDENT LOAN ISSUE

> 8. ERISA REGULATION STILL IN PLACE

> 9. ACA PART OF NATIONWIDE AWARENESS EFFORT

> 10. NEED HELP WITH HIPAA?

> 11. CAN'T ACCESS THESE LINKS?

>

> 1. VIRGINIA STUDY CONFIRMS CHIROPRACTIC EFFICIENCY

>

> The American Chiropractic Association and the Virginia Chiropractic

> Association are continuing to press in court against Trigon Blue

Cross/Blue

> Shield the fact that in all of the studies in referred journals that

doctors

> of chiropractic are not only equal to medical doctors, but superior to

them

> in the treatment of neuromusculoskeletal conditions. In 1992, the

University

> of Virginia (Robins School of Business) study pointed to a potential

economic

> shift form medical doctors to chiropractic doctors by concluding, " If

> chiropractic care were insured to the extent of the other specialists…

> [chiropractic] may emerge as a first option for patients with certain

medical

> conditions.

>

> The ACA is pressing this matter before the court and expects a reasonable

> explanation of why lesser trained, less cost-effective and less efficient

> practitioners should be paid more under any rational program to help

finance

> what Trigon Blue Cross/Blue Shield calls health care.

>

> 2. MEDICARE REFORM LEGISLATION UPDATE: STILL NO CIGAR

>

> The House Energy and Commerce Committee and the Ways and Means Committee

> continue to work behind the scenes in an attempt to reach consensus

regarding

> a comprehensive Medicare bill. As I indicated in my report last week,

this

> is a highly complicated and political process where both committees are

> trying to reach agreement not only among the members within the

committees,

> but also between the committees themselves. The issues are expensive and

> controversial. Within this atmosphere, we are attempting to push a

> chiropractic provision through. We are making great progress with the

> members of the House Energy and Commerce Committee, particularly through

its

> chairman, Congressman Tauzin. Drs. J. Flynn and Glenn

> Manceaux, along with the Louisiana Chiropractic Association, are to be

> congratulated for their efforts in persuading the Congressman to take a

close

> look at our provision.

>

> Our efforts on the Ways and Means side are meeting some resistance. While

> Congressman , subcommittee chair, was given authority to

prepare

> the bill for this committee, the overall chair of Ways and Means, Bill

> , seems to be exhorting his influence in this decision. is

no

> friend of the chiropractic profession.

>

> We are continuing to push the Ways and Means Committee members, and

> Congressman Wes Watkins, author of our bill, is weighing it. Watkins has

> made this his number one priority. We need to continue to push the

members

> of the Ways and Means committee to support a chiropractic provision by

> contacting both and Bill with this request.

>

> 3. REPORT ON CANADIAN INQUEST BY OUR PAST CHAIRMAN

>

> Immediate Past ACA Chairman, Dr. J. Flynn, attended a couple days

of

> the Canadian Inquest. Here are his personal observations:

>

> While attending the WFC Council meeting in Toronto, I was able to attend

> parts of two days of testimony in the Coroner's Inquest stroke trial

> along with Drs. Pedigo, Winkler, Sportelli and representatives of the

> profession from across the globe. Also with us were De Beck and Dr.

Tony

> Rosner of FCER. The first thing you notice is that the Judge is actually

a

> medical coroner. The jury is five with three women and two men chosen by

the

> Coroner without any opportunity of challenge by the attorneys. A three

juror

> majority decision will determine if death was natural,

> accident or undetermined. The trial just finished seven weeks of

testimony

> and will be taking a recess soon to be re-convened after the Labor Day

> Holiday, and expected to conclude the first weeks of September.

>

> Evidence is showing that there was a collaboration by two medical

physicians

> (Katz/Norris) to harm the practice of chiropractic and cause undue alarm

to

> the practice of cervical manipulation. Testimony is also proving no

> relationship to the cervical manipulation and the unfortunate stroke of

this

> woman. Media coverage has in many instances been sensational and brutal

to

> the profession in Canada, with practices down a reported 30%. In speaking

> with many of the leaders in Canada I find their resolve to be courageous

in

> withstanding this assault on the profession. Bringing this travesty to a

> successful conclusion will shed greater light on the safety of cervical

> manipulation, and I am optimistic that chiropractic will gain even higher

> esteem by having weathered this inquest. Henry Ward Beecher said once " We

> are always in the forge, or on the anvil; by trials God is shaping us for

> higher things. " To keep posted, go to HYPERLINK

" http://www.ccachiro.org "

> www.ccachiro.org and pull up " media " for weekly summaries of the trial

and

> recent press releases.

>

> 4. HATCHET JOB BY PBS

>

> I will never watch another episode of MASH again. Alan Alda, who played

> Trapper , M.D., on the TV sitcom MASH, was portrayed in that series as

a

> credible person. Last week, he moderated a one-hour episode of

" Scientific

> American Frontiers " on the subject of alternative medicine that was

anything

> but credible or scientific. Using Baratz, M.D., president of the

> notorious National Council Against Health Fraud, plus a former

chiropractic

> doctor named Badanes, as " objective " reviewers of chiropractic is

like

> asking Yasser Arafat to present a history of the state of Israel. We have

> responded directly to the President & CEO of Public Broadcasting System

> (PBS), and have sent copies of our letter to other appropriate parties.

As a

> foundation supported in part by federal grants, there are other

opportunities

> for action to explore and we intend to do so. To view a copy of our

> response, please go to HYPERLINK

> " http://www.acatoday.com/media/record/pbs.shtml "

> http://www.acatoday.com/media/record/pbs.shtml . If this program aired in

> your community, and you wish to contact your local PBS affiliate, feel

free

> to use this letter as a base for your own response. You can find the

contact

> information for your local affiliate by using this PBS " Station Finder: "

> HYPERLINK " http://www.pbs.org/stationfinder/index.html "

> http://www.pbs.org/stationfinder/index.html

>

> 5. PDR HELPS MICHIGAN

>

> The Automobile Club of Michigan (AAA) recently contacted the ACA

Automobile

> Club of Michigan (AAA), a member of the ACA's Claim Solutions Work Group

> (CSWG) and a large state auto insurer, to obtain the name of a local

> clinician/consultant to work with AAA's Medical Benefits Review Unit. The

> group was interested in upgrading their chiropractic medical review

practices

> and to receive comment on network participation requirements for doctors

of

> chiropractic. AAA's upgrade is the result of the CSWG-developed Medical

> Review Benchmarks and payor education efforts undertaken by the ACA. This

is

> another example of the success the ACA has had in working with major

payors

> through the ACA-sponsored CSWG.

>

> .

>

> 6.. GOOD NEWS FROM CIGNA HEALTH PLAN OF HOUSTON, TX

>

> A practitioner in the Houston, Texas, market recently contacted the ACA

> concerning the CIGNA health plan's network participation requirement that

> doctors of chiropractic be " board certified. " ACA's PDR staff spoke with

the

> plan's credentialing supervisor for clarification on the policy. Indeed,

the

> health plan required practitioners to be specialty council certified in

> addition to being a licensed doctor of chiropractic. PDR staff and ACA's

> legal department developed a 2-page document that provides a basic

> explanation of 'DC' licensure vs. council certification. This document

was

> forwarded to the health plan for review. Based on ACA's questioning of

their

> policy, and by providing this 2-page document, the health plan changed its

> credentials policy. Specialty council certification is no longer required

to

> participate in the health plan. In addition, this document will be used

by

> PDR staff and the Insurance and Managed Care Committee to educate networks

> and payers that might implement similar health plan/network participation

> requirements. This position is consistent with the policy adopted by the

> House of Delegates in the late '90s, which stated that specialty

> certification should not be a prerequisite for inclusion into a managed

care

> provider network.

>

> 7. STUDENT LOAN ISSUE

>

> There is nothing new to report on the student loan issue. The bill

including

> the chiropractic provision passed the Senate, but is still held up in the

> House by attempts to include a pro-life amendment. The House Energy and

> Commerce and the House Ways and Means committees have jurisdiction over

the

> issue. There is not much we can do until the pro-life issue is resolved.

>

> 8. ERISA REGULATION STILL IN PLACE

>

> Despite strong opposition by the managed care industry, the Department of

> Labor has indicated that it plans to move forward with the implementation

of

> its new regulations on ERISA, which if not the silver bullet, is an

important

> tool in fighting the managed care industry. The deadline for

implementation

> is July 1st, 2002. Refer to the EVP Weekly Report dated May 28th, 2002,

for

> details regarding what the new regulations accomplish. This is

significant.

>

> 9,. ACA PART OF A NATIONWIDE AWARENESS EFFORT

>

> The number of organ donors across the United States increased by almost 7

> percent in 2001, fueled primarily by a substantial rise in Hispanic and

> African-American donors and in " living donation, " HHS Secretary Tommy G.

> said recently, in marking the first anniversary of HHS' Gift of

Life

> Donation Initiative. In releasing the 2001 donation statistics, Secretary

> was joined by Klug, a snowboarder who won the bronze medal

in

> the Men's Parallel Giant Slalom event in Salt Lake City just 18 months

after

> receiving a liver transplant.

> To date, more than 1,000 partners - including the American Chiropractic

> Association (ACA) -- have joined the initiative's Workplace Partnership

for

> Life. Workplace partners raise awareness among their employees and

members

> about the urgent need for donation. In addition to ACA, partners include

> labor unions, corporations, nonprofit organizations, small businesses and

> others.

> More information about organ and tissue donation - as well as an organ

donor

> card that you can sign and carry in your wallet -- is available on ACA's

Web

> site at HYPERLINK " http://www.acatoday.com/hot_topics/donor.shtml "

> www.acatoday.com/hot_topics/donor.shtml , or on the HHS Web site at

> HYPERLINK " http://www.organdonor.gov " www.organdonor.gov .

> 10. NEED HELP WITH HIPAA?

>

> Register for the ACA's live phone conference, " HIPAA De-mystified, " and

get

> the facts you need now.

>

> No need to travel. Dial into the phone conference from your office or

home.

> Invite your staff to participate at no additional charge. This session

will

> focus on the administrative simplification aspects of HIPAA with a primary

> emphasis on medical records privacy. The speaker, Marc Cohen, Esq., will

> discuss the impact of the recent law, the requirements of this statute and

> medical records privacy. Interactive Q & A will ensure all of your concerns

> are addressed. Participants receive handouts and an audiocassette of the

> 90-minute session free with conference registration. Can't make the live

> call? Just order the conference audiocassette instead.

>

> Date: Thursday, July 11, 2002, Time: 12:30 - 2p.m., ET

>

> About the Speaker: Marc Cohen, Esq. is a principal at the Health Law

> Department of Ober, Kaler, Grimes & Shriver. Cohen's areas of expertise

are:

> scope of practice, professional compliance, regulatory and disciplinary

> matters related to doctors of chiropractic and other licensed health care

> professionals.

>

> To register, call 1-800-986-4636 today. ACA. Your Solutions Start Here.

>

> 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

> HYPERLINK " http://www.adobe.com " www.adobe.com . If you need further

> assistance viewing anything referred to in this report, please email me at

> HYPERLINK " mailto:gcuneo@... " gcuneo@... .

>

> We have placed my weekly EVP report on our Web site, where members and

> non-members can download the report in various formats. We will have the

> report available in " Publications, " " EVP Report. " The report is available

in

> .html and .txt formats.

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to HYPERLINK

> " mailto:kpark@... " kpark@... with a subject of:

" REMOVE

> - EVP Report. "

>

>

>

[Guest guest]

ACA EVP Weekly Report

> MEMORANDUM

> ACA members, Board of Governors and House of Delegates

> From: Garrett Cuneo

> Re: ACA EVP Weekly Report

> Date: June 17, 2002

>

>

> This week's report includes the following issues:

>

> 1. ACA'S GRASSROOTS MEDICARE CAMPAIGN IS WORKING (BUT WE'RE STILL NOT

THERE)

> LATE BREAKING NEWS

> 2. SIGNIFICANT VICTORY IN ILLINOIS FOR BILLING MASSAGE AND CMT

> 3..PBS CONTROVERSY: THE LATEST

> 4. UPDATE ON LAWSUIT AGAINST TRIGON BC/BS

> 5. BE A PART OF FCER PATIENT APPRECIATION DAY

> 6.. LOOK FOR CHIROPRACTIC IN SELF MAGAZINE

> 8. BRING YOUR LEGAL ACTION FUND CHECK TO PARKER SEMINAR IN SAN DIEGO

> 9. CAN'T ACCESS THESE LINKS?

>

>

> 1. ACA'S GRASSROOTS MEDICARE CAMPAIGN IS WORKING (BUT WE'RE STILL NOT

> THERE) LATE BREAKING NEWS

>

> Our grassroots efforts to include a chiropractic provision (for full scope

of

> practice) in Medicare reform legislation are working on the House Way and

> Means Committee. Congresswoman 's office has reported that

many

> congressional members have contacted her indicating their support for the

> chiropractic provision and that Rep. is herself supportive of it.

> However, some committee staffers are still showing resistance to our

> provision, which leads us to believe that Rep. Bill , chairman of

the

> committee, is the bigger problem. On the other hand, the House Energy and

> Commerce Committee and its chairman, Rep. Tauzin, remain in support

of

> the chiropractic provision.

>

> The situation is still very fluid and we have to keep the pressure on the

> Ways and Means Committee. Each week we are told that the Medicare reform

> bill will be released the following week and each week there is a further

> delay. As I indicated in a previous report, there are many different

issues

> that both committees are trying to address: drug benefits for senior

> citizens; the single conversion factor issue that effects all physicians

and,

> if not corrected, will result in a 20% drop in their Medicare payments

> through fiscal year 2006; and other individual requests by the health care

> community. The entire financial package can't exceed $360 billion for 10

> years. The Republican leaders were already disappointed when the

> Congressional Budget Office scored their " backdoor " fix at $43 billion.

>

> We need to keep pushing. The last significant Medicare bill was passed

in

> 1997. If we are going to get a chiropractic provision passed, it needs to

be

> part of this legislation.

>

> LATE BREAKING NEWS: WE ARE NOW GETTING MIXED SIGNALS FROM NANCY JOHNSON'S

> OFFICE . WE ARE ALSO INFORMED THAT THE WAYS AND MEAN COMMITTEE WILL BEGIN

> MARK UP OF THE MEDICARE BILL TOMORROW . PLEASE CONTINUE TO PRESSURE YOUR

> MEMBERS WHO SEAT ON WAYS AND MEANS TO PUSH REPRESENTATIVES JOHNSON AND

BILL

> THOMAS TO INCLUDE A STRONG CHIROPRACTIC PROVISION. A STUDY IS NOT

ACCEPTABLE.

> PLEASE DO IT TODAY.

>

>

> 2. SIGNIFICANT VICTORY IN ILLINOIS FOR BILLING MASSAGE AND CMT

>

> As reported by the ACA Department of Professional Development and Research

> (PDR), Blue Cross Blue Shield of Illinois will--effective May 20,

> 2002--reimburse for massage (97124) and chiropractic manipulative

treatment

> (CMT) (98940-3) on the same date of service. This is a great win for the

> chiropractic profession, which regularly battles insurers on coding

issues.

> Previously, Blue Cross Blue Shield of Illinois bundled the codes on the

basis

> that they are performed on the same body area on the same date of service.

> The change in coverage came following ACA's insistence that massage and

CMT

> are independently billable procedures according to CPT, and therefore

> bundling of massage with CMT is an unfair claims practice. Through the

work

> of the ACA's Blue CCHIP Program and earlier outreach efforts, ACA has

> established high-level contacts within Blue Cross Blue Shield of Illinois

to

> facilitate problem identification and resolution. Claims dated after May

20,

> 2002, will be eligible for reimbursement based on this change.

>

>

> 3. PBS CONTROVERSY: THE LATEST

>

> As reported last week, the PBS series " Scientific American Frontiers "

> recently aired a program examining various forms of alternative treatment

and

> included a portion on chiropractic.. The program seriously questioned the

> efficacy and legitimacy of chiropractic while offering no scientific or

> otherwise credible evidence to support its assertions. In light of this,

the

> PBS Web site features a statement that screams for comment:

>

> " ...PBS must guard against the public perception that editorial control

> might have been exercised by program funders...therefore even if the

public

> television professionals know that programs have not been inappropriately

> influenced by program funders, and therefore would be acceptable under the

> editorial control principles set forth above, steps must also be taken to

> avoid the public perception that program funders have influenced

professional

> judgments. Should a significant number of reasonable viewers conclude that

> public television has sold its professionalism and independence to its

> program funders, whether or not their conclusions are justified, then the

> entire program service of public television will be suspect and the goal

of

> serving the pubic will be unachievable. "

>

> In the case of " Scientific American Frontiers, " Agilent Technologies is a

> major sponsor of the program. Here is what the Agilent Web site says

about

> the company: " Agilent is a leading provider of life sciences and

analytical

> instrument systems to scientists in life sciences, pharmaceutical,

> environmental and chemical industries, worldwide. " Based on this, it

sounds

> like there could be questions regarding Agilent's objectivity toward the

> subject of alternative medicine.

>

> The grassroots of the chiropractic profession need to inform PBS that this

> kind of one-sided programming will not be tolerated. In fact, there's

still

> time to try and stop the program from airing in some locations or from

being

> aired a second time. Please consult the schedule* to determine if the

> program will air in a market within your state. If this is the case, we

ask

> that you contact the appropriate PBS affiliate and urge them not to

broadcast

> the program. If you need contact information for any PBS affiliate, visit

> www.pbs.org and click on " Station Finder. " A copy of the ACA's letter to

PBS

> can be found on our Web site at www.acatoday.com/media/record/pbs.shtml <

> http://www.acatoday.com/media/record/pbs.shtml>.

>

> *Note: To access the national schedule of Scientific American Program " A

> Different Way to Heal, " do the following:

> 1) go to www.pbs.org <http://www.pbs.org/>

> 2) click on " Programs A-Z "

> 3) scroll down and click on " Scientific American Frontiers "

> 4) scroll down page and click on icon for " A Different Way to Heal "

> 5) on the left, click on " TV Schedule "

> 6) scroll down page and click on " National Schedules "

>

>

> 4. UPDATE ON LAWSUIT AGAINST TRIGON BC/BS

>

> As I previously reported, ACA Legal Counsel Mcs filed a

72-page

> motion to Compel and for Sanctions against Trigon for what we believe is

> its effort to withhold valuable information regarding our lawsuit. Trigon

> has responded with a 37-page brief with extensive attachments, which has

been

> submitted under seal (confidential status). With the issue now in the

hands

> of the court, we are at one of the most critical points in this

litigation.

> The court may rule on the briefs alone or may require oral arguments

before

> ruling.

>

> While the judge considers our motion, both sides are proceeding with

> depositions and further discovery. Trigon has started to depose

plaintiffs,

> including the chiropractic doctors and patients listed in the lawsuit.

Dr.

> McClelland was deposed over a week ago. ACA, meanwhile, has been

> deposing medical doctors and others from Trigon. We have subpoenaed

records

> from the Virginia Medical Society and Virginia Physical Therapy

Association.

> The subpoenas request information regarding communications between Trigon

and

> these societies, as well as any related documentation--among other

things-on

> chiropractic spinal manipulation, the AMA, the ACA, the VCA, Trigon, and

> insurance coverage.

>

> It is interesting that a recent article in AMA News talked about the good

> relationship that exists between Trigon and the Virginia Chiropractic

> Association. Coincidental? The opening paragraph of the June 17 article

> ( " The Medical Society of Virginia is One of Many that Help Resolve

Problems " )

> read: " When Trigon Healthcare announced it wasn't going to recognize a

> certain coding extender, the Medical Society of Virginia's physician

practice

> advocate called company officials and reminded them that state law

requires

> the

> insurer to recognize it. Trigon changed its policy. " All of this from a

> simple phone call? When the doctors of ACA and the Virginia Chiropractic

> Association had a problem with Trigon, a phone call didn't work, a letter

> didn't work, and a face-to-face meeting was an insult. Pardon me for

being a

> little skeptical!

>

> Lets continue to send a message to Trigon and help support ACA in court.

>

>

> 5. BE A PART OF FCER PATIENT APPRECIATION DAY.

>

> ACA encourages doctors to be a part of FCER Patient Appreciation Day. FCER

> has set a goal to raise 1 million dollars this year.

> Help your patients while contributing to an important cause. For more

> information, call FCER at 1-800-622-6309, or visit its Web site at

> www.fcer.org.

>

>

>

>

> 6.. LOOK FOR CHIROPRACTIC IN SELF MAGAZINE

>

> Look for an article on chiropractic in an upcoming issue of SELF magazine.

> ACA spokesperson Dr. Jerry Mcs was recently interviewed by Meryl

s

> on the subject of chiropractic and the treatment of headaches. In all, he

> spent more than five hours talking to the writer and brought up numerous

> studies supporting chiropractic treatment of headaches, including the

> recently released Duke study.

>

>

> 7. BRING YOUR LEGAL ACTION FUND CHECK TO PARKER SEMINAR IN SAN DIEGO

>

> ACA will be represented at the next Foot Levelers/ Seminars program

in

> San Diego from June 27-30 at the Sheraton San Diego Hotel and Marina. We

> will have staff manning booths at the conference, answering questions

> regarding the lawsuits and hopefully collecting checks for the Legal

Action

> Fund. If you are thinking of making a contribution and you will be

attending

> the seminar, please drop by, say hello to ACA staff and maybe drop us a

> check, too. We hope to recognize our contributors during one of the many

> programs organized by . Seminars always boast a string of

> prominent speakers. This program is no exception; it will feature radio

and

> television icon Art Linkletter--hopefully some of you are old enough like

me

> to remember him--and Dr. Wallach, author of " Dead Doctors Don't Lie, "

> among others.

>

> Visit the Seminars Web site for complete details on the seminar:

> www.parkerseminars.com.

>

>

> 8. 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 <http://www.adobe.com/>. If you need further assistance

> viewing anything referred to in this report, please email me at

> gcuneo@... <mailto:gcuneo@...>.

>

> This message is being sent to you as a courtesy by the executive vice

> president of the American Chiropractic Association. If you wish to be

> removed from this list, simply send a message to kpark@... <

> mailto:kpark@...> with a subject of: " REMOVE - EVP Report. "

>

>

>

[Guest guest]

ACA EVP Weekly Report

MEMORANDUM ACA members, Board of Governors and House of Delegates From: Garrett Cuneo Re: ACA EVP Weekly Report Date: June 26, 2002

MEMBERS-ONLY ISSUE

This week's report includes the following issues:

1. SOME CLEAR, POSITIVE OUTCOMES IN LAWSUIT AGAINST TRIGON 2. BLUE CHIP PROGRAM SHOWING SUCCESS 3. UPDATE ON LAWSUIT AGAINST HHS 4. CHIROPRACTIC PROVISION NOT IN MEDICARE DRUG REFORM BILL: WE LOST THE 1ST ROUND 5. EVP ADVISORY COMMITTEE CALL 6. TELL US YOUR PROBLEMS WITH CHIROPRACTIC MANAGED CARE COMPANIES 7. DEADLINES ARE APPROACHING FOR BYLAWS, RESOLUTIONS AND AWARDS 8. CALIFORNIA HAS A NEW EXECUTIVE DIRECTOR 9. ACA STATEMENT REGARDING LIFE COLLEGE LOSING ACCREDITATION 10. CAN'T ACCESS THESE LINKS?

Members, help strengthen our voice for chiropractic. Forward this e-mail and link to our membership application (<http://www.acatoday.com/join.shtml>) to non-member colleagues and encourage them to join the ACA.

************************

1. SOME CLEAR, POSITIVE OUTCOMES IN LAWSUIT AGAINST TRIGON

News from the litigation against Trigon Blue Cross Blue Shield of Virginia and the alleged medical physician co-conspirators is that recent discovery efforts have been very helpful in supporting the allegations brought by ACA, the Virginia Chiropractic Association, and various chiropractic doctors and patients in the lawsuit.

ACA's recent motion to compel and sanction briefs filed with the court--though as yet not ruled upon by the judge--have loosened a flood of documents from Trigon. It's always interesting to see documents suddenly pop up when a court decision is pending.

On a related front, it is reported that 100,000 new contracts have been executed so far in the Blue Cross Blue Shield federal employees benefit plan where the basic option, which covers the chiropractic benefit, has been selected. This adds an estimated 250,000 covered lives to the rolls of potential new chiropractic patients under the BC/BS federal program. The national Blue Cross Blue Shield Association is responsible for negotiating the inclusion of the chiropractic benefit-a first for the program. This was a sign of good faith on their part.

Other signs of good faith are seen in the cooperation between ACA and some of the local Blue Cross plans involved in the ACA's Chiropractic Clinical Healthplan Integration Program, also known as Blue CChip. While some states continue to drag their feet, others are showing progress. The ACA hopes that the goodwill thus far shown by national Blue Cross Blue Shield Association will continue to mean that we can address our very serious problems through dialogue, not litigation.

2. BLUE CHIP PROGRAM SHOWING SUCCESS

One of the reasons that ACA withdrew its lawsuit against national Blue Cross Blue Shield Association was their agreement to assist us in developing contacts within the local Blues of each state, which would in turn help us to address the variety of problems facing our doctors. ACA's Chiropractic Clinical Healthplan Integration Program, or Blue CChip, has shown some progress. ACA doctors have established official liaisons with 73 percent of the Blue Cross plans in the country--the majority of these contacts are on the medical director level. In six states, doctors of chiropractic have been appointed to the local plan's medical policy making committee.

One of our liaisons, Dr. Herd, delegate from Northern New York, took a direct approach by showing his Blue Cross contact firsthand the rigorous education chiropractic students go through by taking him on a tour of New York Chiropractic College. Dr. Herd now contributes to the Empire BC/BS of New York monthly newsletter on chiropractic issues.

3. UPDATE ON LAWSUIT AGAINST HHS

Nothing new to report. Still no word from the judge, who is reviewing the summary judgments filed by ACA and the feds. The physical therapists withdrew their petition for intervention in the case when the Centers for Medicare and Medicaid Services (CMS/formerly HCFA) revised its policy, barring reimbursement to physical therapists under Medicare for performing manual manipulation of the spine to correct a subluxation. The issue remains whether medical doctors and osteopaths should be reimbursed for providing a service that Congress so clearly intended to be a chiropractic service, performed solely by doctors of chiropractic.

Litigation is always expensive. After all, we are going up against the largest law firm in the country, the federal government, and some of the more prestigious firms in the Trigon case. Currently, we stand at one of the most critical junctions of the litigation. Our monthly legal bills are running at $150,000. Depositions are taking place in Richmond, Virginia, and Chicago. Trigon's actions have forced us to go back into court to get information that they withheld in discovery. We have to keep up the pressure and support our legal team. Please make your contribution to the National Chiropractic Legal Action Fund (NCLAF). Consider signing up as a monthly contributor using EZ-pay. Over 272 doctor members and even some non-members are monthly contributors through EZ-pay and/or regular credit card deductions. Sign up today at <http://www.acatoday.com/pd/legal_action.pdf>.

4. CHIROPRACTIC PROVISION NOT IN MEDICARE DRUG REFORM BILL: WE LOST THE 1ST ROUND

As you know, the ACA has been working to include a chiropractic provision in the Medicare reform bill now being considered in Congress. In the House of Representatives, the Ways and Means Committee and Energy and Commerce Committer were tasked by Speaker Hastert to jointly develop a bill. Key members in this process are Congressman Tauzin (chair of Energy and Commerce) and (chair of Ways and Means health subcommittee). We worked closely with these members on a chiropractic provision based on H.R. 902. Both committees completed consideration of this legislation late last week. Unfortunately, we ran up against tremendous resistance in the Ways and Means Committee from chairman Bill , by committee staff, and the medical establishment. We did everything to neutralize this resistance, but at the end we were unable to get a strong chiropractic provision in the bill. They would have granted us a study on the issue--which is how they dealt with the request from the physical therapists--but a study is not acceptable.

But we are not dead yet. We are currently working on a possible floor amendment strategy in the House as well as turning our attention to key members of the Senate Finance Committee. Senator Harkin and other members of the Senate have already indicated their commitment to push for a chiropractic provision in the Medicare bill that they will be drafting. Things are never easy for us, but the end result will be worth the effort.

5. EVP ADVISORY COMMITTEE CALL

The ACA legal counsel, staff vice presidents and I recently held our monthly conference call with state association executives and leadership. Included on this call were ACA President Dr. Daryl Wills, Rob Sherman, representatives from Louisiana, Colorado, North Carolina, Iowa, North Dakota, Texas, and Kentucky. Issues covered included the chiropractic network complaint form, Noridian local medical review policy, an update on Medicare legislation, a PBS special on alternative medicine, updates on the lawsuits, and the new ERISA regulations. The next scheduled call is July 16 at 1:00 pm.

6. TELL US YOUR PROBLEMS WITH CHIROPRACTIC MANAGED CARE COMPANIES

As previously reported, the House of Delegates directed ACA to collect data regarding abuses in the managed care system, particularly in regard to chiropractic networks, and develop a plan to deal with them. Not all chiropractic networks are a problem, but those that are must be dealt with. ACA has developed a Managed Care Data Collection Form that DCs can download, fill out and return to ACA via fax. Go to <http://www.acatoday.com/insurance/managed_care/managed_care_collection.doc> for a copy of the form. Fax completed forms to ACA's PDR Department at 703/243-2593.

7. DEADLINES ARE APPROACHING FOR BYLAWS, RESOLUTIONS AND AWARDS

Deadlines for proposed changes to the ACA bylaws or resolutions, to be considered at the August House of Delegates meeting, and ACA awards are fast approaching. Proposed bylaw changes must reach me no later than July 1. Resolutions and award nominations must reach me by July 16. E-mail proposed changes and nominations to gcuneo@... <mailto:gcuneo@...>.

8. CALIFORNIA HAS A NEW EXECUTIVE DIRECTOR

The California Chiropractic Association recently announced the appointment of Bill Howe as executive director of the CCA. I participated on the CCA search committee during its early stages of interviews and was impressed with Mr. Howe. I talked to Bill recently and he seems to be taking charge. By the way, he called me at 9:30 am EST, which meant it was 6:30 in California. He is indeed a hard-working guy who I am sure will follow in the great tradition of outstanding CCA executive directors--particularly the Italian ones.

9. ACA STATEMENT REGARDING LIFE COLLEGE LOSING ACCREDITATION

The high skills, positive outcomes, professional image, and broad public acceptance of the effective treatments offered by today's doctors of chiropractic are in large part attributable to the high quality and excellent educational experience offered by America's accredited chiropractic colleges and universities.

In order to protect the reputation of the chiropractic profession, protect the consumer public, and to ensure the integrity and quality of the educational experience for all chiropractic students, it is absolutely essential that rigorous and effective accreditation standards be maintained and enforced by the Council on Chiropractic Education (CCE), the profession's singular accrediting body recognized by the U.S. Department of Education. We applaud the fine efforts of the CCE, both past and present, to protect the integrity and quality of chiropractic higher education.

It is regrettable that the chiropractic profession has experienced adverse publicity, particularly in the Georgia area, as a result of CCE's revocation of Life University College of Chiropractic's accreditation status. In order to protect the interests of those students currently enrolled, ACA urges Life University College of Chiropractic (LUCC) to take swift and effective measures to correct all deficiencies identified by the CCE and to work diligently to restore its full accreditation status with the CCE at the earliest opportunity.

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 <http://www.adobe.com/>. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@... <mailto:gcuneo@...>.

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This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... <mailto:kpark@...> with a subject of: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

MEMORANDUM ACA Members, Board of Governors and House of Delegates From: Cuneo Re: ACA EVP Weekly Report MEMBERS ONLY REPORT Date: July 22, 2002 This week's report includes the following items:

1. PICTURE YOURSELF WITH AN OLYMPIC STAR (SPONSORED BY ACAUXILIARY) 2. SENATE TAKES UP MEDICARE REFORM BILL 3. SENATOR DURBIN VISITS NATIONAL UNIVERSITY OF HEALTH SCIENCES 4. DOD APPROPRIATION 5. HIPAA TELECONFERENCE A SUCCESS 6. NEW IOWA EXECUTIVE DIRECTOR 7. WOMEN IN CHIROPRACTIC 8. UPDATE ON TARGETED RACES 9. CAN'T ACCESS THESE LINKS?

1.. PICTURE YOURSELF WITH AN OLYMPIC STAR (SPONSORED BY ACAUXILIARY)

There is another good reason to attend the ACA annual meeting scheduled for August 29-31 at the Fairmont Kansas City Hotel - a chance to hear and be photographed with Parra, the U.S. Olympic gold and silver medallist in speedskating. is a chiropractic patient who is not afraid to proclaim the importance that chiropractic care has had in his recent success. If being an

Olympic star isn't enough, he was recently appointed by President Bush to the highly prestigious President's Council on Physical Fitness and Sports. You may attend his 6:00pm presentation and have a photograph taken for a suggested donation to the ACAuxiliary Education Fund. A photograph with Parra and you displayed in your reception room would make a great public relations item. You may also want to consider attending Mcs' presentation at 3:00pm, followed by a two-hour coding program, before Parra addresses the crowd. It will be worth the trip!

By the way, if you are thinking about making room reservations at the hotel, please do so before July 24th in order to receive the special ACA guest rate. Call (800) 441-1414.

2. SENATE TAKES UP MEDICARE REFORM BILL

The Medicare Reform Bill took numerous twists and turns this week. Senator Daschle directed that a non-controversial generic drug bill, which had just passed a committee, be amended on the floor of the Senate into a comprehensive Medicare proposal, bypassing the normal committee review and recommendation. This would be a very difficult process, since a bill would need 60 votes to pass the Senate complying with their budget rules and avoiding a filibuster. Our original strategy was to work on members of the finance committee where the Medicare Reform Bill would naturally originate. And while we will continue in this effort, we are also lining up members to present a chiropractic amendment to the bill when it hits the floor. Anything can happen, including the whole issue being sent back to the finance committee. Your help in gaining your senator's support is essential. Call ACA's Government Relations office (800-986-4636) for further details.

3. SENATOR DURBIN VISITS NATIONAL UNIVERSITY OF HEALTH SCIENCES

U.S. Senator Durbin (D-IL) visited National University of Health Sciences and was given a tour of its facilities by the school's president, Dr. Jim Winterstein. Senator Durbin serves as a member of the Senate Appropriations and Rules and Administration Committees, just to name a few. While Durbin hasn't been a strong supporter of the profession, the word I received was that he was impressed with the facilities and the curriculum being offered the students. One of our best sales points is our chiropractic colleges. Joining Senator Durbin on the visit were Dr. Georgiou, Dr. Lawrence Pyzik (ACA Delegate) and Col. Mills, Executive Director of the Illinois Chiropractic Society.

4. DOD APPROPRIATION

The House Appropriations Committee recently passed an appropriation bill for DOD that not only included the six million dollars recommended by the White House to implement the DOD, but also a $750,000 provision for Texas Chiropractic College in working with the Air National Guard. We are now working the Senate side to increase the chiropractic provision. Senator Daschle has submitted a letter to Senator Dan Inouye, Chairman of the Senate Appropriations' Defense Subcommittee requesting an additional six million dollars. This would double the appropriation from last year. If Inouye accepts this recommendation, and it passes the Senate, it will go to conference committee where both sides will have to approve the recommendation.

5. HIPAA TELECONFERENCE A SUCCESS

Last week, ACA sponsored a teleconference seminar on HIPAA conducted by Marc Cohen, a prominent attorney with experience in chiropractic, from Baltimore, land. Over 60 doctors and assistants participated on the call, and based on the comments we received, this was one of the better teleconferencing programs we have conducted. Some of the comments included:

"Good use of time, (no travel involved) very good question answer session," and "Very good, well-delivered and understandable. Thank you very much."

If you want to order a two-hour tape of this program, which updates you on your HIPAA responsibilities and the new privacy laws, contact the ACA at 800-986-4636.

Cost of the tape, including background material, is only $39 for ACA members and $65 for non-members.

6. NEW IOWA EXECUTIVE DIRECTOR

The Iowa Chiropractic Society recently announced the appointment of Gene Handley, Phd, as its new Executive Director, replacing Larry Carl. Dr. Handley brings extensive experience in association management that includes the American Academy of Pediatrics and the American College of Healthcare Executives. If you are an executive director, send him a note and offer your help as he gets acclimated to this great profession. Dr. Handley's email address is: iowadcs@... <mailto:iowadcs@...>.

7. WOMEN IN CHIROPRACTIC

Dr. Jackie Buettner, a San Francisco DC and former member of the California State Board, has taken on the project of chronicling the achievements of women in the chiropractic profession. This is a fairly major undertaking, but knowing her as I do, she is more than up to it. If you are aware of a woman chiropractor who has been or is active in the profession, or if you are one yourself, share your story with Dr. Buettner. This material will be put together and will be a resource for future generations of women in chiropractic. For further information, contact Dr. Buettner directly at doctorb@... <mailto:doctorb@...>.

8. UPDATE ON TARGETED RACES

I have mentioned in previous reports that the ACA-PAC is taking strong positions in four Senate races. This year, control of the Senate will boil down to a handful of races, where, for various reasons, the race is too close to call. Both parties can be counted on to dump a ton of dough and grassroots support into these races. While most political action committees avoid such close races for fear of offending someone, chiropractic has never succeeded by being cautious. Your PAC is following a great tradition. Win or lose, we intend to make an impression, so that the PAC support will be noticed.

Senator Tom Harkin vs. Rep. Greg Ganske (Iowa): Not a tough one to call. Harkin is pro- chiropractic. Ganske has used the old, paranoid view of chiropractic in an attempt to rally the medical profession against Harkin. Polls still show Harkin ahead, but this is a state that Bush carried in 2000, and it has a Republican senator. On the other hand, it has been over a month since the primary, and Ganske's primary opponent, who received 41% of the primary vote, still has not endorsed the Republican nominee. It will be a tough race, and we will need to continue to be active.

Senator Tim vs. Rep. Thune (South Dakota): Another tough race -- and once again the choice is easy. Senator Tim is supported by Senator Daschle, which should be enough. But in this case, there is more -- is also a good chiropractic supporter. I had a chance, along with the staff of Government Relations and the PAC, to have a private lunch with him. He and his staff spent an hour with us, giving us a great opportunity to discuss our issues. The race will be tough. South Dakota went for Bush in 2000, and 's opponent, Congressman Thune, is a popular Republican. This is a very close race, with a recent poll showing with only a lead of one or two percent. The National Journal recently noted that, while the state generally leans Republican, Senator has put together a very effective organization. Grassroots will make the difference in this race, and we hope to mobilize our doctors to help Senator .

Senator Tim Hutchinson vs. Attorney General Mark Pryor (Arkansas): A race the democrats want in the home state of the former president. Hutchinson's opponent has a very prominent name, and not surprisingly, polls by both sides show their candidate winning. This will be another close race and money will not be an object for either side. Senator Hutchinson was there for us when the DOD bill was going through the Senate. We need to help him now.

Senator Carnahan vs. Jim Talent (Missouri): It's not easy to go up against an incumbent senator, but we are doing so by supporting former Congressman Jim Talent. No one who watched Jim Talent help us get our DOD bill through the Armed Services Committee should be surprised by this decision.

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 <http://www.adobe.com/>. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@... <mailto:gcuneo@...>.

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This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... <mailto:kpark@...> with a subject of: "REMOVE - EVP Repo

[Guest guest]

ACA EVP Weekly Report

MEMORANDUM ACA Members, ACA Board of Governors, ACA House of Delegates and Other Interested Parties From: Cuneo Re: ACA Executive Vice President's Weekly Report Date: August 5, 2002

In this week's report:

1. SENATE UNSUCCESSFUL IN PASSING MEDICARE BILL; WILL TRY AGAIN IN SEPTEMBER - AS WILL WE 2. DID YOU KNOW... 3. STUDENT LOAN BILL 4. GANSKE IRRITATES CHIROPRACTIC PATIENTS 5. EARN A FEW DOLLARS WHILE HELPING YOUR ASSOCIATION 6. WHAT CONSPIRACY? 7. OHIO KEEPS ON GIVING 8. CHAIRMAN SPEAKS AT TEXAS ASSOCIATION MEETING 9. NEW ERISA REGULATIONS SUBJECT OF TELECONFERENCE SEMINAR 10. HIPAA QUIZ 11. EVP ADVISORY COMMITTEE 12. AMA SUPPORTS VITAMINS: THE END OF THE WORLD MUST BE NEAR 13. ACA ANNUAL MEETING PROMISES TO BE INTERESTING 14. CAN'T ACCESS THESE LINKS?

1. SENATE UNSUCCESSFUL IN PASSING MEDICARE BILL; WILL TRY AGAIN IN SEPTEMBER - AS WILL WE

Last week, Senator Daschle and his supporters tried again to attach a comprehensive Medicare drug benefit provision to a generic drug bill that had passed out of committee. Once again it failed to get the necessary 60 votes. Actually, this time the motion to amend failed by a substantially higher margin of 49 to 50. This was a big disappointment, as it was a somewhat bipartisan effort as Republican Gordon and Democrat Bob Graham were cosponsors. So back to the drawing boards. Of course, all of this was significant to our efforts to get a chiropractic provision included, since the Senate had decided not to accept any provider provisions until the drug issue had been resolved. The Senate now goes into recess until September. What will happen in September is up in the air at this point. Senators will not want to face voters in November without a drug benefit having passed. Provider issues need to be addressed, including the physician payment schedule, which has severely affected all practitioners because the reimbursement formula is tied to the Gross National Product. Here are some possible scenarios:

· Daschle again tries to bring up the drug benefit on the floor, is successful, which opens the opportunity for amendments regarding provider issues. · A drug bill is initiated in committee, probably the Finance Committee, where provider amendments can also be considered. · There is a separate drug bill and a separate provider bill going through the Senate Finance Committee.

This is driving your Government Relations staff crazy, but Senate recess does give our grassroots an opportunity to lobby their individual Senators. We have to plan for all three scenarios. Take the opportunity to push for a chiropractic provision that mirrors the Watkins bill. Remember, opportunities to pass a significant provider provision only come around every three or four years. In fact, the last time a comprehensive bill for providers was passed was in 1997, when we were successful in passing the elimination of the X-ray requirement.

2. DID YOU KNOW...

When the ACA sponsored legislation to eliminate the X-ray requirement in 1997, the action was scored by the Congressional Budget Office at $900 million over a six-year period. And this was at a time when Congress was trying to find a savings of $115 billion to balance the budget. Yet the measure was passed and became law. We can accomplish a lot if we put our minds to it.

3. STUDENT LOAN BILL

This legislation that is of utmost importance to our students continues to be bottled up on the House side. As you know, we were able to include a chiropractic provision on the Senate side that would establish a program to support doctors with student loans who practice in underserved areas. Right now, the bill is in the House where an issue of abortion continues to keep the measure from being considered on the floor. Both parties are committed to getting a student loan bill out, but it won't be until September that this thing will move.

4. GANSKE IRRITATES CHIROPRACTIC PATIENTS

As reported here previously, Congressman Ganske sent a letter to all the medical doctors in the country showing how his position on health issues was radically different from his opponent, Senator Tom Harkin, asking for their financial support. Included in the letter was an obvious appeal to the anti-chiropractic sentiment that still exists with some of our medical colleagues, associating chiropractic with some of the more extreme forms of health care. One chiropractic patient got a hold of the letter and was not pleased. This man wrote a letter to the editor that was printed in the July 29th issue of the Des Moines Register. Here are some excerpts from his letter: "Congressman has succeeded in insulting millions of Americans as well as an Iowan tradition. Chiropractic was founded here in Iowa, and it has been a part of the maintaining of the health and economy of our state for over 100 years. Is Ganske interested in the truth or is he just playing politics? The millions of Americans and thousand of Iowans who visit chiropractors each year are not doing so in vain." Not a smart move by Congressman Ganske.

5. EARN A FEW DOLLARS WHILE HELPING YOUR ASSOCIATION

Triple your impact! Participate in ACA's new member-get-a-member campaign and you'll (1) help the ACA increase the resources needed to sustain and expand initiatives, (2) help your colleagues to reach their practice goals, and (3) earn valuable rewards for yourself, all at the same time. For each Full General DC Member that you sign up between now and September 1, 2002 with either a full annual dues payment of $600 OR enrollment in EZ Pay, in which $50 will be automatically deducted each month from the bank or credit card account of your choice, you will receive a $200 credit. There's no limit to how many $200 credits you may earn. Plus, YOU tell US how you'd like your reward(s): as discounts to your own renewal, contributions to the National Chiropractic Legal Action Fund, towards the purchase of products and/or registration to ACA educational programs, donations to the ACA-PAC, or a cash payment, to do with as you please. Call 1-800-986-4636 for membership applications or more information.

6. WHAT CONSPIRACY?

The ACA PDR office conducted some research for our lawsuit against Trigon and discovered some interesting information. In 1993 the percentage of DC patients that were referrals from medical doctors was only 3.2%, which jumped to 25% in 1995, following the publication of the AHCPR guidelines on low back pain, but slipped dramatically after 1996 and in 1999 had fallen to 9.4%. Was it coincidental that the Blues accelerated their imposition of discriminatory barriers following not only the AHCPR guidelines but also the establishment of new CMT codes and their higher relative values?

7. OHIO KEEPS ON GIVING

I've mentioned in the past the contributions from our doctors in Ohio. A week or two ago we received yet another contribution from one of their districts (District 14), bringing their total to $13,550. Adding this to what has already been contributed, the Ohio doctors have raised $82,765. And they are not finished. I have been informed that the local doctors, led by Dr. Jud Sprandel and Dr. Dick , are helping to put together additional educational seminars. On September 19th in Cincinnati, Ohio, an Ohio work comp attorney will put on a seminar on treating workers comp patients, with all proceeds going to the legal action fund. In November, three Ohio districts are putting on a license renewal seminar with a majority of the funds going to the legal action fund.

8. CHAIRMAN SPEAKS AT TEXAS ASSOCIATION MEETING

Dr. ACA Chairman , DC, helped spread the word about the lawsuits when he was given the opportunity recently to address doctors attending the Texas Chiropractic Association convention. He also addressed the association's board of directors.

9. NEW ERISA REGULATIONS SUBJECT OF TELECONFERENCE SEMINAR

Effective July 1st, the Department of Labor has adopted new regulations regarding ERISA that provide the consumer and provider with new tools to fight self-insured plans that discriminate against the chiropractic profession. The regulations, which went into effect despite strong opposition from the managed care industry, require greater disclosure of claims procedures, more procedures intended to assure full and fair review of claims from plan participants and more definite time frames and procedures to assure timely reviews of initial claims and appeals of denied claims. If properly followed, the new rules would give doctors the ability to find out why a claim is being denied, the policies and protocols used in the review of claims and the identify of the experts used in the review of a denied claim.

The ACA is sponsoring a teleconference seminar to help explain these new regulations and how individual providers can make use of them. The call is scheduled for August 13 from 12:30 pm Eastern to 2:00 pm Eastern. The presenters include ACA Legal Counsel Mr. Tom Daly, Dr. Jin Zhou and Dr. Spyros Bakis. All live registrants will receive free handouts and materials before the phone conference. Call the ACA at 800-986-4636 for details.

10. HIPAA QUIZ

CMS has put on their Web site a section on HIPAA in which they pose and respond to the questions on the new HIPAA requirements that all practitioners need to be most concerned about. As you peruse the response, you will note the number where the government acknowledges that they still don't have an answer. This issue is still in a state of flux. The questions are followed by answers and brief explanations. To take the quiz, go to: www.regreform.hhs.gov/hipaaquiz_0204171/sld001.htm

11. EVP ADVISORY COMMITTEE

The ACA vice presidents, legal counsel and I held our monthly conference call with state association leadership. Included on this call were representatives from Kentucky, Texas, Iowa and Pennsylvania. We discussed the following topics: · Update on Medicare legislation · Parra Promotion for state associations · PBS Update; Blue Chip Program. The next call of the committee is August 20th at 12:00 noon ET

12. AMA SUPPORT VITAMINS: THE END OF THE WORLD MUST BE NEAR

As a sure sign of the apocalypse, the Journal of the American Medical Association (JAMA) is now recommending that all adults take at least one multivitamin pill each day. They further acknowledge that people who get enough vitamins may be able to prevent such common illness as cancer, heart disease and osteoporosis. Finally, they acknowledge that medical doctors aren't adequately trained in nutrition. Recommending vitamins used to be held in the same cultist category as "performing manual manipulation of the spine to correct a subluxation." Now in both instances medicine is attempting to make both of these their own. They sure have a lot of nerve.

13. ACA ANNUAL MEETING PROMISES TO BE INTERESTING

The ACA annual meeting scheduled for August 29-31 has much to offer. Friday's program for ACA members begins at 3:00 with an update from Mcs on the lawsuits, followed by a two-hour coding seminar. The evening wraps up with a guest appearance by Olympic speedskating star Parra.

On Saturday, while the HOD meeting continues, there will be a series of seminars that will help build your practice. A summary is provided below. The FICC will also be holding their annual meeting and luncheon. The cost of the luncheon is $30 per ticket. If you plan to attend the FICC meeting, contact Janet Ridgely at the ACA Office (800-986-4636).

· Seminar One: Let's Talk About HIPAA -- Speaker: Robyne Goates of BC/BS in Kansas and Medicare Part B Provider Representative. Date and Time: Saturday, August 31, 9:00 - 12:00 pm. This seminar will focus on the HIPAA benefits, penalties, transactions, medical records privacy and security issues of this act. Topics of discussion will include how HIPAA affects the small office, and extension requests. ACA Members: $50; Non-Members: $80

· Seminar Two: Backpack Safety and You -- Speaker: Dr. Bautch, past president of ACA's Council on Occupational Health. Date and Time: Saturday, August 31, 1-2:30 pm. This educational seminar will discuss the importance of educating children early about how an overloaded backpack can result in injury. Dr. Bautch will discuss how to implement an educational program for backpack safety in your area. ACA Members: $39; Non-members: $65; SACA students are FREE and encouraged to attend.

SPECIAL VALUE: Attend both seminars, educate yourself and your staff, learn and save $$$! ACA Members: $75, Non-members: $120. Call ACA at 800-986-4636 for details.

14. 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@....

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This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... with a subject of: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

Memorandum

ACA Members, ACA Board of Governors, House of Delegates and Other Interested Parties

From: Cuneo

Re: ACA EVP Weekly Report

Date: August 13, 2002

This weeks report includes the following items:

*LATEST ON THE TRIGON LAWSUIT *INFORMATION ON THE ERISA REGULATIONS. *ACA ON THE ROAD *MEDICARE CARRIERS HAVE AN OBLIGATION TO HELP *BUY A LEANDER AND LLOYD'S TABLE AT THE FLORIDA CONVENTION AND SUPPORT THE LAWSUIT *NON MEMBER FOCUS GROUP *PARKER SEMINAR

LATEST ON THE TRIGON LAWSUIT

On Wednesday, July 31, 2002, the ACA, VCA, 10 doctors of chiropractic and 18 patients served their long-awaited expert witness statements on the Trigon Blue Cross Blue Shield defendants in the Virginia antitrust action.

The plaintiffs have selected the following experts for their upcoming trial:

Haldeman, MD, PhD, DC, for the technical issues involving chiropractic and the interface with medical physicians and osteopaths as they deal with the care and treatment of neuromusculoskeletal problems, particularly of the back.

Prof. Leonard G. Schifrin, PhD, Professor of Economics, Emeritus, College of and , and Clinical Professor of Preventive Medicine, Medical College of Virginia.

Dr. Haldeman attests to the scientific validity and status of chiropractic care with a detailed review of the scientific literature and a particular focus on the 1994 AHCPR Back Care Guidelines, published by the federal government, and the alleged misuse thereof by Trigon and alleged co-conspirator MDs in their redrafted guidelines. He concludes, among other things:

"The documents provided to me on the position of Trigon Health Care in the treatment of neck and back pain are clearly in conflict with the

recommendations from the most rigorous systematic reviews of the medical literature."

Dr. Schifrin concentrates on the economic efficiency and effectiveness studies relating to chiropractic, as well as on the economic damage imposed on chiropractors in the Trigon network in Virginia by the alleged Trigon/MD conspiracy. He concludes that the total damages are quite substantial over the past six years for all of the chiropractors in Virginia, but that the amount of losses for the limited number of chiropractors (10) in the lawsuit is obviously proportionally lower.

Trigon is expected to vigorously contest the opinions of these experts and the facts must be decided by a jury in the trial now scheduled for November.

INFORMATION ON THE NEW ERISA REGULATIONS

If you want to obtain information regarding the new ERISA Regulations, go to the U.S. Dept of Labor's website, which contains a fact sheet on the new regulations. It's at <http://www.dol.gov/pwba/pubs/claimsfs.htm>. For a copy of the actual regulations printed in the Federal Register, go to

<http://www.dol.gov/pwba/regs/fedreg/final/2000029766.htm>.

ACA ON THE ROAD

Last week, various members of the leadership were on the road promoting ACA and the lawsuit.

At the Missouri Chiropractic Association convention, immediate past president Dr. Jim Mertz, with the assistance of delegate Dr. Jack Kessinger and alternate delegate Dr. Carver, presented to the members attending the convention and the association's Board of Directors.

Dr. Flynn attended and participated in the Breakthrough seminar in Los Angeles addressing over 100 doctors regarding the lawsuit and collecting numerous donations.

Dr. Wills represented the ACA at the Palmer Lyceum in Davenport, addressing students and doctors regarding ACA activities and attending a fundraiser for Senator Harkin.

Dr. addressed new doctors who were taking the state board in Texas and signed up a number of members.

MEDICARE CARRIERS HAVE AN OBLIGATION TO HELP

Medicare carriers have an obligation to every provider to furnish information on how to best work within the system. Each carrier has a provider education/outreach department available to clarify issues that providers may be having difficulty with. Feel free to call the carrier and ask questions concerning policies you may be unclear about. If you don't receive a satisfactory response within a reasonable time, the regional office should be contacted next. The ACA is here to step in when it's clear the carrier is in violation of a mandate coming out of CMS, but many issues can be resolved more efficiently between the provider and the carrier. It's worth a try. Let us know if you run into any difficulties.

BUY A LEANDER OR LLOYD'S TABLE AT THE FLORIDA CONVENTION AND HELP THE LAWSUIT

The Florida Chiropractic Association Convention that is being held at the Peabbody Orlando Hotel in Orlando, Florida beginning this Thursday promises to be a lively, information-packed event with over 600 vendors and thousands of chiropractors and chiropractic assistants. ACA will be there in strength. The Florida Chiropractic Association has given us an opportunity to speak to doctors regarding the lawsuits. Additionally, during the conference, the Legal Action Committee will be sponsoring a silent auction for two chiropractic tables, one donated by Lloyd's Table and the other by Leander. Both vendors will be at the convention and will be able to show you the table being auctioned. The ACA booth will also have information about these tables. Support yourself by purchasing a fine table and support your profession with a donation to the lawsuit fund.

NON-MEMBER FOCUS GROUP ON THE LAWSUIT

As I mentioned in a previous report, the National Legal Action Committee conducted a focus group of ACA members to evaluate their understanding of the lawsuits filed against the HHS and the Blues. It gave us valuable insights that will help us better communicate to the entire profession the significance of these lawsuits. Recently, we also conducted a focus group of non-members. Seven of the 11 doctors invited to participate joined the call. It was very insightful. Participating on the call were: Drs. Tom Klapp, Leatherman, Lance Lipton, Mossman, Trudy Raiford, Stickle, and

Wier.

PARKER SEMINAR

The Toronto seminar is just around the corner, running August 29th through September 1st at the Westin Harbour Castle, and ACA will again have a significant presence promoting the lawsuits. We hope you are planning to be part of the events surrounding 50 years of Seminars as they continue their year-long celebration, "Celebrate the Past, Embrace the Future."

Over 40 presenters and Team Teachers will be with you in Toronto sharing the principles, great practice information, and a strong

chiropractic philosophy. There will be a special presentation by Dr. Bernie Siegel, the best-selling author of "Love, Medicine and Miracles."

To view the entire Seminars Toronto program, go to <http://www.parkerseminars.com/seminar/toronto02special.asp>.

To register online or check out registration costs, go to <http://www.parkerseminars.com/registration/index.asp> or call 1-888-727-5338.

[Guest guest]

More on HIPAA from the ACA is in this report.

Vern Saboe, DC

ACA Delegate

ACA EVP Weekly Report

MEMORANDUM

ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: August 19, 2002

The following items are discussed in this week's issue:

1. TRIGON FILES MOTION FOR SUMMARY JUDGMENT 2. MEDICARE UPDATE 3. VICE PRESIDENT CHENEY MEETS WITH CHIROPRACTORS 4. DON'T MISS THIS YEAR'S ANNUAL MEETING IN KANSAS CITY 5. NORTHWESTERN ALUMNI ASSOCIATION MAKES MAJOR PUSH FOR THE LAWSUITS 6. MANCEAUX/FLYNN: FUNDRAISING MACHINE 7. ACA MAKES A SPLASH AT THE FLORIDA CHIROPRACTIC ASSOCIATION MEETING 8. FOOT LEVELERS SEMINAR SUPPORTS LAWSUITS 9. DO YOU HAVE TO WORRY ABOUT HIPAA REQUIREMENTS? 10. DO YOU STILL NEED A REASON TO JOIN THE ACA? 11. CAN'T ACCESS THESE LINKS?

1. TRIGON FILES MOTION FOR SUMMARY JUDGMENT

Trigon Blue Cross/Blue Shield of Virginia filed a 57-page motion for summary judgment with the court stating that there are no legal or factual issues that we have raised that would justify a judge ruling favorably on our case. We are preparing an appropriate response. According to Mcs, it is almost impossible to figure out what the issue is in this case if you relied on Trigon's brief. We will file a total response within a week. Mr Mcs further stated that the issues will be clearly laid out in our response and not obfuscated as they are in Trigon's motion.

2. MEDICARE UPDATE

Be sure to discuss the importance of including a chiropractic provision in the Medicare bill with your senator or your senator's staff while the Senate is in recess. The Senate will consider this bill when it reconvenes in September. Whether it is included in a stand-alone bill or part of a larger Medicare Drug benefit bill, there will be a provider provision. The opportunity to change the law only comes every few years. This is an opportunity we can't afford to miss.

3. VICE PRESIDENT CHENEY MEETS WITH CHIROPRACTORS

Vice President Dick Cheney interacted with doctors of chiropractic at a pair of fundraising events in two different states within five hours of one another last Friday. First, Mr. Cheney attended a luncheon for Mike , a congressional candidate for Alabama's 4th district. Four of our doctors attended this function, carrying an ACA-PAC check for $3,500. Later that afternoon, the Vice President attended a fundraiser in Orlando, Florida, for Tom Feeney, majority leader in the Florida Assembly, who is a candidate for Florida's 24th congressional district. I attended that event along with Florida Chiropractic Association (FCA) President Joe , DC, and Dr. Bartlett, FCA's past president. Dr. Wayne Wolfson also attended the function.

4. DON'T MISS THIS YEAR'S ANNUAL MEETING IN KANSAS CITY

ACA's annual meeting, being held August 29 - September 1 at Kansas City's Fairmont Hotel, is jam-packed with interesting programs and seminars. In addition to the meeting of ACA's House of Delegates, the following is scheduled:

Friday, August 30:

· 3:00 pm -- Presentation by Mcs on the status of the lawsuits · 4:00-6:00 pm -- Coding seminar by McClelland · 6:00 pm -- Presentation by Olympic gold and silver medal-winner Parra, with an opportunity for pictures with the speedskating star

Saturday, August 31:

· 9:00 am - Seminar on HIPAA conducted by representatives of CMS · 12:00 noon - FICC Luncheon · 1:00 pm - Backpack Safety promotion seminar by Dr. Bautch · 4:00 pm - ACA-PAC Golf Tournament

Call the ACA at (800) 986-4636 for information, or visit the Web site at <http://www.acatoday.com/about/meetings.shtml>

5. NORTHWESTERN ALUMNI ASSOCIATION MAKES MAJOR PUSH FOR THE LAWSUITS

After hearing Northwestern Health Sciences University President Dr. Alfred Traina's appeal, the college's alumni association issued a challenge to its doctor alumni members to support the National Chiropractic Legal Action Fund (NCLAF). In a letter signed by Dr. Arlen Lieberman, President of Northwestern's Alumni Association and Valeria Show, president of Northwestern's Student ACA (SACA), the association pledged $5,000 to the NCLAF. Additionally, the association pledged up to $5,000 in matching contributions from doctor members. The overall potential of this pledge is at least $15,000. Northwestern has been a previous supporter of the NCLAF as well.

6. MANCEAUX/FLYNN: FUNDRAISING MACHINE

Probably the most successful fundraising team in this association's history, Drs. Glenn Manceaux and J. Flynn, reported another successful week of fundraising for the lawsuits. With the efforts of Dr. Manceaux, who continues to contact doctors in Louisiana, and the efforts of Dr. Flynn, who raised funds at the Breakthrough Coaching seminar in Los Angeles after his presentation at that seminar, we estimate that the two doctors just raised an additional $20,000 for the lawsuits.

7. ACA MAKES A SPLASH AT THE FLORIDA CHIROPRACTIC ASSOCIATION MEETING

With nearly 2,000 doctors and chiropractic assistants in attendance and nearly 600 vendors at the Florida Chiropractic Association (FCA) convention in Orlando this past weekend, you know the ACA would take the opportunity to promote its activities, and particularly the lawsuits. With the tremendous support of the leadership from the FCA, including Drs. Joe and Ed and CEO Debra Brown, the ACA enjoyed the following:

· We had a letter signed by the president of the FCA supporting the lawsuits and a pledge sheet included in the registration material received by the doctors in attendance.

· ACA's Florida delegates, Drs. Ken Dougherty and Jim Gentile, along with Dr. Don Krippendorf, Dr. Joe ston, and I divided into two teams to talk about the lawsuits with doctors attending five different classes. We think we covered nearly 800 doctors, giving each copies of a fact sheet and pledge sheet, and speaking for nearly fifteen minutes in each classroom. The presenters in each room were particularly supportive of our efforts and encouraged doctors to participate. I want to give special appreciation to Kathy Mills from Breakthrough Coaching. Not only was her room packed with doctors, but she encouraged support for the lawsuits and encouraged doctors to purchase our CPT Coding Book and Medicare Manual.

· We presented each vendor booth with a folder containing information and material geared toward the vendor community.

· Leander Corporation and Lloyd Table Company each donated chiropractic tables for auction. We accepted the bid for the Leander table and will continue to show the Lloyd table at the upcoming HOD meeting.

· We invited members of the press in attendance to participate in a briefing on the lawsuits and other activities of the ACA. Representatives of Foot Levelers' publication, Chiropractic Products and Chiropractic Wellness and Fitness Magazine attended.

· We were given the opportunity to speak at the Florida Gavel Club luncheon. The Gavel Club is made up of the past presidents of the Florida Chiropractic Association.

Overall, it was a successful week during which we signed up a number of new members, raised funds for the lawsuits and sold a number of coding and Medicare manuals. Special thanks to a Aviles and Teri Howell of the ACA staff who worked tirelessly during the entire weekend.

8. FOOT LEVELERS SEMINAR SUPPORTS LAWSUITS

This past weekend, 250+ doctors attended a Foot Levelers seminar in Philadelphia, Pennsylvania in which one half of the proceeds went to support the National Chiropractic Legal Action Fund. Dr. Spoto was given the opportunity to discuss the lawsuits and their importance. Dr Spoto reported that many of the speakers, particularly Drs K.S.J.Murkowski, and Mark Charrette were particularly supportive of the lawsuit and urged doctor support for it.

9. DO YOU HAVE TO WORRY ABOUT HIPAA REQUIREMENTS?

Over the last few months, there have been conflicting reports regarding the issue of exactly who falls under the HIPAA requirements for disclosure. Stavenjord, ACA's Assistant Director of Government Relations, went directly to the source for an answer on this. Here is her report:

....Today I spoke with an official from the federal HHS Office of Civil Rights here in Washington, the agency handling the enforcement of the HIPAA Privacy Rule, and received some much needed clarification on this issue. I had received conflicting information on this from very authoritative sources, including other HHS and CMS officials and wanted to be 100% certain that we had the correct information. If a provider does not fall into the definition of a "covered entity" under the regulations, they do not have to comply with either the Privacy Rule or the Electronic Transactions Standard. The definition of a "covered entity" is this: "health plans, health care clearinghouses, and health care providers who transmit health information in electronic form in connection with any transaction referred to in section 1173(a)(1) of the Act." The transactions referred to in this definition are electronic billing, coordination of benefits, health care claim status transactions, etc. The point is, if a provider is transmitting no patient information whatsoever electronically, they are not subject to any aspect of HIPAA. Regarding electronic submission of claims to Medicare, the Administrative Simplification Compliance Act, Public Law 107-105, states that practitioners with fewer than ten full-time equivalent employees will not be required to bill Medicare electronically even after the compliance date of October 15, 2002. (We have already informed our members that a one-year extension is available to those "covered entities" who would like one if they fill out a Compliance Plan and submit it to CMS and we can emphasize this again). These were very important issues to clarify for our association, since many of our members will not be affected by HIPAA. If our members are in fact "covered entities," the "HIPAA Demystified" phone conference tape is an excellent resource for them, along with the "HIPAA Update" I wrote for the upcoming issue of The Addendum...

10. DO YOU STILL NEED A REASON TO JOIN THE ACA?

I hope that learning about the numerous vital activities of this association convinces you of the importance of membership in the ACA. We accomplish a great deal with very limited resources.

However, if you are still not convinced, please consider the following statistics regarding those organizations that are in competition with the ACA and the chiropractic profession for similarly limited resources: The ACA has 40 full-time employees. The American Medical Association has 1,100; the American Physical Therapy Association has 168; the American Occupational Therapy Association has 140; the American Osteopathic Association has 143; and the American Academy of Orthopedic Surgeons has 220. Please join the ACA today. If you are already a member, please encourage others to do the same.

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 <http://www.adobe.com/>. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@... <mailto:gcuneo@...>.

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This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... <mailto:kpark@...> with a subject of: "REMOVE - EVP Report."

[Guest guest]

ACA EVP Weekly Report

MEMORANDUM

ACA Members, ACA Board of Governors, ACA House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Date: August 26, 2002

The following items are discussed in this week's report:

1. VA ANNOUNCES ADVISORY COMMITTEE APPOINTMENTS 2. MEDICAL DOCTORS ALSO HAVE CONCERNS ABOUT ANTHEM 3. U.S. SENATOR REFERS DOCTORS TO ACA WEB SITE FOR INFORMATION 4. DR. RIEKEMAN - PALMER COLLEGE SHOW SUPPORT FOR LAWSUITS 5. TEXAS CHIROPRACTIC COLLEGE JOINS THE EFFORT 6. GET THE FACTS YOU NEED ON THE NEW ERISA CLAIMS REGULATIONS 7. JIM ROME DOES IT AGAIN 8. EVP ADVISORY COMMITTEE CALL 9. LEADERSHIP ON THE ROAD 10. CHIROPRACTIC UNDER ATTACK IN ITALY 11. CAN'T ACCESS THESE LINKS?

1. VA ANNOUNCES ADVISORY COMMITTEE APPOINTMENTS

Last week, the Secretary of the Veterans Administration (VA) announced his eleven-member advisory committee to assist him in the implementation of chiropractic into the VA. We were disappointed, but not surprised, to learn that the appointments reflect the continued resistance to chiropractic by the bureaucrats in the VA. Five of the eleven members of the committee represented medical organizations that opposed various chiropractic provisions in Congress.. Also appointed was well known chiropractic critic DuVall, DC. I attended a meeting with the VA a couple of years ago where he pleaded with the bureaucrats to not allow doctors of chiropractic to treat veterans without medical supervision. No wonder some in the VA refer to him as "Chuck." It didn't help our cause either when the ICA and WCA broke an agreement with the ACC and ACA to push for a unified slate of candidates. We will let Congress know of our displeasure and will closely monitor the activities of the committee. Given our past experience, we will be going back to Congress asking for even stronger statutory language so that the wishes of Congress and the veterans will not be ignored.

2. MEDICAL DOCTORS ALSO HAVE CONCERNS ABOUT ANTHEM

The August 19 issue of AMA News had a story indicating that the American Medical Association, numerous other medical societies and individual doctors have issued complaints against Anthem, pressing the company to stop down-coding and reducing payments on those claims. Anthem, which operates in more than eight states, has also been a concern to a number of our doctors. The company had made a bid to purchase Trigon Blue Cross/Blue Shield of Virginia.

3. U.S. SENATOR REFERS DOCTORS TO ACA WEB SITE FOR INFORMATION

Responding to a constituent's concerns regarding HIPAA, Senator ph Biden of Delaware referred the constituent to the CMS Web site as well as the Web site of the American Chiropractic Association.

4.. DR. RIEKEMAN - PALMER COLLEGE SHOW SUPPORT FOR LAWSUITS

At the recent Palmer Lyceum in Davenport, Iowa, attended by 2,500+ doctors and friends, Dr. Guy Reikeman introduced ACA President Daryl D. Wills to the crowd and urged them to support our lawsuits. Additionally, he provided a personal check for the legal action fund. Dr. Reikeman had previously committed to send a letter to the Palmer alumni requesting them to support the lawsuits.

5, TEXAS CHIROPRACTIC COLLEGE JOINS THE EFFORT

Members of the Texas Chiropractic College Alumni Association received an appeal from Dr. Shelby Elliott requesting their support for the lawsuits. We are already receiving contributions resulting from this solicitation.

6, GET THE FACTS YOU NEED ON THE NEW ERISA CLAIMS REGULATIONS Did you miss the live audio phone conference titled "ERISA CLAIMS AND APPEALS?" Don't worry. You may now order the 90-minute audiocassette and find out what you need to know about the new ERISA regulations adopted by the Department of Labor and how individual providers can make use of them.

Dr. Jin Zhou, Dr. Spyros Bakis and ACA Legal Counsel Tom Daly will provide you with the information you'll need to know about new standards and regulations for processing ERISA benefit claims. Jin Zhou, DC, is an expert on the ERISA issue and is the author of the book "ERISA For Physicians: ERISA Health Care Claim Denials and Appeals."

ACA Member Price: $39, Non-member Price: $65 Call 800-986-4636 to order your 90-minute tape.

7. JIM ROME DOES IT AGAIN

Controversial sports radio personality Jim Rome has once again used his radio program to discredit the chiropractic profession. On his August 8th program he read with enthusiasm and support a letter from a medical student who referred to chiropractic colleges as "voodoo school" and the chiropractic profession as the "chiro cult." It is curious that the very next day Rome interviewed Lance Armstrong, who is an enthusiastic chiropractic patient. It is unfortunate Rome didn't make these comments to Armstrong. The ACA has released a news bulletin urging doctors of chiropractic to protest the comments. Be sure to express your concerns to the program directors and advertisers affiliated with the Rome show. The major advertisers can be found here: http://www.jimrome.com/home/jim_rome/advertisers.html, and the affiliates can be found here: http://www.jimrome.com/home/apr/affiliate_list.html. For the ACA's news bulletin on this issue, including instructions on how to respond, click here: http://www.acatoday.com/hot_topics/082202.shtml

8. EVP ADVISORY COMMITTEE CALL

On August 20th, the ACA EVP and staff, including legal counsel, held their monthly conference call with state association executive directors. Included on the call were representatives from Kentucky, Iowa, Alabama, Louisiana and Texas. ACA Chairman Dr. Jim also joined the call. The issues that were discussed include: Preparation and input regarding ACA's planned meeting with CIGNA insurance company in their main office in Connecticut; VA appointments to the Advisory Committee; Medicare; HIPAA Privacy Consent Requirements; and an update on the lawsuits. The next call of the committee is scheduled for October 1 at 12:00 noon ET.

9. LEADERSHIP ON THE ROAD

Last weekend, Daryl D. Wills, DC, represented the ACA at the Nebraska Chiropractic Physicians Association meeting. He was given the opportunity to speak to the attendees about the lawsuits, and came away with $3,200 in individual contributions; a $10,000 contribution from the association and a $100 per month contribution. Additionally, he and his wife were honored for their contributions to the association.

10. CHIROPRACTIC UNDER ATTACK IN ITALY

The Italian Chiropractic Association has informed the ACA that the National Federation of Doctors of Medicine, Surgeons and Dentists have declared that chiropractic is a "medical act" that can only be practiced by doctors of medicine. Further, they have called for a ban on the practice of chiropractic by chiropractic doctors. The Federation is pushing the Italian Parliament to implement these provisions in the laws that govern health care in that country. Of added concern, there are over 100 members of the Italian Parliament who are medical doctors. The Italian Chiropractic Association notes that there were 300,000 doctors of medicine in Italy, of which 80,000 are recognized as underpaid or unemployed. The Italian Chiropractic Association is calling on the chiropractic community in the world to assist in this moment of peril. The World Federation of Chiropractic is coordinating a worldwide campaign of support. ACA has already submitted a letter of concern.

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@....

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This message is being sent to you as a courtesy by the executive vice president of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to kpark@... with a subject of: "REMOVE - EVP Report."