Fw: ACA EVP Weekly Report

September 11, 2002

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 September 11, 2002

In this week's report are the following items:

*1) TRIGON COUNTERS WITH EXPERT WITNESSES *2) INTERESTED IN IMPACTING ACA POLICY? DELEGATE ELECTIONS *3) FINANCIAL SUPPORT FOR LAWSUIT CONTINUES *4) ASSOCIATION OF CHIROPRACTIC COLLEGES GIVES AGAIN *5) ACA AUXILARY CONTINUE TO GIVE *6) ACA ELECTS ITS LEADERS AND HONORS ITS VOLUNTEERS *7) MRS WINTERSTEIN PASSES ON

*8) SURPRISES IN STORE AT 2003 PARKER

1)TRIGON COUNTERS WITH EXPERT WITNESSES

I guess we should have figured that Trigon would not simply roll over and quit after our two expert witnesses projected millions of dollars in damages because of the Blues' discriminatory practices. Trigon came up with its own expert witnesses, a retired Justice Department official and a professor of economics from the University of Utah, filing a 100-page-plus brief attempting to counter our arguments.

We have filed our response to Trigon's Motion for Summary Judgment. Trigon can now respond to our brief, and then the Motion is in the hands of the judge.

2) INTERESTED IN IMPACTING ACA POLICY? DELEGATE ELECTIONS COMING UP

Members seeking election as a delegate or alternate delegate must signify such intent in writing via certified mail by December 16, 2002 to the Corporate Secretary of the American Chiropractic Association, 1701 Clarendon Blvd, Arlington, VA 22209.

Ballots will be sent January 15, 2003 to voting members in the states of Alaska, Arkansas, Colorado, Delaware, N. Florida, S.Florida, Hawaii, N. Illinois, Iowa, Kentucky, Maine, Massachusetts, Minnesota, New Hampshire, New Mexico, New York (upstate), North Dakota, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, and West Virginia.

The term of office is two years. For other details of the delegate election, qualifications and procedures, consult the ACA Bylaws, Article VIII, Section C.

3) FINANCIAL SUPPORT FOR LAWSUIT CONTINUES

At the annual meeting of the ACA, we were successful in raising over $144,600 in cash and pledges, including 32 new monthly contributors who will pay $100 each month for the duration of the lawsuits. Some of the organizations that made their contributions at the meeting include:

Missouri State Chiro. Assn. - Dist. II $500, brings total to $1,000 Missouri State Chiro. Assn. - Dist. 5 $2,000, brings total to $2,500 Washington Chiropractic Association $500, brings total to $1,000 Montana Chiropractic Association $1,500, brings total to $15,500 CSRI, Inc. $5,000.00, brings total to $7,000 ACA Auxiliary $10,000, brings total to $12,500 SACA - Palmer $500, brings total to $977.35 SACA - NWCC $500, brings total to $500 SACA - Logan $300, brings total to $1,325 North Alabama Chiro. Society $2,600, brings total to $2,600 Central Alabama Chiro. Society $1,000, brings total to $2,000 Baldwin County Chiro. Society $700, brings total to $1,900 South East Alabama Chiro. Society $500, brings total to $2,500 Council on Diagnostic Imaging $500, brings total to $1,000 International College of Chiropractors $ 1,000, brings total to $2,000 Association of Chiropractic Colleges $10,000, brings total to $110,000

4)ASSOCIATION OF CHIROPRACTIC COLLEGES GIVES AGAIN

The organization representing all of the chiropractic colleges in the country continues to show its active support for the lawsuits. Last week, we received from its president, Dr. Dallas, a check for $10,000. This brings the total contribution from the ACC to $110,000.

5) ACA AUXILARY CONTINUES TO GIVE

The ACA Auxilary also weighed in and contributed $10,000 to the lawsuit.. This Auxiliary has been tremendously active the last couple of years. Did you know that it was the Auxiliary that cosponsored Parra with us before he became a household name, and was responsible for sponsoring his presentation to the House of Delegates this past weekend? Or that they have continually supported for years, along with the American Chiropractic Foundation, the issuance of scholarships to qualified students? This year, the auxiliary handed out 11 scholarships, ranging from $1000 to $2500. Do you need another reason to support the Auxiliary? Here is a link to join <http://www.acatoday.com/about/auxiliary/>

6) ACA ELECTS ITS LEADERS AND HONORS ITS VOLUNTEERS

At the recent annual meeting of the ACA, the officers of the association were selected for the year. Here is a quick summary of the major offices selected and the major awards given:

ACA OFFICERS

ACA Chairman of the BOG: Dr. ACA President: Dr. Daryl Wills ACA Vice President: Dr. Don Krippendorf ACA Council President: Dr. Brassard ACA Council Vice President: Dr. Glenn Manceaux ACA Council Secretary: Dr. Herd Drs. Jerilynn Kaibel, Zange, and Lou Bazakos were reelected Governors of their respective districts.

NEW SACA OFFICERS ELECTED National Chair - Janelle Whitehead - National Vice Chair - Mayeda - Northwestern National Legislative Rep - Skow - Northwestern National Vice Legislative Rep - Caitlin roe - National

ACA HONORS ITS OUTSTANDING VOLUNTEERS Chiropractor of the Year: Dr. Flynn Humanitarian of the Year: Senator Tom Daschle Delegate of the Year: Dr. Overland Academic of the Year: Dr. Lester Lamm Researcher of the Year: Dr. Cheryl Hawk, D,C, PhD Flynn/Lynch Award Dr Bruns

7) MRS. WINTERSTEIN PASSES ON

Mrs. Diane Winterstein, wife of Dr. Jim Winterstein, president of National University of Health Sciences, passed away last week after a long illness. Mrs. Winterstein has been a long time supporter of the profession and of the college. We deeply regret her passing. At the request of the family, donations should be sent to either National College or to St. 's Lutheran Church. Here are the addresses:

St. 's Lutheran Church 215 S. Lincoln Ave. Lombard, Illinois 60148

For National, send to:

Ms. McHugh National University of Health Sciences 200 E. Roosevelt Rd. Lombard, Illinois 60148

8) SURPRISES IN STORE AT 2003 PARKER SEMINARS Advance registration has begun for the 2003 Seminars, including the spectacular Las Vegas event set for Jan. 30 - Feb. 2, which will feature more than 100 special presenters and celebrities. According to Dana Mackison, DC, director of seminars, over 50 sessions will be offered on Friday, Jan. 31, alone. "Doctors will be treated to an incredible array of chiropractic presentations," he says. "There'll be something for everyone." Saturday boasts a "super success" motivational program headlined by top chiropractic instructors, some of the world's most famous health and wellness speakers AND big-name celebrities. "The line-up is incredible. Some of the names will absolutely astound you," said College President Fabrizio Mancini, DC. "There will definitely be some surprises. We want to make this an event the whole profession can celebrate." The Las Vegas Hilton is the site of the seminar. Seminars has negotiated a special room rate of just $95 per night for attendees. To make reservations, call 888/732-7117. Last year, the hotel was sold out fast, so don't delay in making a reservation today. Early-bird registration has begun for the Las Vegas Seminar and is $195 for doctors, $115 for CAs and other guests, and $49.95 for students. To register, call 888/727-5338 or visit www.parkerseminars.com to register online. 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@...>.

************************ 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."

September 18, 2002

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: September 16, 2002 NON MEMBER'S REPORT

This report contains the following items:

1. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI 2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY 3. ACA REPRESENTATIVE QUOTED IN USA TODAY 4. MEDICARE LEGISLATION: AN UPDATE 5. ACA PAC OFFICERS FOR 2002-03 6. STUDENT LOAN ISSUE STILL IN DOUBT 7. ACA PROVIDES ASSISTANCE TO NEW JERSEY 8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM 9. INFO ON 2003 EDITION OF ACA CODING SOLUTIONS 10. CAN'T ACCESS THESE LINKS?

1.. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI

We have been receiving a tremendous amount of support from the presidents of the chiropractic colleges. Dr. Bill Dallas from Western States College of Chiropractic, Dr. Shelby Elliott from Texas Chiropractic College, and Dr. Goodman from Logan Chiropractic College each sent letters to their alumni urging support for the National Chiropractic Legal Action Fund. At the encouragement of Dr. Alfred Traina, Northwestern Health Sciences University's alumni association pledged a contribution and sent out letters urging its members to do so as well.

Transitions Magazine, the magazine of the New York Chiropractic College, includes a solicitation for contributions. Additionally, the National University Health Sciences Alumni magazine includes a letter from the ACA in support of the lawsuit.

2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY

The Congress of Chiropractic State Associations (COCSA) has joined with the ACA in protesting the Secretary of Veterans Affairs' recent appointments of Dr. DuVall and five representatives from other health care professions to the Chiropractic Advisory Committee. Noting that the majority of the committee was made up of individuals representing groups which opposed portions of the chiropractic legislation when it was going through Congress, or in the case of DuVall, someone who represents the extreme elements of the profession, COCSA expressed great disappointment over this action . As the ACA did in its letter of protest, COCSA urged the Secretary to remove Dr DuVall. . COCSA also encouraged its state association members to do the same. Copies of the ACA letter to the secretary can be found on ACA's Web site at: <http://www.acatoday.com/hot_topics/090302.shtml>.

3. ACA REPRESENTATIVE QUOTED IN USA TODAY

ACA is mentioned in an article on backpacks in last week's USA Today. Dr. Bautch, past president of ACA's Council on Occupational Health, is quoted in the story on page 6D. The article can be found on the USA Today Web site at this location: <http://www.usatoday.com/usatonline/20020911/4437037s.htm>.

4. MEDICARE LEGISLATION: AN UPDATE

As you know, the ACA is currently working with the Senate for the inclusion of a Medicare chiropractic provision, based on H.R. 902, in the Medicare reform legislation that is being developed. Because of the political environment in Washington, you still get various opinions from members of the Senate on whether the Medicare reform legislation will go through the

Senate Finance Committee (normal process) or go straight to the Senate floor as an amendment. As a result, we need every Senator's support on this issue. It is imperative that you urge your Senators to support ACA's effort, which will help ensure Medicare beneficiaries' access to covered services while at the same time significantly improving their choice of licensed health care providers in the program. Specifically, respectfully request that your Senators contact the Senate Finance Committee and Senate Leadership in support of the inclusion of a chiropractic provision (supported by the ACA) in the Medicare reform legislation. If a chiropractic provision is not included in the Medicare bill, urge your Senators to vote no on the final passage of the legislation. This issue is extremely time sensitive, so please take action as soon as possible. The ACA has prepared a draft Senate letter, which you can access by clicking here: <http://www.acatoday.com/hot_topics/091302.shtml>. If you have already contacted your Senators about this, follow up with them to see what they have done to support our provision.

5.. ACA PAC OFFICERS FOR 2002-03

· Chairman: Dr. Joe , West Virginia Delegate · Vice Chairman: Dr. Gentile, Florida Delegate · Treasurer: Dr. Perusich · Secretary: Dr. Overland, Connecticut Delegate · Officer-at-Large: Dr. , Chairman of the Board · Officer-at-Large: Dr. Spoto, Pennsylvania Delegate · Officer-at-Large: Dr. Fidler, Minnesota Delegate

6. STUDENT LOAN ISSUE STILL IN DOUBT

As you know, the ACA has been working to pass legislation allowing doctors of chiropractic to participate in the National Health Service Corps program. Legislation, which for the first time would include doctors of chiropractic in the National Health Service Corps, passed the Senate last April. As a result. the ACA is currently working with the House to have them accept the Senate version of the language. However, the legislation in the House is currently being held up by a poison-pill amendment. The ACA has recently learned the nation's community health centers are turning up the heat on House Majority Leader Dick Armey, who they say is holding up action on the bill to reauthorize the National Health Service Corps. The National Association of Community Health Centers has stated that time is running out in this session and that Armey's stance is putting the program at risk. This pressure may unlock the logjam on this issue. The ACA will alert the profession when grassroots action is needed.

7. ACA PROVIDES ASSISTANCE TO NEW JERSEY

Dr. Stiso, ACA Delegate to New Jersey, and Pat , ACA staff, met with the New Jersey Department of Banking and Insurance (DOBI) on August 22, 2002 to relay national and state association opposition to the severe limitations placed on chiropractic care by regulators under the PIP No-Fault fee schedule. The Assistant Commissioner was pleased with ACA's role in providing clarity around chiropractic care definitions, coding policy, anti-fraud statements and appropriate medical review benchmarks that insurers should follow when handling chiropractic claims. DOBI officials indicated they did not like the $90.00 cap and felt it was cumbersome, and indicated the policy provided would give the Department possible grounds for reassessing the need for a cap. ACA requested involvement on the internal committee to help make decisions on the PIP Fee Schedule.

8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM

ACA's Chairman of the Board, D. , DC, has been invited as a Distinguished Guest and offered the opportunity to speak on the chiropractic lawsuits at the Second Annual Masters Circle Conference, scheduled for November 14th -16th at the Caribe Royale Resort and Villas in Orlando, Florida. For further details regarding the program contact Beth at 1-800-451-4514, or visit the Web site at: www.themasterscircle.com <http://www.themasterscircle.com>.

..

9.. 2003 EDITION OF ACA CODING SOLUTIONS HELPS DCs THROUGH THE REIMBURSEMENT QUAGMIRE

I'm proud to announce that ACA's Official Chiropractic Coding Solutions Book 2003 (available December 2002) is the most accurate, chiropractic-specific coding resource available on the market today. The new edition of this bestseller features new and improved sections on hot topics such as HIPAA and ICD-9 Codes, including an expanded section on consultation codes, a new sections on laboratory services, nutritional counseling codes and manipulation under anesthesia. The Chairman of ACA CPT Coding and Reimbursement Committee, Dr. Hamm, has remarked that "this user-friendly resource makes it easy for doctors of chiropractic to use the codes correctly, and more importantly, get paid." You can't afford not to have this reference book in your office, order today!

ACA Member Price: $39.95; Non-member Price: $69.95. Order Item CPT2003. To reserve your copy today, call 800-368-3083. Books will be available in December 2002.

Special Members Only Savings: Complete your CPT Series and SAVE! Purchase ACA's Official Chiropractic Coding Solutions Book 2003 and save 50% off the normal member price of the 2002 coding book. Members Only Price: $59.95 for both books. Order Item CPT0203.

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@...>.

************************ 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."

September 18, 2002

Vern, Do you have item 9 the ACA Chiropractic Office Coding Solutions book? Any other feedback from those of you who might have it?Ron Johansen,Portland

On Wed, 18 Sep 2002 07:00:50 -0700 "Vern Saboe DC" <las@...> writes:

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: September 16, 2002 NON MEMBER'S REPORT

This report contains the following items:

1. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI 2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY 3. ACA REPRESENTATIVE QUOTED IN USA TODAY 4. MEDICARE LEGISLATION: AN UPDATE 5. ACA PAC OFFICERS FOR 2002-03 6. STUDENT LOAN ISSUE STILL IN DOUBT 7. ACA PROVIDES ASSISTANCE TO NEW JERSEY 8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM 9. INFO ON 2003 EDITION OF ACA CODING SOLUTIONS 10. CAN'T ACCESS THESE LINKS?

1.. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI

We have been receiving a tremendous amount of support from the presidents of the chiropractic colleges. Dr. Bill Dallas from Western States College of Chiropractic, Dr. Shelby Elliott from Texas Chiropractic College, and Dr. Goodman from Logan Chiropractic College each sent letters to their alumni urging support for the National Chiropractic Legal Action Fund. At the encouragement of Dr. Alfred Traina, Northwestern Health Sciences University's alumni association pledged a contribution and sent out letters urging its members to do so as well.

Transitions Magazine, the magazine of the New York Chiropractic College, includes a solicitation for contributions. Additionally, the National University Health Sciences Alumni magazine includes a letter from the ACA in support of the lawsuit.

2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY

The Congress of Chiropractic State Associations (COCSA) has joined with the ACA in protesting the Secretary of Veterans Affairs' recent appointments of Dr. DuVall and five representatives from other health care professions to the Chiropractic Advisory Committee. Noting that the majority of the committee was made up of individuals representing groups which opposed portions of the chiropractic legislation when it was going through Congress, or in the case of DuVall, someone who represents the extreme elements of the profession, COCSA expressed great disappointment over this action . As the ACA did in its letter of protest, COCSA urged the Secretary to remove Dr DuVall. . COCSA also encouraged its state association members to do the same. Copies of the ACA letter to the secretary can be found on ACA's Web site at: <http://www.acatoday.com/hot_topics/090302.shtml>.

3. ACA REPRESENTATIVE QUOTED IN USA TODAY

ACA is mentioned in an article on backpacks in last week's USA Today. Dr. Bautch, past president of ACA's Council on Occupational Health, is quoted in the story on page 6D. The article can be found on the USA Today Web site at this location: <http://www.usatoday.com/usatonline/20020911/4437037s.htm>.

4. MEDICARE LEGISLATION: AN UPDATE

As you know, the ACA is currently working with the Senate for the inclusion of a Medicare chiropractic provision, based on H.R. 902, in the Medicare reform legislation that is being developed. Because of the political environment in Washington, you still get various opinions from members of the Senate on whether the Medicare reform legislation will go through the

Senate Finance Committee (normal process) or go straight to the Senate floor as an amendment. As a result, we need every Senator's support on this issue. It is imperative that you urge your Senators to support ACA's effort, which will help ensure Medicare beneficiaries' access to covered services while at the same time significantly improving their choice of licensed health care providers in the program. Specifically, respectfully request that your Senators contact the Senate Finance Committee and Senate Leadership in support of the inclusion of a chiropractic provision (supported by the ACA) in the Medicare reform legislation. If a chiropractic provision is not included in the Medicare bill, urge your Senators to vote no on the final passage of the legislation. This issue is extremely time sensitive, so please take action as soon as possible. The ACA has prepared a draft Senate letter, which you can access by clicking here: <http://www.acatoday.com/hot_topics/091302.shtml>. If you have already contacted your Senators about this, follow up with them to see what they have done to support our provision.

5.. ACA PAC OFFICERS FOR 2002-03

· Chairman: Dr. Joe , West Virginia Delegate · Vice Chairman: Dr. Gentile, Florida Delegate · Treasurer: Dr. Perusich · Secretary: Dr. Overland, Connecticut Delegate · Officer-at-Large: Dr. , Chairman of the Board · Officer-at-Large: Dr. Spoto, Pennsylvania Delegate · Officer-at-Large: Dr. Fidler, Minnesota Delegate

6. STUDENT LOAN ISSUE STILL IN DOUBT

As you know, the ACA has been working to pass legislation allowing doctors of chiropractic to participate in the National Health Service Corps program. Legislation, which for the first time would include doctors of chiropractic in the National Health Service Corps, passed the Senate last April. As a result. the ACA is currently working with the House to have them accept the Senate version of the language. However, the legislation in the House is currently being held up by a poison-pill amendment. The ACA has recently learned the nation's community health centers are turning up the heat on House Majority Leader Dick Armey, who they say is holding up action on the bill to reauthorize the National Health Service Corps. The National Association of Community Health Centers has stated that time is running out in this session and that Armey's stance is putting the program at risk. This pressure may unlock the logjam on this issue. The ACA will alert the profession when grassroots action is needed.

7. ACA PROVIDES ASSISTANCE TO NEW JERSEY

Dr. Stiso, ACA Delegate to New Jersey, and Pat , ACA staff, met with the New Jersey Department of Banking and Insurance (DOBI) on August 22, 2002 to relay national and state association opposition to the severe limitations placed on chiropractic care by regulators under the PIP No-Fault fee schedule. The Assistant Commissioner was pleased with ACA's role in providing clarity around chiropractic care definitions, coding policy, anti-fraud statements and appropriate medical review benchmarks that insurers should follow when handling chiropractic claims. DOBI officials indicated they did not like the $90.00 cap and felt it was cumbersome, and indicated the policy provided would give the Department possible grounds for reassessing the need for a cap. ACA requested involvement on the internal committee to help make decisions on the PIP Fee Schedule.

8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM

ACA's Chairman of the Board, D. , DC, has been invited as a Distinguished Guest and offered the opportunity to speak on the chiropractic lawsuits at the Second Annual Masters Circle Conference, scheduled for November 14th -16th at the Caribe Royale Resort and Villas in Orlando, Florida. For further details regarding the program contact Beth at 1-800-451-4514, or visit the Web site at: www.themasterscircle.com <http://www.themasterscircle.com>.

..

9.. 2003 EDITION OF ACA CODING SOLUTIONS HELPS DCs THROUGH THE REIMBURSEMENT QUAGMIRE

I'm proud to announce that ACA's Official Chiropractic Coding Solutions Book 2003 (available December 2002) is the most accurate, chiropractic-specific coding resource available on the market today. The new edition of this bestseller features new and improved sections on hot topics such as HIPAA and ICD-9 Codes, including an expanded section on consultation codes, a new sections on laboratory services, nutritional counseling codes and manipulation under anesthesia. The Chairman of ACA CPT Coding and Reimbursement Committee, Dr. Hamm, has remarked that "this user-friendly resource makes it easy for doctors of chiropractic to use the codes correctly, and more importantly, get paid." You can't afford not to have this reference book in your office, order today!

ACA Member Price: $39.95; Non-member Price: $69.95. Order Item CPT2003. To reserve your copy today, call 800-368-3083. Books will be available in December 2002.

Special Members Only Savings: Complete your CPT Series and SAVE! Purchase ACA's Official Chiropractic Coding Solutions Book 2003 and save 50% off the normal member price of the 2002 coding book. Members Only Price: $59.95 for both books. Order Item CPT0203.

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@...>.

************************ 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."OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

September 18, 2002

Ron and colleagues out there in "cyberspace:"

As 's weekly report indicates the coding book for 2003 will not be available until Dec. of this year. However I would recommend you buy the thing the 2002 edition is excellent. With that said I have a copy of a Power Point presentation that McClelland, BS.,CCA.,RT gave August 30 at the House of Delegates meeting which covered the latest on coding solutions and has a wealth of information. If any of you folks would like a copy simply send me a self address lg. manila envelope and I'll send you a copy ASAP you will need to place 4 stamps of the envelope.

Vern Saboe, DC.,DACAN.,FICC.,DABFP

ACA Delegate

CAO Execuitive Board

Albany

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: September 16, 2002 NON MEMBER'S REPORT

This report contains the following items:

1. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI 2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY 3. ACA REPRESENTATIVE QUOTED IN USA TODAY 4. MEDICARE LEGISLATION: AN UPDATE 5. ACA PAC OFFICERS FOR 2002-03 6. STUDENT LOAN ISSUE STILL IN DOUBT 7. ACA PROVIDES ASSISTANCE TO NEW JERSEY 8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM 9. INFO ON 2003 EDITION OF ACA CODING SOLUTIONS 10. CAN'T ACCESS THESE LINKS?

1.. CHIROPRACTIC COLLEGES COMMUNICATING WITH THEIR ALUMNI

We have been receiving a tremendous amount of support from the presidents of the chiropractic colleges. Dr. Bill Dallas from Western States College of Chiropractic, Dr. Shelby Elliott from Texas Chiropractic College, and Dr. Goodman from Logan Chiropractic College each sent letters to their alumni urging support for the National Chiropractic Legal Action Fund. At the encouragement of Dr. Alfred Traina, Northwestern Health Sciences University's alumni association pledged a contribution and sent out letters urging its members to do so as well.

Transitions Magazine, the magazine of the New York Chiropractic College, includes a solicitation for contributions. Additionally, the National University Health Sciences Alumni magazine includes a letter from the ACA in support of the lawsuit.

2. COCSA JOINS THE ACA IN SENDING LETTERS OF PROTEST TO THE VA SECRETARY

The Congress of Chiropractic State Associations (COCSA) has joined with the ACA in protesting the Secretary of Veterans Affairs' recent appointments of Dr. DuVall and five representatives from other health care professions to the Chiropractic Advisory Committee. Noting that the majority of the committee was made up of individuals representing groups which opposed portions of the chiropractic legislation when it was going through Congress, or in the case of DuVall, someone who represents the extreme elements of the profession, COCSA expressed great disappointment over this action . As the ACA did in its letter of protest, COCSA urged the Secretary to remove Dr DuVall. . COCSA also encouraged its state association members to do the same. Copies of the ACA letter to the secretary can be found on ACA's Web site at: <http://www.acatoday.com/hot_topics/090302.shtml>.

3. ACA REPRESENTATIVE QUOTED IN USA TODAY

ACA is mentioned in an article on backpacks in last week's USA Today. Dr. Bautch, past president of ACA's Council on Occupational Health, is quoted in the story on page 6D. The article can be found on the USA Today Web site at this location: <http://www.usatoday.com/usatonline/20020911/4437037s.htm>.

4. MEDICARE LEGISLATION: AN UPDATE

As you know, the ACA is currently working with the Senate for the inclusion of a Medicare chiropractic provision, based on H.R. 902, in the Medicare reform legislation that is being developed. Because of the political environment in Washington, you still get various opinions from members of the Senate on whether the Medicare reform legislation will go through the

Senate Finance Committee (normal process) or go straight to the Senate floor as an amendment. As a result, we need every Senator's support on this issue. It is imperative that you urge your Senators to support ACA's effort, which will help ensure Medicare beneficiaries' access to covered services while at the same time significantly improving their choice of licensed health care providers in the program. Specifically, respectfully request that your Senators contact the Senate Finance Committee and Senate Leadership in support of the inclusion of a chiropractic provision (supported by the ACA) in the Medicare reform legislation. If a chiropractic provision is not included in the Medicare bill, urge your Senators to vote no on the final passage of the legislation. This issue is extremely time sensitive, so please take action as soon as possible. The ACA has prepared a draft Senate letter, which you can access by clicking here: <http://www.acatoday.com/hot_topics/091302.shtml>. If you have already contacted your Senators about this, follow up with them to see what they have done to support our provision.

5.. ACA PAC OFFICERS FOR 2002-03

· Chairman: Dr. Joe , West Virginia Delegate · Vice Chairman: Dr. Gentile, Florida Delegate · Treasurer: Dr. Perusich · Secretary: Dr. Overland, Connecticut Delegate · Officer-at-Large: Dr. , Chairman of the Board · Officer-at-Large: Dr. Spoto, Pennsylvania Delegate · Officer-at-Large: Dr. Fidler, Minnesota Delegate

6. STUDENT LOAN ISSUE STILL IN DOUBT

As you know, the ACA has been working to pass legislation allowing doctors of chiropractic to participate in the National Health Service Corps program. Legislation, which for the first time would include doctors of chiropractic in the National Health Service Corps, passed the Senate last April. As a result. the ACA is currently working with the House to have them accept the Senate version of the language. However, the legislation in the House is currently being held up by a poison-pill amendment. The ACA has recently learned the nation's community health centers are turning up the heat on House Majority Leader Dick Armey, who they say is holding up action on the bill to reauthorize the National Health Service Corps. The National Association of Community Health Centers has stated that time is running out in this session and that Armey's stance is putting the program at risk. This pressure may unlock the logjam on this issue. The ACA will alert the profession when grassroots action is needed.

7. ACA PROVIDES ASSISTANCE TO NEW JERSEY

Dr. Stiso, ACA Delegate to New Jersey, and Pat , ACA staff, met with the New Jersey Department of Banking and Insurance (DOBI) on August 22, 2002 to relay national and state association opposition to the severe limitations placed on chiropractic care by regulators under the PIP No-Fault fee schedule. The Assistant Commissioner was pleased with ACA's role in providing clarity around chiropractic care definitions, coding policy, anti-fraud statements and appropriate medical review benchmarks that insurers should follow when handling chiropractic claims. DOBI officials indicated they did not like the $90.00 cap and felt it was cumbersome, and indicated the policy provided would give the Department possible grounds for reassessing the need for a cap. ACA requested involvement on the internal committee to help make decisions on the PIP Fee Schedule.

8. ACA CHAIRMAN AT THE MASTERS CIRCLE PROGRAM

ACA's Chairman of the Board, D. , DC, has been invited as a Distinguished Guest and offered the opportunity to speak on the chiropractic lawsuits at the Second Annual Masters Circle Conference, scheduled for November 14th -16th at the Caribe Royale Resort and Villas in Orlando, Florida. For further details regarding the program contact Beth at 1-800-451-4514, or visit the Web site at: www.themasterscircle.com <http://www.themasterscircle.com>.

..

9.. 2003 EDITION OF ACA CODING SOLUTIONS HELPS DCs THROUGH THE REIMBURSEMENT QUAGMIRE

I'm proud to announce that ACA's Official Chiropractic Coding Solutions Book 2003 (available December 2002) is the most accurate, chiropractic-specific coding resource available on the market today. The new edition of this bestseller features new and improved sections on hot topics such as HIPAA and ICD-9 Codes, including an expanded section on consultation codes, a new sections on laboratory services, nutritional counseling codes and manipulation under anesthesia. The Chairman of ACA CPT Coding and Reimbursement Committee, Dr. Hamm, has remarked that "this user-friendly resource makes it easy for doctors of chiropractic to use the codes correctly, and more importantly, get paid." You can't afford not to have this reference book in your office, order today!

ACA Member Price: $39.95; Non-member Price: $69.95. Order Item CPT2003. To reserve your copy today, call 800-368-3083. Books will be available in December 2002.

Special Members Only Savings: Complete your CPT Series and SAVE! Purchase ACA's Official Chiropractic Coding Solutions Book 2003 and save 50% off the normal member price of the 2002 coding book. Members Only Price: $59.95 for both books. Order Item CPT0203.

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@...>.

************************ 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."OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

October 3, 2002

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 October 2,2002

In this issue are the following items:

1) JUDGE ORDERS ORAL ARGUMENTS IN TRIGON CASE 2) FIRST MEETING OF VA ADVISORY COMMITTEE 3) EXTENSION OF DEADLINE FOR COVERED ENTITIES SUBMITTING COMPLIANCE PLANS UNDER HIPAA (IMPORTANT) 4) COMMONLY ASKED QUESTION REGARDING MEDICARE ABN 5) LATEST ON MEDICARE 6) ACA CHAIRMAN HONORS PARKER COLLEGE 7) MISSOURI DOCTORS PUSH FOR CONTRIBUTIONS 8) UPDATE ON THE SPECIALTY COUNCIL ON OCCUPATIONAL HEALTH 9) ACA WILL BE WELL REPRESENTED AT PARKER IN MIAMI 10) SPECIAL TELECONFERENCING PROGRAM ON BACKPACK PROMOTION

1) JUDGE ORDERS ORAL ARGUMENTS IN TRIGON CASE

The judge in the Trigon suit has ordered in-person oral arguments on the "Motion for Summary Judgment" filed by Trigon Blue Cross/Shield for next Friday in Abingdon, Virginia. Mr. Mcs will be traveling to Abington to personally argue against the motion.

2) FIRST MEETING OF VA ADVISORY COMMITTEE

The members of the VA Advisory Committee held their first meeting in Washington D.C. on September 23-25. The committee, established by statutes signed by the President in January, is responsible for advising the Secretary of the Veterans Administration regarding the implementation of chiropractic in the Veterans Administration health care system.

The first meeting showed some positive signs: The committee reached agreement regarding the basic requirements of a doctor to participate in the system. They also agreed to recommend to the Secretary that a major occupational study be initated on chiropractic case as soon as possible. The chiropractic doctors on the committee, who had been recommended by the ACA, ACC, WCA and ICA, were working well together and in fact organized a planning meeting at the end of the second day. . There still remain difficult issues to address, but those participating are cautiously optimistic that they will be able to work together for the betterment of the profession.

The next meeting is scheduled for December 4-5. At the next meeting, the chiropractic representatives will be presenting to the full committee a comprehensive review of chiropractic, its education, practice and science.

3) EXTENSION OF DEADLINE FOR COVERED ENTITIES SUBMITTING COMPLIANCE PLANS UNDER HIPAA

As most of you are already aware, the Administrative Simplification Compliance Act, signed into law on December 27, 2001, provides for an extension to those "covered entities" under HIPAA who would like an additional year to make sure their electronic transactions are HIPAA compliant. A "covered entity" under HIPAA is defined as a health care provider, health plan or health care clearinghouse that transmits patient information electronically. A provider who does no electronic transactions in-house, but contracts with a third party such as a billing service, is also a "covered entity." The compliance date for the electronic transactions standards is October 15, 2002, however, if an extension form is submitted, entities automatically receive a one year extension until October 15, 2003. If you are currently not transmitting patient information in an electronic format, but anticipate that you may begin to within the coming year, the ACA is recommending that you go ahead and fill out this form. The link to the form is on the ACA website. Go to the "Government" section of the site and then to "HIPAA." Or, you can go directly to <http://www.cms.hhs.gov/hipaa/hipaa2/ascaform.asp>.

4) COMMONLY ASKED QUESTION REGARDING MEDICARE ABN

As reported earlier in this weekly report, Medicare has issued a new Advance Beneficiary Notice (ABN). The ACA has received a number of questions concerning whether the ABN should be routinely used prior to each visit by a Medicare patient. The answer, according to Medicare, is no. Medicare instructions on the use of the ABN make clear that, "Giving routine notices for all claims and services is not an acceptable practice." Medicare states, "Physicians and suppliers should not give ABNs to beneficiaries unless the physician or supplier has some genuine doubt that Medicare will make payment as evidenced by their stated reasons." For more information on the use of the new ABN, contact ACA home offices at (703) 276-8800.

5) LATEST ON MEDICARE

In the ever changing situation regarding Medicare it now appears that the reform bill will not go through the Senate Finance Committee The most likely bill that will move in the Senate is one being drafted by Senator Baucus, chairman, and Senator Grassley, ranking member on the Finance Committee., even though the bill will not have a hearing in committee. Confused? It's a complicated issue, where both sides are trying to find a way for compromise with the least amount of political pressure. Whatever they draft will be submitted to the floor of the senate for a vote. We will continue to work with the offices of Senators Grassley and Baucus to assure that our provision is included. We are also looking at the option, that if we are unsuccessful, to have a friendly senator include our provision as an amendment. Senator Daschle has already agreed to introduce our provision if it becomes necessary. The Senate is scheduled to go into recess on October 10th. It is questionable whether they will be able to hold to that date.

While the Finance Committee will not formerly vote on the bill as a committee, they will certainly have imput into what is developed and we ask you to continue to call your senators about this issue. Specifically, senators should be asked to contact the Senate Finance Committee and request that ACA's chiropractic provision be included in the base Baucus/Grassley Medicare bill (the legislation is still in draft form so it has not yet been assigned a bill number). It would be best if Republican Senators contacted Senator Grassley and Democratic Senators contacted Senator Baucus. Doctors, students and patients can find contact information for their Senators at <http://www.senate.gov/senators/senator_by_state.cfm>.

6) ACA CHAIRMAN HONERS PARKER COLLEGE

ACA Chairman Dr. attended the College 20th Anniversary Homecoming on Sept. 21 in Dallas, Texas. Dr. presented an ACA award commemorating the event to Dr. Mancini at the Saturday night dinner.

7) MISSOURI DOCTORS PUSH FOR CONTRIBUTIONS

Volunteerism is alive and well in Missouri. Dr. Jack Kessinger and Dr. Carver, delegate and alternate delegate for the state of Missouri, have organized 25 doctors in the state to contact other doctors in the state in support of the lawsuit. They have a goal of reaching 250 doctors.

8) UPDATE ON THE SPECIALTY COUNCIL ON OCCUPATIONAL HEALTH

The ACA's Council on Occupational Health (ACACOH) recently exhibited at the Florida Chiropractic Association's August convention. Officers of the council staffing the booth responded to numerous convention-going doctors interested in what the Council was about, and how they could become informed about occupational health consulting.

In addition, the ACACOH sponsored speakers for two separate workshops at the FCA Convention. Dr. Bautch and Dr. W. Nevius, both spoke about occupational health-related topics for DCs. Both workshops were well attended. Having Drs. Bautch and Nevius present in workshops served to increase visibility for the council as well as raise awareness of the specialty of occupational health for chiropractic. Thank you Dr. Bautch and Dr. Nevius!

The council held its annual business meeting while in Orlando, and held elections for officers for the year 2002-2003. The current officers were re-elected and are as follows:

Conway, DC, DACBOH - President Bruce Hansbrough, DC, DACBOH - Vice President Chad Henriksen, DC, - Secretary Thorpe, DC, DACBOH - Treasurer

The council phone number is (507) 455-1025.

9) ACA WILL BE WELL REPRESENTED AT PARKER IN MIAMI

I will be joining Dr. Mike Flynn, Warner de ez, vice president of member services and Caroline Fuchs, vice president of business development, in Miami to attend the seminar, October 17-20, at the Inter-Continental Miami Downtown. The program will once again provide us with the opportunity to promote the ACA lawsuits with booth space and time on the agenda. For further information regarding the program go to:

www.parkerseminars.com/seminar/miami02special.asp <http://www.parkerseminars.com/seminar/miami02special.asp>.

To register online or check out registration costs, go to www.parkerseminars.com/registration/index.asp <http://www.parkerseminars.com/registration/index.asp> or call 1-888-727-5338.

10) SPECIAL TELECONFERENCING PROGRAM ON BACKPACK PROMOTION

ACA's live 90-minute teleconference is designed to teach you how to implement a backpack safety program in your local area, and will provide you with the information you need to educate kindergarten and elementary school children, teachers and parents on proper backpack wear and use. The speaker, Dr. Bautch will discuss the importance of educating children early about how overloaded backpacks can result in injury, back pain and curvature of the spine. The program includes sample outlines, scripts and presentations to get you started.

In addition to this program, Dr. Bautch will discuss ACA's endorsement of the Chiropak backpack, the features, and how to order these specially-designed backpacks to sell in your office. Members will receive registration information via email. For more information, call 800-986-4636.

October 9, 2002

ACA EVP Weekly Report

TO: ACA MEMBERS, BOARD OF GOVERNORS, HOUSE OF DELEGATES AND OTHER INTERESTED PARTIES

FROM: GARY CUNEO

RE: ACA EVP WEEKLY REPORT DATE: October 7, 2002

This week's report includes the following items:

1. TRIGON HEARING UPDATE 2. EXTENSION OF DEADLINE FOR COVERED ENTITIES SUBMITTING COMPLIANCE PLANS UNDER HIPAA 3. MEDICARE DISAPPOINTMENT 4. WFC CONGRESS AT DISNEY WORLD 5. ACA NEWS RELEASE FEATURES ADHD SERIES IN JACA 6. SPECIAL THANKS TO PARKER 7. ACA A HIT AT AARP CONVENTION 8. ACA PRESIDENT SPENDS WEEK ON ROAD: MAKES GREAT INROADS 9. COMBS ADDRESSES ALASKA DOCTORS 10. CAN'T ACCESS THESE LINKS?

1. TRIGON HEARING UPDATE

Counsel for the ACA and VCA and counsel for Trigon squared off in a one-hour and 10-minute oral argument before U.S. District Court Judge in Abingdon, Virginia on Friday, October 4th. The court asked numerous questions of the Mcs, primarily focusing on the economic motivation and reasons why medical physicians would be reluctant to refer patients to doctors of chiropractic. The judge took the motion to dismiss (Summary Judgment) under advisement and indicated he will be ruling on this case in due course.

2. EXTENSION OF DEADLINE FOR COVERED ENTITIES SUBMITTING COMPLIANCE PLANS UNDER HIPAA

As most of you are already aware, the Administrative Simplification Compliance Act, signed into law on December 27, 2001, provides for an extension to those "covered entities" under HIPAA who would like an additional year to make sure their electronic transactions are HIPAA compliant. A "covered entity" under HIPAA is defined as a health care provider, health plan or health care clearinghouse that transmits patient information electronically. A provider who does no electronic transactions in-house, but contracts with a third party such as a billing service, is also a "covered entity." The compliance date for the electronic transactions standards is October 15, 2002; however, if an extension form is submitted, entities automatically receive a one-year extension until October 15, 2003. If you are currently not transmitting patient information in an electronic format, but anticipate that you may begin to within the coming year, the ACA is recommending that you go ahead and fill out this form. A copy of the form is attached for members.

3. MEDICARE DISAPPOINTMENT

As earlier reported, Senator Max Baucus (D-MT) and Senator Grassley (R-IA) developed and introduced legislation to correct problems with the Medicare program. This bill may be the Medicare vehicle that is considered by the full Senate. We have been very disappointed that the proposal put together by Senators Max Baucus and Grassley didn't include the chiropractic provision -- despite our best lobbying efforts and intervention by our friends. Everyone we had talked to indicated there was no opposition to our proposal. Well, it appears that someone opposed it. In any case, we still have options to play in this matter. Senators Harkin and Daschle are committed to amending the proposal if and when it reaches the floor of the Senate. It is a big if, since both the Senate Democratic and Republican Leaders need to reach a time agreement. Regarding the floor debate.. Given the price tag of the bill and the upcoming elections, it will be difficult to get the required agreement.. Still the Senate will have to deal with the Medicare or do some serious explaining. We will continue to play out our options and it's important that you maintain the pressure.

4. WFC CONGRESS AT DISNEY WORLD

Don't miss the World Federation of Chiropractic's Congress to be held May 1-3, 2003 at the Hilton at the Walt Disney World Resort, Orlando, Florida. The two main themes are the cervical spine and sports chiropractic, and the more than 60 lecturers and technique instructors are a Who's Who in chiropractic. It all begins with a Disney Show.

For the full program, registrations, exhibit/sponsorship opportunities and all other information, visit www.chiroweb.com/wfcorlando2003 <http://www.chiroweb.com/wfcorlando2003>. This major event is co-sponsored by the ACA, ICA, CCA, FCER and FICS.

5. ACA NEWS RELEASE FEATURES ADHD SERIES IN JACA ACA's Communications Department has issued a news release to the national media regarding a series of articles in the Journal of the American Chiropractic Association (JACA) on chiropractic approaches to attention deficit hyperactivity disorder (ADHD). As the JACA series points out, prescriptions for Ritalin have increased five-fold in the past decade, with 90 percent of all prescriptions worldwide consumed in the United States - and many parents are growing leery of the traditional medical approach to ADHD. The JACA series features the promising results that doctors of chiropractic are experiencing with non-drug treatments that focus on postural muscles, nutrition and lifestyle changes that affect brain activity.

Visit ACA's Web site at <<http://www.acatoday.com/media/releases/adhd.shtml>> for a copy of the news release, as well as a copy of the two-part series, "Children with ADHD-Medical vs. Chiropractic Perspective and Theory," from the July 2002 and August 2002 issues of JACA.

6. SPECIAL THANKS TO PARKER (New Donation)

Dr. Fabrizio Mancini, president of the Chiropractic College and the Seminars, has been very helpful in promoting the lawsuits at various seminars. Dr. Mancini and his staff have provided us with free booth space and opportunities to address the doctors in assembly. Dr. Mancini has set a personal goal of raising $1 million, and hasn't missed an opportunity to show his support. He did so again recently when The College sent out a seven-page mailer to their 20,000-plus mailing list of chiropractic doctors and assistants urging support for the lawsuit. The value of this mailing was over $13,000.

7. ACA A HIT AT AARP CONVENTION

The ACA was well represented at the AARP Convention in San Diego, CA, September 11-14, with the more than 15,000 senior citizens who attended the convention having an opportunity to visit ACA's booth and/or receive a bone density scan sponsored by Osteometer. The ACA-endorsed Osteometer contributed $4000 to help fund the effort and donated three scanners for the weekend. The doctors performed 439 bone densitometry examinations during the three-day convention. Seventy-eight people received a postural analysis at another station at ACA's booth. Attendees waited in lines at each of the stations for 45 to 60 minutes for the evaluation.

Representing the ACA were the ACA delegate from Arizona, Dr Jerry Gerrard, and his wife; ACA alternate delegate from Texas, Dr. Don Handley, and his wife; ACA delegate from Iowa, Dr. Dow Bates, and his wife; and ACA Immediate Past President Dr. Jim Mertz, and his wife. The doctors worked hard promoting chiropractic and should be recognized

8. ACA PRESIDENT SPENDS WEEK ON ROAD: MAKES GREAT INROADS

The week of September 23, ACA President Dr. Daryl Wills made numerous appearances throughout the country promoting the lawsuits and the ACA. On Monday, he traveled to Logan College addressing the 100-plus students in attendance. In the evening, he addressed an audience of 75 members of the Missouri State Chiropractic Association. He was successful in raising funds for NCLAF. On Wednesday, he flew to Wisconsin to speak at the Allied Health Foundation. Efforts to secure an invitation to speak at the Wisconsin Association were unsuccessful.

The 200-plus doctors attending the Allied Health program were impressed with his presentation and more than 15 doctors pledged to become monthly contributors. Allied Health has been one of the strongest supporters of the legal action fund, contributing $32,925.

The next day he traveled to Michigan and spoke at the ICA-affiliated Michigan Chiropractic Association. He was well received by the 200-plus doctors in attendance and received in pledges nearly $73,000 for NCLAF. All and all, it was a successful week for the president and ACA.

9. COMBS ADDRESSES ALASKA DOCTORS

Dr Combs, ACA Governor, addressed the doctors attending the Alaska Chiropractic Society State Convention in Garwood, Alaska. Dr. Combs discussed ACA activities and specifically the lawsuit. He received $2900 in credit card pledges and an additional $589 in cash. More contributions are anticipated.

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@...>.

************************ 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."

October 16, 2002

ACA EVP Weekly Report

MEMORANDUM TO ACA MEMBERS, BOARD OF GOVERNORS, HOUSE OF DELEGATES AND OTHER INTERESTED PARTIES FROM GARY CUNEO RE: ACA EVP Weekly Report October 14, 2002

This week report includes the following items:

*UPDATE ON LAWSUIT *OUR GRASSROOTS EFFORTS ARE WORKING

*LOUISIANA,MAINE,AND WEST VIRGINIA ADDED TO LIST OF MEDICALLY UNDERSERVED AREAS *ACA AT CMS *NCLC:MARK YOUR CALENDAR *ACA WEB SITE RECOGNIZED *WHITE HOUSE AND REPUBLICAN SENATORS COME TO THE ASSISTANCE OF FORMER ACA EMPLOYEE *OCTOBER IS SPINAL HEALTH MONTH *OUR LEADERSHIP HAS GUTS *PUBLICATION PURCHASES SUPPORT NCLAF

UPDATE ON THE LAWSUIT

Nothing from the judge on the ruling regarding Trigon's Motion for Summary Judgment. The judge needs to rule shortly as the trial is set for November 12th in Virginia. It will be a jury trial estimated to last at least 30 days. The issues are involved and the outcome critical.

September was an excellent month for the Legal Action Fund. We collected $184,942. $120,000-plus came from 860 ACA members. Just for your information, there are 457 doctors on the EZ Pay NCLAF program that automatically give $100 per month for the fund. Please consider becoming a monthly contributor. Contact the ACA or go to the web site:

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

OUR GRASSROOTS EFFORTS ARE WORKING

We have been hearing from the staff of the Senate Finance Committee regarding the level of calls that members of the Senate are receiving regarding the failure to include our provision in the Medicare bill that is under consideration. Keep up the heat!

LOUISIANA, MAINE, AND WEST VIRGINIA ADDED TO LIST OF MEDICALLY UNDERSERVED AREAS

The U.S. Office of Personnel Management (OPM) has issued its listing of medically underserved areas (MUA's) for 2003. Chiropractors in those states may be reimbursed for all covered services within their scope of practice provided to federal employees and their dependants covered by a non-HMO federal employee health benefit (FEHB) plan. Louisiana, Maine, and West Virginia have been added to the 2003 listing of underserved states, which also includes: Alabama, Idaho, Kentucky, Mississippi, Missouri, Montana, New Mexico, North Dakota, South Carolina, South Dakota, Texas, Utah, and Wyoming. OPM has removed Georgia from the 2003 listing. Please contact the ACA Legal Department for more information on FEHB and MUA's.

ACA AT CMS

Tom Daly, along with Jay Witter and Stavenjord, visited with Dr. Gerold, Deputy Director of Program Integrity for CMS. During the hour-long discussion, the ACA raised a number of ongoing issues of concern. One concern centered on a member's complaint that although the medical director of a regional CMS office had recently addressed their state association and had invited more open communication from the chiropractic community, questions directed to him had not been answered. Dr. Gerold explained that the focus of the carriers is being shifted more toward customer service and provider education, and away from investigational and enforcement activities. He also stated that CMS is still very much in a transitional phase with this and it will probably take a while for this change to become evident system-wide. Another issue of concern deals with the recent regulations promoting the release of utilization guidelines used in connection with chiropractic services by the carriers. The ACA expressed the concern that some carriers do not fully understand the significance of the CMS directive. Dr. Gerold assured us of CMS' continued cooperation on this issue as well as its cooperation in addressing other carrier-specific

issues.

ACA's strategy is to continue to follow up with the carriers, and if necessary, the regional offices or CMS, in cases of overly restrictive application of Medicare policy when it comes to our attention.

NCLC; MARK YOU CALENDAR-MARCH 5-7, 2003

The American Chiropractic Association would like to invite you to attend the 2003 National Chiropractic Legislative Conference scheduled for March 5-7, 2003 in Washington, DC. NCLC will be held at the Hyatt Regency Washington conveniently located on Capitol Hill. To make your room reservation, please call the Hyatt Regency Washington at 202-737-1234. When making your room reservation, please mention that you are with the American Chiropractic Association to get the special group room rate of $219 per evening for a single or $244 for a double room. The Hyatt Regency is located at 400 New Jersey Ave., NW, Washington, DC 20001. Please note the room reservation cut-off date is February 7, 2003. After that date, the hotel will not guarantee room availability or the special group rate. We will start posting more detail information on our Web site.

ACA WEB SITE RECOGNIZED

I am pleased to report that the ACA Web site has won a "Standard of Excellence" Award in the 2002 Web Marketing Assocation Web Award Competition. The ACA staff and in particular the Web Site Task Force, chaired by Cundiff, are to be complimented for this recognition.

WHITE HOUSE AND REPUBLICAN SENATORS COME TO THE ASSISTANCE OF FORMER ACA EMPLOYEE

I figured this would get your attention, but actually this is true. . Last week, Senator Thurmond made an appearance on the Senate floor expressing outrage over the actions of Senator Leahy, chairman of the Senate Judiciary Committee, for going back on his commitment to consider the nomination of U.S. District Judge Dennis Shedd to the U.S. Court of Appeals for the 4th Circuit in Richmond, Virginia. It looks like it won't happen now until next year. The White House and other Republican Senators weighed in, criticizing this action. Judge Shedd was a consultant to the ACA in the early 90s. Now you know the rest of the story.

OCTOBER IS SPINAL HEALTH MONTH Educate Your Community on the Proper Use of Backpacks We all know that back pain is pervasive among American adults, but a new and disturbing trend is emerging. Young children are suffering from back pain much earlier than previous generations, and the use of overweight backpacks is a contributing factor. In fact, the U.S. Consumer Product Safety Commission reports that the use of book bags or back carriers resulted in more than 6,500 injuries in 2000 alone.

This October, during Spinal Health Month, educate your community about the potential dangers of overweight backpacks using the kit that was inserted into the July-August "Members Only" issue of ACA Today. You can also access the kit on ACA's Web site at<http://www.acatoday.com/media/tips/> by entering your username and password.

OUR LEADERSHIP'S GOT GUTS

Dr. Glenn Manceaux, delegate from Louisiana and Vice President of the ACA Council, reported on his recent visit to the Oklahoma Chiropractic Association. With the assistance of Dr. , Glenn was given opportunities to discuss the ACA activities and, in particular, the lawsuits. The association presented him with a check for $5,000. Additionally, a number of doctors signed pledge sheets deducting $100 per month.

Dr Manceaux had a successful trip, but also a long one. He originally planned to take a flight to Oklahoma, but with the hurricane in the area, the airport at New Orleans was closed. This would have been enough for me to cancel the trip and head for the bunkers--but not Glenn. He drove 665 miles to the convention.and then, of course, had to drive back after the program. This guy has commitment.

Our chairman and president have shown the same commitment right after 9-11, fulfilling commitments that required them to fly to another city. It's amazing the level of commitment that can be found in parts of the country.

PUBLICATION PURCHASES SUPPORT NCLAF

Doctors of chiropractic can now support the National Chiropractic Legal Action Fund (NCLAF) with every purchase of two popular consumer-oriented publications: Sitting on the Job and Peak Performance Body and Mind. The author of these publications, Dr. W. Donkin, an ACA member and a past president of the ACA Council on Occupational Health, has generously offered to contribute a significant portion of each purchase to the NCLAF effort.

The classic Sitting on the Job, recently revised and updated, guides Individuals to create the best working environment for comfort and job productivity. The new publication, Peak Performance Body and Mind, offers a systematic approach to life that anyone can use to gain higher levels of health, comfort, satisfaction, and accomplishment. These books are beneficial to chiropractors, office staff, and patients.

These publications are available for $14.95 each, plus shipping & handling charges. Orders can be placed by calling 1-800-552-6347, faxing 402-488-6651 or by emailing wellback@... <mailto:wellback@...>. Visa and MasterCard are accepted. Be sure to mention NCLAF when ordering.

If you have received this e-mail newsletter in error, or if you wish to be removed from the electronic mailing list, please reply to this email with the word "REMOVE" in the subject field.

October 22, 2002

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: October 21, 2002

The following items are covered in this week's report:

1. CHIROPRACTIC IN NATIONAL HEALTH SERVICE CORPS: ANOTHER VICTORY FOR CHIROPRACTIC 2. ACA HITS THE AIRWAVES IN SUPPORT OF CANDIDATES 3. LAWSUIT UPDATE 4. ACA WELLNESS CAMPAIGN 5. RECENT CANADIAN INQUEST TESTIMONY FOCUSES ON WOMAN'S DOCTOR 6. RECOGNITION OF ORGANIZATIONAL CONTRIBUTORS 7. ACA WORKS THE MEDIA 8. CAN'T ACCESS THESE LINKS?

1. CHIROPRACTIC IN NATIONAL HEALTH SERVICE CORPS: ANOTHER VICTORY FOR CHIROPRACTIC

Last week, the House and Senate conference committee finished work on the National Health Service Corps (NHSC) reauthorization legislation. The conferees have included a provision that will make doctors of chiropractic eligible for student loan reimbursement under the NHSC. This provision will not only permit our doctors to get their student loans reimbursed by practicing in states designated as underserved areas but also will be the first significant step by the federal government in recognizing chiropractic doctors as primary care providers. The conference committee report was adopted by the House of Representatives by a 392-5 vote, and on Friday was unanimously passed by the Senate. It now goes to President Bush's desk for his signature.

This provision culminates a two-year lobbying and grassroots effort by the American Chiropractic Association and the Association of Chiropractic Colleges in getting chiropractic included in the National Health Services Corps. Special recognition needs to go to Senator Harkin whose efforts resulted in the chiropractic provision being included in the senate version and for Congressman Tauzin who helped in the conference committee to assure that the provision was maintained.

Here are examples again of personal relationships being part of the reason for success. In Iowa, ACA delegate F. Dow Bates, DC, and other doctors from the area have been early supporters of Senator Harkin. And in Louisiana, Drs J. Flynn and Glenn Mancauex and others doctors have been longtime supporters of Tauzin. When the staff of the House threatened to scuttle the chiropractic provision from the final conference report, it was Tauzin that intervened. Like Dr. Luedtke with Secretary Tommy and Dr. Kerwin Winkler with Senator Daschle, longtime relationships have been the basis of chiropractic successes throughout the years.

2. ACA HITS THE AIRWAVES IN SUPPORT OF CANDIDATES

For a political junkie like me, there is no more exciting time than right now. With less than three weeks before the election that could determine the control of both the Senate and House of Representatives, voters are beginning to take a close look at the elections and start making their decisions. Here is where the more aggressive organizations come forward and show their mettle. Cautious organizations don't get involved in targeted races, and instead support the incumbent running against weak opposition. This way they can go back to their bosses and show a successful tally sheet. But cautious organizations don't make the radar screen in the political process. This profession has succeeded because it hasn't been afraid to get involved in tight races -- races that both parties feel are too close to call. And this year we have many, particularly in the senate. The main rule that one needs to follow is that if you get involved in a tight race, do so with vigor. Supporting a candidate and not backing it up with resources is like shouting in the wind. You won't be heard.

As you've probably noted in past reports, we have been particularly involved this year in five senate races, including Minnesota, Missouri, Iowa, South Dakota and Arkansas. In each of the races, we have contributed to the candidate of our choice, and in most of them have sent letters of support to doctors in the state indicating why we support the candidate. In two of the races we have taken the additional step of making an independent expenditure by purchasing radio time. We reserved the time nearly two months in advance, knowing that the time slots we were seeking (mid-October) would be difficult to secure if we waited too long. Here is a summary of what we have done:

In South Dakota, the ACA is supporting U.S. Senator Tim over Congressman Thune. is supportive of our efforts and has the strong support of Senator Tom Daschle. Do I need to say more? In addition to our direct contributions to Senator ston and our mailings on his behalf. We have purchased 30-second spots eight times daily on 24 radio stations in South Dakota between the hours of 6:00 am and 7:00 am supporting Senator . These spots will occur from Monday October 21st to Saturday November 2nd. It will result in 192 spots per day, for a total of 2,304 for the two-week period. That's a total of 2,304 hits over a two-week period on behalf of Senator . . Even at this late stage the polls are showing this race is just too close to call.

In Iowa, the ACA is supporting Senator Tom Harkin over Congressman Greg Ganske, a medical doctor whose views on chiropractic are well known. Stealing an expression of 40 years ago in a presidential campaign, this race is a "Choice, not an echo." Harkin has to win. Again, we have "maxed out" on this campaign, we've sent a letter of support to our members, and beginning on

Monday, Oct 21 and extending to October 26, we will be running daily eight times per day on 24 radio stations a 30-second spot supporting Harkin with the above tagline -- a total of 240 spots per day and 1,440 spots per week.

3. LAWSUIT UPDATE

There is still no word from the judge on Trigon's motion for summary judgment. There is no doubt in my mind that the ACA Board of Governors will authorize an appeal to the 4th circuit Court of Appeals should Trigon's motion be successful. If we do, we will not only be appealing the judge's ruling but also his previous ruling that denied our motion to extend discovery beyond the restricted dates as requested by Trigon.

4. ACA WELLNESS CAMPAIGN

Through its Wellness Campaign, the ACA is working to demonstrate to the public the ability of chiropractors to function as wellness practitioners. This campaign also serves to raise awareness within the chiropractic community about the roles and responsibilities of chiropractors as wellness care providers. The ACA Wellness Committee has put together a position that serves as the basis of this campaign. This position maps out the responsibilities of doctors of chiropractic as wellness practitioners as well as a plan for implementing this campaign. ACA's position statements/public policies are available on our website at <http://www.acatoday.com/pdf/2002_aca_policies.pdf>. To see the "Wellness Model" statement, scroll down alphabetically to "Wellness Model."

At the request of the Wellness Committee, the ACA has put together a wellness survey with help from researchers, including Cheryl Hawk, DC, of Palmer College. The survey was tested and revised several times before the final survey was distributed in late August. A copy was sent to the chief academic officer at each of the accredited chiropractic colleges, as well as 150 tenth trimester students through the SACA program. The diversified distribution is intended to yield a more accurate reading of the education that upcoming chiropractors receive and how the colleges prepare their students to function as wellness providers. Once the results of the surveys are tallied, this information will be disseminated to the committee members and used to determine the next steps with this campaign.

5. RECENT CANADIAN INQUEST TESTIMONY FOCUSES ON WOMAN'S DOCTOR

While the court in the Canadian inquest into the stroke death of 45-year-old Lana Dale did not sit during the past week, proceedings in previous weeks have centered on the testimony of Dr. Philip Emanuele, the woman's chiropractor.

Ms. died of a stroke on September 12, 1996. ' family alleges that a chiropractic adjustment a little more than two weeks earlier caused the stroke, while Dr Emanuele and other chiropractic experts believe her poor health was to blame.

In recent testimony, Dr. Emanuele has stated that Ms. looked "fine" after her treatment, and that there were no indications that the upper neck manipulation he had given her had caused any discomfort or problems. Dr. Emanuele also stated that he had found no contraindications to neck adjustment. In addition, although he testified that he never had her sign a written consent form informing her of the risks associated with chiropractic treatment, he said he verbally outlined the risks for her on February 2, 1995 - her first visit to his office.

In earlier testimony, ' husband said his wife had complained that, on her last visit, the doctor had hurt her by reaching around her body to adjust her neck - rather than physically moving to the other side of the treatment table to perform the adjustment. However, Dr. Emanuele denied this description, saying he "always placed himself directly behind the patient to adjust their upper neck," according to an October 8 article in The Toronto Star.

For regular updates on the Canadian inquest, visit the Canadian Chiropractic Association Web site at www.ccachiro.org <http://www.ccachiro.org>. Click on "media," then " Inquest Weekly Summaries." You can also follow media coverage on the Toronto Star's Web site at www.thestar.com

6. RECOGNITION OF ORGANIZATIONAL CONTRIBUTORS

State associations, SACA chapters, practice management consultants and vendors continue to show their support for the lawsuits. Here is a list of contributors from the last two weeks:

· Alaska Chiropractic Society: $1,000, bringing its total to $4,000 · Northwest Alabama Chiropractic Society: $500, bringing its total to $1,750 · Southeast Alabama Chiropractic Society: $2,500, bringing its total to $5,000 · SACA chapters: $3,465.13 bringing its total to $11,325.48 · Tennessee Chiropractic Association: $2,500, bringing total to $4,500 · Allied Health of Wisconsin: $50, bringing total to $32,925 · Gibson Management Company: $1,000

7. ACA WORKS THE MEDIA

September was another busy month for the ACA's Communications Department working with the media. Here is a sampling of the periodicals with which ACA national spokesperson Dr. Jerome Mcs has interviewed during September:

· Real Simple magazine · Shape magazine · Kiplinger's newsletter · Wall Street Journal · Associated Press · Today's Health and Wellness

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 e-mail 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."

October 30, 2002

Dear Colleagues:

In this weekly report Exec. Vice. President Guneo quotes Jodi Goldstein, JD from HHS Civil Rights Division whom wrote much of the last bit of language of HIPAA regarding the issue of if faxes are a covered entity or not?

In her presentation to the Dist. of Columbia Bar Association she states that fax to fax transmission is Not considered to be or make you a covered entity.

Interestingly if the transmission is computer to plan paper fax machine you then are or become a covered enitity.

This finally puts the "FAX ISSUE" rest!

Vern Saboe, Jr., DC.,DACAN.,FICC.,DABFP

ACA Delegate

CAO Executive Board

ACA EVP Weekly Report

TO: ACA MEMBERS, BOARD OF GOVERNORS, HOUSE OF DELEGATES AND OTHER INTERESTED PARTIES

FROM: GARY CUNEO MEMBER ISSUE

RE: ACA EVP WEEKLY REPORT DATE: October 28, 2002

This week's report includes the following items:

1. Judge Cancels Trial Date 2. President Signs Student Loan Bill 3. CCE Announces Life College's Loss of Accreditation 4. ND Blues and State Insurance Department Enter into Settlement 5. ACA Pursues the Wal-Mart Problem 6. Are Faxes Covered Transactions under HIPAA? 7. State Associations Support Membership Efforts 8. Update on Key Races 9. ACA Leadership on the Road 10. An Update on the Seminars 11. EVP Advisory Committee Call 12. New Kit Prepares Your Practice for HIPAA

*** *** ***

1.JUDGE CANCELS TRIAL DATE FOR ACA vs. TRIGON

U.S. District Court Judge , who is the presiding judge in the ACA et al vs. Trigon et al case in Virginia, faced with an extensive motion by Trigon to dismiss the case as a matter of law and an extensive response by the ACA, VCA, chiropractic doctors and patient plaintiffs, has issued an order canceling the November 12th trial date and halting all court activity in the case pending resolution of the existing motions. There is no doubt that resolving the multi-faceted motion will set the guidelines for either trial of the case or an immediate appeal to the 4th circuit.

2. PRESIDENT SIGNS STUDENT LOAN BILL

S. 1533, a bill that includes a provision to include doctors of chiropractic in the National Health Service Corps, a program that provides participants with reimbursement of their student loans in exchange for service in medically underserved areas, was presented to the president on Oct. 23 and signed by him on October 26th.

3. CCE ANNOUNCES LIFE COLLEGE'S LOSS OF ACCREDITATION

On Oct. 20, 2002, the Council on Chiropractic Education conducted a hearing before the CCE Appeal Panel regarding the Life University College of Chiropractic (LUCC) appeal of the CCE Commission on Accreditation (COA) decision not to reaffirm the accreditation of LUCC. Representatives of LUCC and the COA participated in the hearing.

The CCE Appeal panel has announced its ruling in the matter, and has upheld the decision of the COA. This ruling means that as of Oct. 20, 2002, LUCC has no form of accredited status with CCE.

CCE accreditation is voluntary in nature. A chiropractic program can initiate the normal processes for CCE accreditation by application at anytime

4. NORTH DAKOTA BLUES AND STATE INSURANCE DEPARTMENT ENTER INTO SETTLEMENT

In May 2000, the North Dakota Insurance Department initiated an examination of Blue Cross Blue Shield of North Dakota's (BCBSND) chiropractic claims handling practices. The department issued a report that was challenged by BCBSND. A settlement agreement and order has been entered by the North Dakota insurance commissioner and contains 16 items.

Among the recommendations are the following: 1) "For services that are within the scope of practice of chiropractors, BCBSND should not reimburse services of certain professionals while denying similar services provided by chiropractors;" 2) "The written [appeal] policies and procedures will address notice, the right of the patient or affected chiropractor to be heard and receive an independent review, avoidance of conflicts of interest, and the selection and length of terms of Peer Review Committee members;" 3) "BCBSND should adhere to its contractual appeals provisions and the URAC standards, to the extent URAC applies to chiropractic treatment;" 4) "BCBSND should revise its descriptions of supportive and maintenance care to more closely resemble ACA definitions;" and 5) "BCBSND should establish written guidelines for placing chiropractors under focused medical review and communicate those guidelines, once formulated, to each chiropractor."

The settlement agreement also requires BCBSND to provide the state insurance department with a copy of its written policy and procedures adopted in connection with the recommendations on or before Jan. 2, 2003.

5. ACA PURSUES THE WAL-MART PROBLEM

Wal-Mart Stores Inc. recently informed its associates of the elimination of chiropractic benefits, effective Jan. 1, 2003. While benefits in 2002 were slim at best, we believe the elimination of all chiropractic benefits creates a hardship for Wal-Mart employees. ACA leadership attempted to meet with Wal-Mart's vice president of health benefits in early 2001. Wal-Mart's reply indicated they had no interest in meeting with ACA representatives. A letter from ACA President Dr. Daryl Wills was forwarded last week to Wal-Mart's president, H. Lee . The ACA is considering all options while it awaits a response from . In the December issue of ACA Today, ACA members are encouraged to send letters to expressing their concern over Wal-Mart's elimination of chiropractic benefits.

A copy of Dr. Wills' letter can be found in that issue and on the ACA Web site at: <http://www.acatoday.com/insurance/managed_care/WalMart.shtml>. Future updates will be provided in this report and in ACA Today.

6. ARE FAXES COVERED TRANSACTIONS UNDER HIPAA?

At a presentation before the District of Columbia Bar Association, Jodi Goldstein, JD, from the HHS Civil Rights Division, Office of the General Counsel, provided clarification on an issue that has caused much confusion: whether faxes are covered transactions under HIPAA. Goldstein, who wrote portions of the final modifications to the Privacy Rule, states that electronic HIPAA transactions do not include basic paper faxes, also known as paper-to-paper faxes.

Please note that faxes originating from a computer would be considered covered HIPAA transactions and necessitate compliance with all HIPAA regulations.

7. STATE ASSOCIATIONS SUPPORT MEMBERSHIP EFFORTS

I'm sure it's happened before, but I certainly haven't heard of it. The presidents of the Texas Chiropractic Association, Florida Chiropractic Association and the Illinois Chiropractic Society have each agreed to send a letter to their members urging them to become members of the ACA. Sure makes sense...and we hope more state associations will take this position. This profession needs both strong state associations and a strong national association.

8. UPDATE ON KEY RACES

There are just under two weeks before the Nov. 5 elections, and political activity is heating up. Following is an update of the races that both Democrats and Republicans have targeted in the House and Senate, and that ACA has been most heavily involved in:

SENATE

* Iowa: Senator Tom Harkin vs. Congressman Greg Ganske. Harkin is clearly our candidate and polls show him in the lead.

* South Dakota: Senator Tim vs. Congressman Thune. is supporting our Medicare provision and has the strong support of Senator Tom Daschle. Need I say more? Three recent polls showed ahead, while one Republican survey gave Thune the advantage. Bottom line: too close to call.

* Missouri: Senator Carnahan vs. Jim Talent, former member of Congress. When Talent was in Congress, he was a member of the Armed Services Committee. His efforts were extremely important in reviving the chiropractic provision in the DOD bill and ensuring its passage. We support Talent. Polls show this race is dead even.

* Minnesota: Senator Wellstone vs. Norm . The tragic death of Senator Wellstone has naturally stopped all politics in this race. Over the weekend there were news reports about what the Democrats might do next . There was also speculation on what Governor Ventura would do since he is authorized to appoint Wellstone's replacement. Nothing is certain. In fact, I rewrote this paragraph three different times. Let me say the only thing for certain (fairly certain, anyway) is that former Vice President Walter Mondale will replace Wellstone on the ballot. We have been supporting in an extremely tight race.

* Arkansas: Senator Tim Hutchinson vs. Attorney General Mark Pryor. This is another tight race where the latest polls show Pryor 2 percent up. Hutchinson was very helpful to chiropractic when our DoD bill was being considered in the Senate. He once stated that he wanted to be known as the profession's new "Thurmond" in the Senate (referring to Sen. Strom Thurmond, one of chiropractic's staunchest supporters over the years).

HOUSE

* Connecticut: One of the most closely watched congressional campaigns has been that of Rep. vs. Rep. Jim Maloney. Due to redistricting, both members of Congress were placed into the same district. The polls are showing with a 7 percent lead--although 17 percent of the voters remain undecided (a significant number). We support Congresswoman . She has written a letter to Connecticut doctors indicating her intention to support our chiropractic provision should the Medicare bill get to the conference committee stage.

* South Dakota: In the only congressional race in South Dakota, Governor Janklow is having a tougher race than anticipated against attorney Herseth (D). One poll has him trailing her. Our doctors in South Dakota urged ACA to support Janklow because of his strong support of the profession as governor.

All of the races are extremely tight. One political pundit speculated that five Senate races are so tight that they could be decided by a total of 15,000 votes. We are definitely in the thick of it!

9. ACA LEADERSHIP ON THE ROAD

ACA President Dr. Daryl Wills joined the delegate and alternate delegate for Kansas to promote the National Chiropractic Legal Action Fund, which supports ACA's lawsuits against HHS and Trigon Blue Cross Blue Shield. They were successful in raising $14,100 and signing up several new members. Also speaking with the group was ACA Past President Dr. Mertz.

Dr. Wills spoke earlier to doctors attending the meeting of Allied Health in Wisconsin. After tallying the results, he was pleased to report that there were a total of 28 contributors to the lawsuit fund, including some contributions with a five-year commitment and a few one-time contributions, for a grand total of $109,335. Allied Health has already contributed $32,925.00.

Dr Wills also reported on a successful presentation before the Chiropractic Knights, which brought in additional pledges and support.

10. AN UPDATE ON THE PARKER SEMINARS

Last weekend, former ACA Chairman Dr. J. Flynn joined ACA staff in exhibiting at the Seminar in Miami. Dr. Flynn was given the opportunity to speak at the team teachers' luncheon and later to seminar attendees. Joining Dr. Flynn at various times were Drs. Gentile, Ken Dougherty, and Steve Perman. We were successful in raising additional funds for the lawsuit and in signing up some new ACA members.

11. EVP ADVISORY COMMITTEE CALL

On Oct.1, ACA vice presidents, legal counsel and myself held our monthly conference call with state association leadership. Included on the call were representatives from North Carolina, Colorado, Ohio, Iowa, Kentucky, South Dakota, North Dakota, Missouri, Florida, Louisiana and Alabama. The topics discussed included an update on HIPAA implementation, the revised ABN form, a review of the recent ACA visit to CIGNA headquarters, Medicare legislation and the lawsuits. The next call is scheduled for Tuesday, Nov. 5. We will again include on the agenda a discussion about HIPAA as these requirements continue to evolve.

12. NEW KIT PREPARES YOUR PRACTICE FOR HIPAA ACA has developed a HIPAA kit that will help to answer your questions about HIPAA and what the Privacy Rule requires. Our 90-minute audiocassette of the live teleconference tells you what the act requires in order to be compliant by April 14, 2003, and includes an outline of the actual conference and a valuable supplement page. In addition, ACA has also developed an 11-page introductory insert about HIPAA that provides background information about the law and focuses on its transaction standards, privacy standards, consent, authorization, restrictions and penalties. The insert includes a sample patient privacy notice form and sample consent and authorization forms. Purchase both of these ACA HIPAA products and get the facts you need.

The kit includes the 90-minute audiocassette of the live teleconference and the 11-page HIPAA insert. Speaker of the tape: Marc Cohen, Esq.

Ø ACA Member Value: $58.95 Ø Non-member Price: $104.95

To order (Item HIPAA1Kit), call 800/368-3083 or go to www.shopaca.com <http://www.shopaca.com>.

*** *** ***

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."

November 12, 2002

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: November 12, 2002 MEMBER ISSUE

The following items are covered in this week's report:

1. ELECTION 2002: HOW DID WE DO? 2. PRACTICE MANAGEMENT CONSULTANT HELPS THE CAUSE 3. ACA IN THE NEWS 4. APTA STRENGTH: WHAT YOU CAN DO ABOUT IT 5. WHERE WE ARE GOING: THE VISION STATEMENT OF THE ACA 6. PARKER IN LAS VEGAS 7. COMMUNITY OUTREACH TOOLS NOW AVAILABLE ON ACA'S WEB SITE 8. UPCOMING DELEGATE ELECTIONS: JANUARY 2003 9. CAN'T ACCESS THESE LINKS?

1. ELECTION 2002: HOW DID WE DO?

ACA's PAC supported an overwhelming number of winning candidates in the November 5 elections this year. Here are the numbers to back it up:

We were involved in 97 races in the House. Of these, we won 89 and lost only 7, for a 92% winning percentage. On the Senate side, we were involved in 14 races. Of these, we won 11 and lost 2 (One seat is still pending a result). This gives us a temporary winning percentage on the Senate side of 79%. Should we win the pending seat, that percentage would jump to 86%.

For more specific information on any of these races, contact the PAC at the ACA office (800-986-4636). While these are pretty impressive statistics, they are not the only reason why our results were impressive. Picking winners (except for the close and targeted races) isn't extremely difficult. Incumbents usually win, and with few exceptions that was the case this year. Making a non- threatening contribution of $500 to a winner is nice, but it certainly doesn't make a statement.

What I think is most impressive about our success was that we became significantly involved in races where the outcome was too close to call. While this is not the safest way to make PAC decisions, it is the best way to get noticed.

Here is a summary of the races that we took a particular interest in, the contributions we made to them, and their outcomes. In many of these races, we also sent letters to our members in the respective states urging support for the candidate. I think you will notice that the majority of these were races that the major networks were declaring as "to close to call" on election day leading up to the vote counts.

· Candidate: Senator Tom Harkin (D-IA); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $21,630; ACA-PAC Independent Expenditure: $8,050 for the purchase of radio time on 24 Iowa stations (1,440 30-second spots)

· Candidate: Senator Tim (D-SD); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $22,170; ACA-PAC Independent Expenditure: $14,170 for the purchase of radio time on 24 South Dakota stations (2,304 30-second spots)

· Candidate: Senator Tim Hutchinson (R-AR); Outcome: Loss; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Candidate: Norman for Senate (D-MN); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Candidate: Jim Talent for Senate (R-MO); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Congresswoman (R-CT); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Governor Jankow for Congress (R-SD) Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Senator Max Cleland (D-GA) Outcome: Loss; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

· Senator Lindsey Graham (R-SC); Outcome: Victory; ACA-PAC Hard/Soft Money Contribution: $5,000; ACA-PAC Independent Expenditure: None

We wanted to make a statement, and I think we did that. The only major disappointment from the profession's standpoint was that Senator Daschle lost his majority leadership position with a shift in control of the Senate to the Republicans. Hopefully, this loss will be tempered with the new friends that we have in the Senate. NOTE: The Tim race in South Dakota is subject to a recount currently being conducted.

2. PRACTICE MANAGEMENT CONSULTANT HELPS THE CAUSE

One of the satisfying outcomes of our lawsuits against Trigon and HHS has been the support we have received from many practice management consultants. Dr. Mark Sanna of Breakthrough Coaching is one of the prime examples. Dr. Sanna's ACA-endorsed company has provided our leadership with numerous opportunities to address its clients regarding ACA activities, including the legal action. Recently, Dr Ken Dougherty, ACA's delegate to Florida, spoke to the group in Orlando, Florida. Dr. Sanna presented him with a check for $5,000 for the legal action fund, plus membership applications and legal action pledges from himself and his staff. He was successful in signing up 20 new ACA members and receiving numerous pledges for the legal action fund

3. ACA IN THE NEWS

In my report last week, I mentioned that ACA continues to be called upon by the media nationwide to represent the chiropractic profession on a variety of topics. I have included some links below to original ACA information that has been picked up by other news outlets, as well as stories that were the result of interviews with ACA officials. ACA's holiday safety story was posted on many major news sites, including CBS Market Watch, Dallas Morning News and .

· ACA's Holiday Safety Tips: <http://biz./prnews/021108/dcffns1_1.html> · ACA's Pregnancy Tips: <http://www.nlm.nih.gov/medlineplus/pregnancy.html> · Interview with AMA News: <http://www.ama-assn.org/sci-pubs/amnews/pick_02/prsd1111.htm> · Interview with National Underwriter: <http://www.nationalunderwriter.com/pandc/hotnews/viewPC.asp?article=11_4_02_11_7034.xml>

4. APTA STRENGTH: WHAT YOU CAN DO ABOUT IT

Last week, ACA Council Vice President Dr. Glenn Manceaux, sent me a copy of the 2001 Annual Report of the American Physical Therapy Association (APTA). In looking through the document, it didn't take me long to see some disturbing things. The first thing I noticed was a picture of two hands on the back of a person. It sure looks like an adjustment about to be done. Secondly, I noticed the emphasis in the article by their EVP in pushing their efforts in seeking direct access under Medicare. But what really got my attention was their annual budget, which gives their drive for direct access a chance to succeed. Their revenue for 2001 was $22,164,125. While expenditures exceed this amount by $2 million, I don't think anyone over there is filing for unemployment. They have a staff of 130 to support their goals. Meanwhile, we have a budget of $6 million and a staff of 40.

I'm sure this information has grabbed your attention as well. An organization whose unstated goal is to push us aside is something we ought to be concerned about.

What can you do about it? First of all, you already are doing something simply by being an ACA member. But you can do something else: Recruit a new member. And if you are uncomfortable about doing this, recommend to us the name of someone in your community you think we should recruit. Just allow us to use your name when we contact the doctor, and provide us with the doctor's address and phone number. Please also let us know why you think he/she isn't a member. Please send your recommended candidate to me at this email address..

5. WHERE WE ARE GOING: THE VISION STATEMENT OF THE ACA

It is surprising how many doctors aren't clear about the Vision of the ACA and what we are trying to accomplish as an organization. Obviously we haven't done a good enough job in communicating this information. Here is the revised Vision Statement of the ACA that was recently approved by the ACA House of Delegates:

"The ACA seeks a transformation in health care, from a focus on disease to a focus on wellness.

In this new health care environment, doctors of chiropractic are respected and widely used for their unique conservative approach, primary care knowledge, hands-on expertise, and effective patient communication skills. The full integration of doctors of chiropractic as decision makers in the nation's healthcare delivery system results in positive outcomes for public health, primary care delivery, and patient wellness.

The ACA, as the profession's preeminent leadership organization , envisions a patient-centered, wellness-oriented and outcomes-driven health care environment, with open access for all Americans to utilize comprehensive chiropractic care. "

This is our vision...now help us achieve it. Sign up a member.

6. PARKER IN LAS VEGAS

It's not too early to think about in Las Vegas, from January 30th to February 2nd, 2003. Register now at www.parkerseminars.com/registration/index.asp <http://www.parkerseminars.com/registration/index.asp>.

7. COMMUNITY OUTREACH TOOLS NOW AVAILABLE ON ACA'S WEB SITE ACA has always worked to help you promote your practice and your profession. Now ACA has tools available on its Web site to enhance your community outreach efforts as well.

The issue of overloaded backpacks is a growing health concern that can be alleviated through education. To assist member efforts to educate children, parents and teachers on the issue, the ACA has developed a backpack safety program with program scripts and abstracts that ACA members can now access from our Web site. Visit <http://acatoday.com/hot_topics/backpack_safety.shtml>.

You can now view the ACA-developed Parra PSAs and television ad spots on the home page of our Web site. Parra, the Olympic speed skater who won both a gold and silver medal at the 2002 Winter Olympics, touts the benefits of chiropractic in a new, professionally produced Public Service Announcement (PSA) and television ad spot available to ACA members only. PSAs and television ad spots are perfect community outreach tools to help educate your local community about the importance of chiropractic care. Take a look and order a customized video today! Visit us today at <http://www.acatoday.com/media/related/070102.shtml>.

8. UPCOMING DELEGATE ELECTIONS: JANUARY 2003

Members seeking election as delegate or alternate delegate must signify such intent in writing via certified mail by Dec. 16, 2002, to the Corporate Secretary of the American Chiropractic Association, 1701 Clarendon Blvd, Arlington, VA 22209.

Ballots will be sent Jan. 15, 2003, to voting members in the states of Alaska, Arkansas, Colorado, Delaware, N. Florida, S. Florida, Hawaii, N. Illinois, Iowa, Kentucky, Maine, Massachusetts, Minnesota, New Hampshire, New Mexico, New York (upstate), North Dakota, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, and West Virginia.

Term of office is two years. For other details of the delegate election, qualifications, and procedures, consult the ACA Bylaws, Article VIII, Section C. <http://www.acatoday.com/pdf/2002_aca_bylaws.pdf>

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@...>.

************************ 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."

December 10, 2002

ACA EVP Weekly Report

TO: ACA MEMBERS, BOARD OF GOVERNORS, HOUSE OF DELEGATES AND OTHER INTERESTED PARTIESFROM: GARY CUNEORE: ACA EVP WEEKLY REPORT DATE: December 9, 2002*** *** ***ACA MISSION STATEMENT: "The ACA is a professional organization representing doctors of chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of doctors of chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, we accomplish our mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment, and by carrying out a dynamic strategic plan to help ensure the professional growth and success of doctors of chiropractic."*** *** ***This week's report includes the following items:1. NAII Considers Partnership with ACA2. November Was a Great Month for NCLAF3. Wal-Mart Meeting Scheduled4. Singer Supports Lawsuits5. Landrieu Wins in Louisiana: Another ACA Victory6. Doctor Loren Heeds the Call for Membership7. PBS to Air Special on Dr. Frederick Carrick8. Senator Harkin Comments on ACA's Involvement in His Campaign9. The BOG to Hold Its Mid-Winter Meeting in Conjunction with the 2003 Las Vegas Seminar: Celebration for Chiropractic10.. Can't Access These Links?*** *** ***1. NAII CONSIDERS PARTNERSHIP WITH ACAAt the invitation of the National Association of Independent Insurers (NAII) Medical Issues Committee, Pat , ACA vice president of professional development and research, met the group at its offices in Des Plaines, IL, to discuss the possibility of holding a joint meeting between ACA and NAII. NAII is the largest trade association for property and casualty insurers in the country. The group is interested in bringing to light the work of the ACA Claims Solutions Work Group and finding ways for insurers and DCs to relay its policies--developed in conjunction with participating insurance groups--on the state level. The topic of HIPAA will also be added to the agenda, as many insurers are struggling with HIPAA privacy issues and need feedback from providers on how this law may impact the request and release of clinical documentation.The plan is to hold the ACA/NAII meeting during the ACA's National Chiropractic Legislative Conference (NCLC) in March 2003.It is remarkable to see the improved relationships that have developed between the ACA and some insurance organizations in recent years, thanks to the efforts of the ACA leadership and PDR staff. I remember it was not too long ago that the idea of ACA partnering with an insurance organization would have been totally out of the question.2. NOVEMBER WAS A GREAT MONTH FOR NCLAFContributions to the National Chiropractic Legal Action Fund (NCLAF) for the month of November 2002 totaled $231,083--the highest monthly amount since July 2001. This includes contributions from 1,007 members and 231 non-members. In October 2002, we raised $172,000, which had been the highest monthly amount in the past six months. While these were great months for contributions, we need to maintain our professions financial support and raise the number of monthly contributors. As of this date there are 572 doctors on NCLAF EZ Pay. The membership breakdown is as follows: 348 members,107 former members, and 117 have never been members.3. WAL-MART MEETING SCHEDULEDBy the time you read this report, the ACA Executive Committee and Pat, VP of professional development and research, may have completed their Dec. 12 meeting with officials from Wal-Mart at the giant retailer's offices in , AR. The purpose of the meeting was to discuss Wal-Mart's decision to eliminate the chiropractic benefit from employee health plans. The meeting represents a starting point as the ACA attempts to forge an understanding with Wal-Mart regarding the importance of chiropractic care to the 1 million employees affected by the company's health care policies.4. SINGER SUPPORTS LAWSUITSA practice management consultant who has been an early and active supporter of our lawsuits is Singer of Singer Enterprises. His company has given $2,500 to the National Chiropractic Legal Action Fund and has offered ACA representatives opportunities to present updates on the lawsuits during his programs.We had one such opportunity on Nov. 9-10 at the DSE's Master Club in Tampa, FL. Dr Fidler, ACA delegate from Minnesota, spoke on behalf of the NCLAF. He was successful in getting 17 doctors to sign pledges of $100 per month for the duration of the suits. This represents $20,400 per year on an annual basis.5. LANDRIEU WINS IN LOUISIANA: ANOTHER ACA VICTORYLouisiana Senator Landrieu (D) on Dec. 7 won re-election in a run-off against Republican candidate Suzanne Terrell in what was one of the most hotly contested races of the November elections. Both parties had pulled out all the stops. President Bush and members of his cabinet even visited the state on behalf of Terrell.ACA supported Senator Landrieu with a $2,500 contribution in the primary and another $5,000 contribution two weeks ago. The Chiropractic Association of Louisiana was also a strong supporter of the senator. We are naturally pleased with this development as it continues to increase the support of the chiropractic profession in the Senate.6. DOCTOR LOREN MILLER HEEDS THE CALL FOR MEMBERSHIPDoctor Loren of Spokane, WA, sent a great e-mail testimonial to eight or nine doctors urging them to become members of the ACA. She stated in part, "I rejoined the ACA this past year after leaving it for a couple of years. Since my return, I have found an association that I am very proud of. ... There are people there working very hard for you and I. ..."I could not have written a better testimonial. And frankly, if I had, it would not have carried the credibility of this one, coming from a local doctor. We can make all the statements in the world, but they will fall on deaf ears if the doctor members in the field don't echo these sentiments. Please help grow this association by contacting your non-member colleagues and urging them to join us. ACA will follow-up with them. To find further information on ACA's accomplishments that you can communicate to potential members, go to www.acatoday.com/membership/done_lately.shtml.7. PBS TO AIR SPECIAL ON DR. FREDERICK CARRICKNot all PBS programs are anti-chiropractic. A PBS special about the work of Frederick Carrick, DC, PhD, who is president of the ACA Council on Neurology, will be broadcast on December 12 at 8:30 pm on PBS stations throughout the country.The special, entitled "Waking up the Brain, Amazing Adjustments," is also cross-linked by PBS as "Conscious Chiropractic."8. SENATOR HARKIN COMMENTS ON ACA'S INVOLVEMENT IN HIS CAMPAIGNAfter his re-election, Iowa Senator Tom Harkin stated that, "While I enjoyedsupport for my re-election from a broad range of organizations and individuals from around Iowa and the country, the support and counsel of the American Chiropractic Association and its members throughout Iowa were especially critical to my re-election victory. I look forward to building on our strong friendship and working together to ensure fairness and equal treatment for doctors of chiropractic throughout the country."9. THE BOG TO HOLD ITS MID-WINTER MEETING IN CONJUNCTION WITH THE 2003 PARKER LAS VEGAS SEMINAR: CELEBRATION FOR CHIROPRACTICThe ACA House of Delegates passed a motion a few years ago requiring that all Board of Governors meetings be held at the ACA offices in Arlington, VA. It's not the most glamorous place to hold a meeting, but from a budgetary and practical standpoint-and with staff resources the most readily available-it's the right thing to do. I don't think too many organizations consider these factors when planning their meetings. However, the HOD allowed an exception to the rule when it permitted the ACA Board to hold its mid-winter meeting in conjunction with the Seminar Jan. 30-Feb. 2 in Las Vegas.Once again College President Dr. Fabrizio Mancini and the people are providing the National Chiropractic Legal Action Fund (NCLAF) Committee with numerous opportunities to promote our lawsuit and raise funds. Dr. Mancini set the goal earlier this year to raise $1 million for the lawsuit fund. So far, approximately $300,000 has been raised from the various Seminars held throughout the year. ACA will be out in force at the Las Vegas program, assisting Dr. Mancini in raising the balance of the funds. Any help you can provide at the program will be greatly appreciated.The program has negotiated a special room rate of just $95 per night. To make hotel reservations, call the Las Vegas Hilton at 888/732-7117 or go to www.lv-hilton.com. Room reservations are going fast.The program promises to be a real happening for chiropractic. A sampling ofthe many presenters includes Dr. Weil, Zane Pilzer, Dr. Wayne Dyer, Jack Canfield and Mark Victor Hansen. The speaker schedule is now available online: go tohttp://www.parkerseminars.com/seminar/lasvegas2003.pdf. 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 http://www.adobe.com/. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@... <mailto:gcuneo@...>.*** *** ***

December 17, 2002

I don't want to steal any of Vern's thunder, but I couldn't wait to send this recent ACA Report. You will notice that ASHN is listed twice and not in a favorable light. I will be personally calling and emailing Phil of Providence to provide him a copy of the court's recent decision compelling ASHN to produce documents to allow the case to proceed. I have spoken to Mr. , emailed him and sent him at least two separate letters asking that Providence reconsider its association with ASHN.

I think its time the Oregonian, Eugene Registered Guard and the Salem Spokesmen all run an article entitled "PROVIDENCE HEALTH PLANS SIGNS ON WITH ASHN, DESPITE SEVERAL WARNINGS OF THE COMPANY'S ILLEGAL BUSINESS PRACTICES."

Yours,

DR. COBY L. HANES991 NE THIRD STREETPRINEVILLE, OR 97754voice: 541.447.7230fax: 541.447.5775dochanes@...

ACA EVP Weekly Report

Memorandum

ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report MEMBER ISSUE Date: December 16, 2002

The following topics are covered in this week's report:

1. ACA SENDS STRONG LETTER TO ASHN 2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP 3. COURT HANDS CCA VICTORY IN ASHP SUIT 4. ACA PAC: HOW WE COMPARE TO OTHERS 5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE 6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF 7. PHYSICAN PAYMENT ISSUE STILL A MESS 8. WFC CONGRESS AT DISNEY WORLD 9. LAST EVP REPORT FOR THE YEAR 10. THE 2003 CODES ARE PENDING 11. CAN'T ACCESS THESE LINKS?

1. ACA SENDS STRONG LETTER TO ASHN

ACA President Daryl Wills, DC, sent a letter to Mr. DeVries, President of American Specialty Health Network (ASHN) expressing concern that, at a recent meeting of the Congress of Chiropractic State Associations (COCSA), an ASHN representative implied that the views of his company were similar to the ACA and that there existed some type of affiliation or endorsement of his company by the ACA.

In his letter, Dr. Wills insisted that ASHN "cease and desist from making any reference to the ACA in your marketing or public relations efforts. To the extent that such a reference should be understood as implying a direct or indirect relationship between ASHN and the ACA, such a representation is both false and misleading. Please confirm to me that your spokespeople have been appropriately instructed of our very deep concern about this matter."

2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP

Last Thursday, ACA's executive committee(Drs Jim , Daryl Wills and McClelland) and Pat , Vice President of Professional Development and Research, met with the benefit payment decision-makers of Wal-Mart at their corporate headquarters to discuss their decision to eliminate chiropractic as a benefit for its employees ($750 benefit with a $350 deductible). The company's representatives made clear at the beginning of the meeting that they would not change the decision to eliminate the benefit for 2003, a decision that was made in April of this year. Our representatives spent the next two hours presenting the latest chiropractic studies and learning of Wal-Mart's concerns. Their bottom line concern is the overall cost of health care. One of the decision makers is a patient.

Wal-Mart pointed out that while the chiropractic benefit for its employees under the PPO plan had been eliminated, chiropractic is still part of their HMO plan and their workers' compensation program. They offered to include an affinity program for the PPO plan, which we rejected outright. At the end of the meeting, they agreed to work with us in their future health benefit decisions. They indicated that they would be looking to again evaluate their health benefits in April of 2003 for implementation in the following year, and that they want to work with us in this process. They also plan to write a press release with us.

We were of course disappointed that we could not change Wal-Mart's decision. What is important, however, is Wal-Mart's interest in working with us in the future. As an ERISA plan they don't have an obligation to talk with us, but have decided to do so anyway. This is significant and hopefully will send a strong signal to other large ERISA plans that chiropractic does have a responsible professional organization representing its doctors that should be talked with before making decisions about employee health plans.

3. COURT HANDS CCA VICTORY IN ASHP SUIT

The California Chiropractic Association (CCA) reported that a California appellate court has ruled in favor of CCA in its lawsuit against American Specialty Health Plan (ASHP), rejecting ASHP's attempts to stay CCA's claims for injunctive relief.

As doctors will recall, in response to the chiropractic profession's complaints and concerns, CCA filed in June 2001 a lawsuit against ASHP. The landmark complaint alleges that ASHP engaged in fraudulent, unlawful and unfair business practices that have injured doctors of chiropractic and the general public.

Significantly, the court's ruling that CCA's request for injunctive relief could proceed means that ASHP must now respond to CCA's discovery requests relating to these claims. (In this instance, "injunctive relief" refers to CCA's demand that ASHP cease its alleged illegal and unfair business

practices. "Discovery" is the process by which parties to a claim obtain internal documents, records, depositions, etc., to arm the plaintiff and defendant with as much knowledge as possible to defend their positions at the time of trial). At the time of this writing, ASHP is in the process of responding to CCA's discovery requests.

As was reported to members at the outset, CCA's litigation on behalf of the chiropractic profession and its patients is likely to be a long, laborious and expensive undertaking. With the continued health of chiropractic and chiropractic patients at risk, CCA is unalterably committed to seeing this action through to its conclusion.

4. ACA PAC: HOW WE COMPARE TO OTHERS

We have talked in previous editions of this report about our successes in the recent elections. I am not sure how our competitors did, although I understand in a few instances the AMA supported both sides - a very safe way of doing things, but also very transparent. We took chances, and I think that in the long run our efforts will be appreciated by the winners that we supported, and respected by those who didn't receive our support. Provided below is the amount of money that we raised and spent during the past year, compared to others. You should note in each instance the PAC came into the beginning of the year with a balance.

Consider becoming a PAC contributor. FEC rules allow only ACA members to contribute. If you aren't a member, please consider becoming one and give to the PAC. I'm sure you'd agree that we have a good track record in utilizing the funds. While PACs don't always guarantee success in the legislature, without one there is no chance for success at all.

· ACA PAC (2001-02)

Receipts: $294,690 Disbursements: $278,958

· Osteopathic PAC

Receipts: $456,264 Disbursements: $474,479

· Physical Therapy PAC

Receipts: $678,708 Disbursement: $681,756

· AMA PAC

Receipts: $3,985,582 Disbursement: $4,493,581

5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE

New guidance on the HIPAA regulations was issued by the Office on Civil Rights on December 3, 2002. Among other things, the new guidance indicates that disclosure of DNA information is specifically prohibited under the regulations. The guidance also deals with the fairly complex marketing requirements which, in general, provide that a covered entity cannot disclose patient information for marketing purposes without prior patient authorization. The "Notice of Privacy Practices" has largely the same function as the consent requirement that was eliminated in the Final Rule. The Notice must contain a statement of all uses and disclosures of patient information. Doctors must have all patients read and preferably sign and acknowledge receipt of the Notice before treatment begins, according to the most recent guidance. The new guidance may be found at: www.hhs.gov/ocr/hipaa/privacy.html <http://www.hhs.gov/ocr/hipaa/privacy.html>.

6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF

In the July-Nov.02 issue of Palmer College's Alumni News, Dr. Guy Riekeman included an open letter to the alumni doctors calling for strong support for the lawsuits against Trigon and against HHS. Within the letter, Dr. Riekeman stated, "We are now in a position to make an immensely positive economic impact on chiropractic that will benefit the entire profession for decades to come..." He continued, "Doctor, we are not safe until we can establish this fundamental truth in federal court: doctors of chiropractic are the only health care providers qualified to diagnose and correct a subluxation..."

Palmer students have been longtime contributors to the National Chiropractic Legal Action Fund (NCLAF). During the last two weeks, we have received two checks for $100 each from this Student ACA (SACA) chapter, bringing its total to $1,177.35.

7. PHYSICAN PAYMENT ISSUE STILL A MESS

As of December 6, the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) had still not published a schedule for the 4.4% scheduled cut in Medicare, even though the agency had indicated it would be made public by December 2. Because the cut does not take effect until 60 days after the schedule is published, this delay buys some extra time for doctors while they wait for Congress to return on January 7. This year, physicians took a 5.4% cut in Medicare reimbursements. If the new schedule is published this month, physicians will face another cut in February. The issue concerns the formula used on calculating physician payments under Medicare. Tied to the GNP, the payments over the last couple of years have been lower.

Health care groups are looking at an anticipated Omnibus spending bill as a vehicle to attach language to prevent the anticipated cuts. Some Representatives are considering using the Congressional Review Act (PL 104-121) to kill the payment schedule. This law requires that agencies inform Congress of rules that are published, and then Congress has 60 days to pass a joint resolution of disapproval. However, this resolution must be signed by the president.

As earlier reported, the ACA is working with the AMA and other health care groups on this issue. We will keep you apprised of any further developments.

8. WFC CONGRESS AT DISNEY WORLD

Don't miss the World Federation of Chiropractic's (WFC) Congress to be held May 1 -3, 2003 at the Hilton at the Walt Disney World Resort, Orlando, Florida. The two main themes are the cervical spine and sports chiropractic, and the more than 60 lecturers and technique instructors are a "Who's Who" in chiropractic. It all begins with a Disney Show. You only have 22 days left to benefit from the early bird rate of $450, which comes to an end on December 31, 2002. The regular rate of US $550 applies as of January 1, 2003. For the full program, registrations, exhibit/sponsorship opportunities and all other information, visit www.chiroweb.com/wfcorlando2003 <http://www.chiroweb.com/wfcorlando2003>. This major event is co-sponsored by the ACA, ICA, CCA, FCER and FICS.

9. LAST EVP REPORT FOR THE YEAR

The ACA office will be closed between Christmas and New Years Day. The EVP report will also take a holiday. Look for the next issue on January 8, 2003. For Christmas, consider a subscription to the EVP Report as a stocking stuffer...only kidding (I know,it makes a good bird cage lining). But do consider membership in the ACA and/or contribution to the National Chiropractic Legal Action Fund if you aren't already a member, and contributions to the PAC and the Legal Action Fund if you are a member. Merry Christmas and Happy New Year!

10. THE 2003 CODES ARE PENDING

ACA's 2003 Chiropractic Coding Solutions Manual is almost complete, but will not be released in December as originally planned due to delays in the release of important content.

The Federal Register has yet to release the valuable RVUs, fee schedules and the fee formula for the upcoming 2003 year. We want you to receive the highest quality coding resource and once the figures are released, we will continue production and send you the newly-designed, ACA's 2003 Chiropractic Coding Solutions Manual.

For information about what is new and updated in the 2003 edition, or to order your manual, just click here: <http://www.acatoday.com/about/products/pm_products.shtml> or call 800-368-3083.

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@...>.

************************ 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."

December 18, 2002

ACA EVP Weekly Report

Memorandum

ACA Members, Board of Governors, House of Delegates and Other Interested Parties From: Cuneo Re: ACA EVP Weekly Report Non Member Issue Date: December 16, 2002

The following topics are covered in this week's report:

1. ACA SENDS STRONG LETTER TO ASHN 2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP 3. COURT HANDS CCA VICTORY IN ASHP SUIT 4. ACA PAC: HOW WE COMPARE TO OTHERS 5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE 6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF 7. PHYSICAN PAYMENT ISSUE STILL A MESS 8. WFC CONGRESS AT DISNEY WORLD 9. LAST EVP REPORT FOR THE YEAR 10. THE 2003 CODES ARE PENDING 11. CAN'T ACCESS THESE LINKS?

1. ACA SENDS STRONG LETTER TO ASHN

ACA President Daryl Wills, DC, sent a letter to Mr. DeVries, President of American Specialty Health Network (ASHN) expressing concern that, at a recent meeting of the Congress of Chiropractic State Associations (COCSA), an ASHN representative implied that the views of his company were similar to the ACA and that there existed some type of affiliation or endorsement of his company by the ACA.

In his letter, Dr. Wills insisted that ASHN "cease and desist from making any reference to the ACA in your marketing or public relations efforts. To the extent that such a reference should be understood as implying a direct or indirect relationship between ASHN and the ACA, such a representation is both false and misleading. Please confirm to me that your spokespeople have been appropriately instructed of our very deep concern about this matter."

2. ACA MEETS WITH WAL-MART OFFICIALS; ESTABLISHES BUSINESS RELATIONSHIP

Last Thursday, ACA's executive committee(Drs Jim , Daryl Wills and McClelland) and Pat , Vice President of Professional Development and Research, met with the benefit payment decision-makers of Wal-Mart at their corporate headquarters to discuss their decision to eliminate chiropractic as a benefit for its employees ($750 benefit with a $350 deductible). The company's representatives made clear at the beginning of the meeting that they would not change the decision to eliminate the benefit for 2003, a decision that was made in April of this year. Our representatives spent the next two hours presenting the latest chiropractic studies and learning of Wal-Mart's concerns. Their bottom line concern is the overall cost of health care. One of the decision makers is a patient.

Wal-Mart pointed out that while the chiropractic benefit for its employees under the PPO plan had been eliminated, chiropractic is still part of their HMO plan and their workers' compensation program. They offered to include an affinity program for the PPO plan, which we rejected outright. At the end of the meeting, they agreed to work with us in their future health benefit decisions. They indicated that they would be looking to again evaluate their health benefits in April of 2003 for implementation in the following year, and that they want to work with us in this process. They also plan to write a press release with us.

We were of course disappointed that we could not change Wal-Mart's decision. What is important, however, is Wal-Mart's interest in working with us in the future. As an ERISA plan they don't have an obligation to talk with us, but have decided to do so anyway. This is significant and hopefully will send a strong signal to other large ERISA plans that chiropractic does have a responsible professional organization representing its doctors that should be talked with before making decisions about employee health plans.

3. COURT HANDS CCA VICTORY IN ASHP SUIT

The California Chiropractic Association (CCA) reported that a California appellate court has ruled in favor of CCA in its lawsuit against American Specialty Health Plan (ASHP), rejecting ASHP's attempts to stay CCA's claims for injunctive relief.

As doctors will recall, in response to the chiropractic profession's complaints and concerns, CCA filed in June 2001 a lawsuit against ASHP. The landmark complaint alleges that ASHP engaged in fraudulent, unlawful and unfair business practices that have injured doctors of chiropractic and the general public.

Significantly, the court's ruling that CCA's request for injunctive relief could proceed means that ASHP must now respond to CCA's discovery requests relating to these claims. (In this instance, "injunctive relief" refers to CCA's demand that ASHP cease its alleged illegal and unfair business

practices. "Discovery" is the process by which parties to a claim obtain internal documents, records, depositions, etc., to arm the plaintiff and defendant with as much knowledge as possible to defend their positions at the time of trial). At the time of this writing, ASHP is in the process of responding to CCA's discovery requests.

As was reported to members at the outset, CCA's litigation on behalf of the chiropractic profession and its patients is likely to be a long, laborious and expensive undertaking. With the continued health of chiropractic and chiropractic patients at risk, CCA is unalterably committed to seeing this action through to its conclusion.

4. ACA PAC: HOW WE COMPARE TO OTHERS

The American Chiropractic Association-Political Action Committee (ACA-PAC) is a separately segregated fund of the ACA which is permitted under federal law to make political contributions to federal candidates. Federal law restricts the ACA to solicit only ACA members for contributions to ACA-PAC. The following is a report of various health profession PAC's receipts and disbursements taken from Federal Election Commission findings:

· ACA PAC (2001-02)

Receipts: $294,690 Disbursements: $278,958

· Osteopathic PAC

Receipts: $456,264 Disbursements: $474,479

· Physical Therapy PAC

Receipts: $678,708 Disbursement: $681,756

· AMA PAC

Receipts: $3,985,582 Disbursement: $4,493,581

5. OFFICE OF CIVIL RIGHTS ISSUES ADDITIONAL HIPAA GUIDANCE

New guidance on the HIPAA regulations was issued by the Office on Civil Rights on December 3, 2002. Among other things, the new guidance indicates that disclosure of DNA information is specifically prohibited under the regulations. The guidance also deals with the fairly complex marketing requirements which, in general, provide that a covered entity cannot disclose patient information for marketing purposes without prior patient authorization. The "Notice of Privacy Practices" has largely the same function as the consent requirement that was eliminated in the Final Rule. The Notice must contain a statement of all uses and disclosures of patient information. Doctors must have all patients read and preferably sign and acknowledge receipt of the Notice before treatment begins, according to the most recent guidance. The new guidance may be found at: www.hhs.gov/ocr/hipaa/privacy.html <http://www.hhs.gov/ocr/hipaa/privacy.html>.

6. DR. RIEKEMAN ANNOUNCES STRONG SUPPORT FOR NCLAF

In the July-Nov.02 issue of Palmer College's Alumni News, Dr. Guy Riekeman included an open letter to the alumni doctors calling for strong support for the lawsuits against Trigon and against HHS. Within the letter, Dr. Riekeman stated, "We are now in a position to make an immensely positive economic impact on chiropractic that will benefit the entire profession for decades to come..." He continued, "Doctor, we are not safe until we can establish this fundamental truth in federal court: doctors of chiropractic are the only health care providers qualified to diagnose and correct a subluxation..."

Palmer students have been longtime contributors to the National Chiropractic Legal Action Fund (NCLAF). During the last two weeks, we have received two checks for $100 each from this Student ACA (SACA) chapter, bringing its total to $1,177.35.

7. PHYSICAN PAYMENT ISSUE STILL A MESS

As of December 6, the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) had still not published a schedule for the 4.4% scheduled cut in Medicare, even though the agency had indicated it would be made public by December 2. Because the cut does not take effect until 60 days after the schedule is published, this delay buys some extra time for doctors while they wait for Congress to return on January 7. This year, physicians took a 5.4% cut in Medicare reimbursements. If the new schedule is published this month, physicians will face another cut in February. The issue concerns the formula used on calculating physician payments under Medicare. Tied to the GNP, the payments over the last couple of years have been lower.

Health care groups are looking at an anticipated Omnibus spending bill as a vehicle to attach language to prevent the anticipated cuts. Some Representatives are considering using the Congressional Review Act (PL 104-121) to kill the payment schedule. This law requires that agencies inform Congress of rules that are published, and then Congress has 60 days to pass a joint resolution of disapproval. However, this resolution must be signed by the president.

As earlier reported, the ACA is working with the AMA and other health care groups on this issue. We will keep you apprised of any further developments.

8. WFC CONGRESS AT DISNEY WORLD

Don't miss the World Federation of Chiropractic's (WFC) Congress to be held May 1 -3, 2003 at the Hilton at the Walt Disney World Resort, Orlando, Florida. The two main themes are the cervical spine and sports chiropractic, and the more than 60 lecturers and technique instructors are a "Who's Who" in chiropractic. It all begins with a Disney Show. You only have 22 days left to benefit from the early bird rate of $450, which comes to an end on December 31, 2002. The regular rate of US $550 applies as of January 1, 2003. For the full program, registrations, exhibit/sponsorship opportunities and all other information, visit www.chiroweb.com/wfcorlando2003 <http://www.chiroweb.com/wfcorlando2003>. This major event is co-sponsored by the ACA, ICA, CCA, FCER and FICS.

9. LAST EVP REPORT FOR THE YEAR

The ACA office will be closed between Christmas and New Years Day. The EVP report will also take a holiday. Look for the next issue on January 8, 2003. For Christmas, consider a subscription to the EVP Report as a stocking stuffer...only kidding (I know,it makes a good bird cage lining). But do consider membership in the ACA and/or contribution to the National Chiropractic Legal Action Fund if you aren't already a member, and contributions to the PAC and the Legal Action Fund if you are a member. Merry Christmas and Happy New Year!

10. THE 2003 CODES ARE PENDING

ACA's 2003 Chiropractic Coding Solutions Manual is almost complete, but will not be released in December as originally planned due to delays in the release of important content.

The Federal Register has yet to release the valuable RVUs, fee schedules and the fee formula for the upcoming 2003 year. We want you to receive the highest quality coding resource and once the figures are released, we will continue production and send you the newly-designed, ACA's 2003 Chiropractic Coding Solutions Manual.

For information about what is new and updated in the 2003 edition, or to order your manual, just click here: <http://www.acatoday.com/about/products/pm_products.shtml> or call 800-368-3083.

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@...>.

************************ 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."

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