Fw: [PMX:#] ACA EVP Weekly Report (2nd try)

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[PMX:#] ACA EVP Weekly Report (2nd try)

Some members received my report in "garbled" computer code. I apologize for any inconvenience. Should you have trouble viewing this version, please contact Dean Millard - ACA Director, Information Systems at dmillard@... or via phone at 800-986-4636.

Memorandum

To ACA Members, House of Delegates, Board of Governors and other Interested PartiesFrom: CuneoRe: ACA EVP Weekly ReportDate: January 12, 2004

This week's report includes the following items:

1. GENERAL WESLEY CLARK IS LATEST PRESIDENTIAL CANDIDATE TO ENDORSE CHIROPRACTIC: IOWA CAUCUSES AND NEW HAMPSHIRE PRIMARY AROUND THE CORNER 2. ACA STAFF IN IOWA 3. ERISA EXPERT AT NCLC 4. A MESSAGE FROM COCSA: COCSA TO HOST STATE ROUND TABLE AT NCLC5. CAC REPRESENTATIVES AT NCLC 6. CIGNA AND ITS UTILIZATION REVIEW VENDOR FOUND GUILTY 7. NEW HAMPSHIRE DELEGATE (Special Election) 8. MEMBERSHIP CAMPAIGN PLANNED FOR END OF MONTH

1. GENERAL WESLEY CLARK IS LATEST PRESIDENTIAL CANDIDATE TO ENDORSE CHIROPRACTIC; IOWA CAUCUSES AND NEW HAMPSHIRE PRIMARY AROUND THE CORNER

The first presidential nominating event – the Iowa Presidential Precinct Caucuses -- is set for January 19th. Iowa will be center of attention by the media and politicos as the aspirations of many of the Democratic candidates could be determined by the outcome. If not in Iowa, then certainly after the January 27th New Hampshire primary. If not then, then surely after the seven primaries including South Carolina which are scheduled for February 3rd. I think it’s very possible that the field of democratic candidates will narrow greatly by the second week of February. Incredible.

Although it’s good not to have a horse in this race, I am glad the ACA made it a priority to pin the candidates down on the issues that matter most to the profession. Since the field first began to take shape last year, the ACA -- working with the Iowa Chiropractic Society (ICS) and a network of politically active DCs around the country – began urging each candidate to issue a written policy statement on chiropractic care. The ACA has now received statements from all six leading Democratic contenders, including retired U.S. Army General Wesley whose just-released statement notably endorses chiropractic care for America’s military. General now joins Senator ph Lieberman, Senator Kerry, Congressman Dick Gephardt and Senator in responding to the ACA’s Presidential candidate outreach. Even Dean, an MD whose record as governor of Vermont has provoked great concern from within t! he ACA and from DCs across New England is actively seeking the pro-chiropractic vote and offered a policy statement to the ACA. In addition to the ICS, special thanks are due to Dr. Dan Redwood of Virginia, a coordinator for General ’s campaign, Dr. Overland of Connecticut, a health care advisor to Senator Joe Lieberman’s campaign, and ACA Iowa Delegate Dr. F. Dow Bates for making the most of their contacts with the candidates on behalf of the profession.

Very simply, the candidate statements provide recognition not only of our issues but our political clout at the highest level of national politics. Please take a moment to review each one now posted on the ACA website:

http://www.acatoday.com/government/other/candidates_endorse.shtml

- General Wesley - Senator ph Lieberman- Senator Kerry- Congressman Dick Gephardt- Governor Dean- Senator

2. ACA STAFF IN IOWA

To further maximize the influence of the profession in the early stages of the nominating process, ACA recently mailed copies of all six candidate statements to every doctor of chiropractic and chiropractic student in Iowa and New Hampshire. We’re encouraging them to get involved and to cast their vote in support of chiropractic. Also, we’ve dispatched two ACA staffers – PAC Manager Kim Krocker and Membership Coordinator Mulligan, to meet with students at Palmer Chiropractic College and promote awareness of our key national issues. Jon Hymes, ACA VP for Government Relations will also be in Iowa for the caucuses as a guest of Senator Tom Harkin, one of the profession’s true friends on Capitol Hill.

3. ERISA EXPERT AT NCLC

Did you know that ERISA now permits you to obtain the identity and credentials of the reviewer who denied your claim? It also allows you to obtain the criteria used to deny claims, and allows you to have an independent party review the denied claims. You can now turn the tables in ERISA plans to require that they demonstrate why a claim was denied rather than you trying to justify the claims yourself. A complete shift in the burden of proof. On Friday of NCLC/HOD week, Handorf, Deputy Associate Solicitor for the Plan Benefits Security Division of the U.S. Department of Labor, will be discussing these and other important procedures that have come into effect as a result of recent U.S. Supreme Court decision on ERISA, as well as regulations adopted by the Department of Labor. Ms Handorf is responsible for the coordination of ERISA rules in the Department.

4. A MESSAGE FROM COCSA: COCSA TO HOST STATE ROUND TABLE AT NCLC

The Congress of Chiropractic State Associations (COCSA) is pleased to be sponsoring a State Association Round Table on Saturday, March 6, immediately following ACA's National Chiropractic Legislative Conference (NCLC). COCSA appreciates the opportunity to provide this added bonus to the NCLC program for state association leaders. Past round table discussions have focused on spinal manipulation protection legislation, hospital relations, HIPAA regulations, and developing a plan for the future of the chiropractic profession. With so many hot topics coming to the forefront during the past twelve months---like PACE, the development of best practices, dwindling enrollment at chiropractic colleges, a proposed profession-wide public relations program, and the Work Comp crisis in states like California---this year's discussions should be lively and informative. Dr. Donovan, COCSA President, and Dr. Walt Engle, COCSA Treasurer, are once again ho! sting the State Association Round Table and are seeking input on topics. Anyone interested in leading a discussion or recommending a specific topic is encouraged to contact Janet Jordan in the COCSA office at cocsa@....

5. CAC REPRESENTATIVES AT NCLC

Here is the link to the agenda for the CAC meeting: http://www.acatoday.com/about/nclc2004/agenda.shtml

6. CIGNA AND ITS UTILIZATION REVIEW VENDOR FOUND GUILTY

, ACA’s vice president for professional development and research, noted that CIGNA and its utilization review vendor have been found guilty and were fined nearly one million dollars in Maine. This is a case of regulatory non-compliance committed by an insurance company and their business partner that performs utilization review. Insurers are totally responsible for the actions of any hired vendor or business partner. Late claim payments, if there is an established business pattern, is one way to get the Department of Insurance to open an investigation or market conduct exam against a payer, where other issues like medical review practices, benefit limitations and reimbursement can be explored simultaneously. ACA has two active investigations in progress with Departments of Insurance, one in New Jersey and one in Nevada involving the Blues plans. While they do not center on timely payments they do ! deal with fair treatment of the chiropractic profession.

7. NEW HAMPSHIRE DELEGATE (Special Election)

One month ago we had a special ACA delegate/alternate delegate election in New Hampshire. Dr. Wesley Merritt was declared the winner, with Dr. Guild elected as Alternate Delegate. Dr. Merritt is the current president of the New Hampshire Chiropractic Association, and Dr. Guild is the current 1st vice president. We welcome Drs. Merritt and Guild to the leadership of the ACA.

Half of the ACA delegate offices in the country are up for reelection in January. However, it appears that there will only be a few contested races. In Georgia, there will be a race for delegate and for alternate delegate. In Wisconsin, there will be a race for alternate delegate.

The ballots will be mailed to ACA voting members in Wisconsin and Georgia on January 15th. Ballots must be returned in the envelope provided by February 5, 2004 to our auditing firm, which will tabulate the ballots and inform the ACA of the results of the election by Monday, February 9.

8. MEMBERSHIP CAMPAIGN PLANNED FOR END OF MONTH

The ACA will be conducting a nationwide campaign beginning at the end of the month to increase ACA membership. As a member, you appreciate the value of membership. Now we need to convince the non-members that all the reasons that may have existed not to join are no longer part of this organization. Here is a link to a membership application. I would appreciate your signing up at least one member: http://www.acatoday.com/join.shtml. If you simply took what we accomplished over the last four months, it would be the best argument that ACA dues is the best investment for the future of the profession. Here is a list:

Heaney, an op-ed writer with the Washington Times, acknowledged what we have known for years: That ACA is the only effective chiropractic organization on Capitol Hill. http://www.acatoday.com/government/medicare/regulatory/aca_lobbying_efforts.shtml#2 In his ranking of the top 25 most effective health care lobbying organizations, Heaney ranked ACA among the top 25 (#19). ACA was even listed ahead of the U.S. Chamber of Commerce and the American Physical Therapy Association. Not listed at all were the American Osteopathic Association, the American Academy of Orthopedics, and a surprising number of other medical specialty health care groups.

After completing his op-ed piece for the Washington Times, Heaney was interviewed by Chiropractic Economics. During his interview with Chiropractic Economics, Heaney reiterated his findings. As a result of Heaney’s interview, it is clear that neither ICA nor WCA is a force on Capitol Hill. http://www.chiroeco.com/news/aca_grassroots%20lobbying.html

Through the efforts of our grassroots supporters, lobbyists and Senator Chuck Grassley, we beat back the Office of Management and Budget, Senator Bill Frist and Congressman Bill -- some of the most powerful players in Washington, D.C. to achieve Medicare victory. http://www.acatoday.com/government/medicare/regulatory/backoff.shtml

The insurance industry continues to reach out to the ACA. During the last three months, the National Association of Independent Insurers, composed of over 700 companies, sponsored our recent Claims Solutions Work Group meeting, scheduled a chiropractic program with their recent leadership conference, and is organizing telemarketing programs with their claims adjusters specifically on chiropractic issues. Insurance carriers who never understood chiropractic--or never wanted to--are now reaching out to the profession as never before, urging their claims adjustors to be educated as well. http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104 & STORY=/www/story/01-09-2004/0002086706 & EDATE=

We are now being contacted by the mass media before--and not after--a story appears. The recent WNBC situation in New York, in which the reporter examined the stroke issue, is a good example. Don't get me wrong--no story on chiropractic and stroke is positive. But we had a chance to exchange arguments with the reporter long before the segment aired, and the results were better than they could have been. Most importantly, we got advanced warning out to our members before the program aired, supplying them with critical ammunition to help answer the concerns of patients. Considering the report aired during "sweeps week," it is significant that the report wasn't rebroadcast to the degree that it could have been. Our response and backup information was both timely and informative. http://www.acatoday.com/media/record/wnbc-tv2.shtml. While many complain that we don't have a comprehensive public relations campaign, doctors should take another look. We do a good job with a small budget. Through independent efforts of our doctors via the Internet, over $50,000 has been raised from over 200 doctor for Senator Grassley. This figure is at least twice as high as any amount ever raised for a single member of Congress by doctors of chiropractic.

Presidential candidate Dean made a strong effort to appeal to the chiropractic profession. His initial position statement on chiropractic was stronger than the statement we received from Al Gore three years ago. And after a subsequent meeting with us, Dean submitted an even more positive statement. Make no mistake about it, Dean had an anti-chiropractic record as Governor of New Hampshire. Yet he recognized the potential power of this profession-- particularly in states like Iowa and New Hampshire--and took steps to rectify his stance. Other presidential candidates followed suit. Getting onto the radar screen at the Capitol and on the campaign trail is important to a successful legislative campaign. We are squarely on the radar screen. http://www.acatoday.com/pdf/deanstatement! .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. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@.... If you do not wish to receive further e-mail promotions, Click Here to be removed. DO NOT REPLY to this message. The e-mail address in which you are subscribed is rcross@.... Copyright 2002. All rights reserved.

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[PMX:#] ACA EVP Weekly Report (2nd try)

Memorandum

ACA Members, Board of Governors, House of Delegates and Other Interested PartiesFrom: CuneoRe: ACA Executive Vice President's Weekly ReportDate: February 2, 2004

*Some of you had troubles again with the previous email - this time, including hyperlinks within the text that allows you to jump from topic to topic. This is a non formatted text version that you all should be able to read with no problems. We are working on the issue of hyperlinks and will keep you informed. Thank you for your patience.

This week's report includes the following items:

MDs TARGET OF INSURERS’ AUDITS BREAKTHROUGH COACHING COMMITS ANOTHER $100,000 TO THE LAWSUITS NCLC 2004 IS GOING TO BE TREMENDOUS CCA STOPS THE PTs IN CALIFORNIA FEDERAL EMPLOYEE HEALTH PLAN (BLUE CROSS/BLUE SHIELD): IS IT WORKING FOR YOU? BEYOND THE CALL OF DUTY ACABizDoc GENERATES HOT TOPICS CAN’T ACCESS THESE LINKS?

1. MDs TARGET OF INSURERS’ AUDITS

It may be of small comfort, but health care providers other than doctors of chiropractic are also being targeted for insurers’ audits. A recent article in the Washington Post looked at the growing concerns among private and government health insurers about the accuracy of physicians’ claims and the system for calculating reimbursements. Both types of health insurers have increased their audits of health care providers’ bills to determine if the providers are insufficiently documenting care, billing for unnecessary services or using incorrect codes for billing. According to the article, Medicare is expected to audit 150,000 claims this fiscal year, compared with 128,000 and 6,000 audited in the two previous fiscal years, respectively. In the Washington, DC, area, CareFirst BlueCross BlueShield last year conducted an audit of "tens of thousands of claims" from 2,800 physicians, "igniting a doctors' revolt," according to the Po! st. Physicians say such investigations are designed to pressure them to bill less for services to avoid increased scrutiny from insurers.

The ACA constantly strives to provide its members with the most up-to-date and accurate information for coding available. Protect yourself by frequently viewing and adhering to the coding section of ACA’s Web site, found here http://www.acatoday.com/insurance/coding/. You may also want to consider purchasing a copy of the newly revamped 2004 Coding Solutions Manual, for which information can be found here http://www.acatoday.com/insurance/coding/coding_solutions2004.shtml.

Lastly, if you are audited, it is extremely important from a documentation standpoint to keep your patient records and notes up to standard. You can view the ACA's policy on documentation standards here http://www.acatoday.com/insurance/policy/standards.shtml.

2. BREAKTHROUGH COACHING COMMITS ANOTHER $100,000 TO THE LAWSUITS

Last year at the program in Las Vegas, Dr. Mark Sanna, President of Breakthrough Coaching, pledged that he and his coaches would raise $100,000 for the National Chiropractic Legal Action Fund (NCLAF). Three weeks ago, we received the final contribution fulfilling that pledge. A week later at the 2004 Seminar in Vegas, Dr. Sanna committed Breakthrough Coaching to another $100,000 pledge to the NCLAF. Although Dr. Sanna’s personal contributions and those of his coaches are very significant, this doesn’t even reflect the additional funds that were raised at his programs, where Breakthrough Coaching religiously played our “Simple Justice” video and stressed how important it is that all doctors participate in this effort. I’ve watched Dr. Sanna a number of times promote the lawsuits, and no matter how many times I saw it, I was always moved to reach for my wallet.

3. NCLC 2004 IS GOING TO BE TREMENDOUS

We anticipate one of the largest crowds ever of students and doctors converging on the capital for the 29th annual National Chiropractic Legislative Conference (NCLC), scheduled for March 3-6 at the Hyatt Regency on Capitol Hill. Our total room count for the week is already 100 rooms higher than last year at this time. And why not? Through the efforts of its hundreds of attendees, supporters and sponsors, NCLC reminds our elected leaders and government officials of the national reach and magnitude of the pro-chiropractic lobby, and offers unique opportunities for professional development, continuing education and networking.

Provided below is a link to information on NCLC 2004. We have just added to the program a special briefing on employment of DCs in the Department of Veterans Affairs. This program will be led by members of the VA committee, and will include a discussion of the committee’s recommendations, their status and their impact, as well as practical steps ACA members can take to position themselves to treat veterans through the VA system. http://www.acatoday.com/about/nclc2004/

4. CCA STOPS THE PTs IN CALIFORNIA

Congratulations to the California Chiropractic Association (CCA). They are reporting that a measure, carried by a prominent state senator on behalf of the physical therapists, was pulled from the Senate Business and Professions Committee just hours before it was scheduled for a hearing. The bill would have permitted physical therapists to perform manipulation and have direct access to patients. The CCA remains diligent on this issue, as it is confident that the physical therapists will continue with their efforts. It is very important that the CCA’s success continues on this front.

5. FEDERAL EMPLOYEE HEALTH PLAN (BLUE CROSS/BLUE SHIELD): IS IT WORKING FOR YOU?

We are continuing to monitor the implementation of the physical therapy benefit under both the basic and standard plans of Blue Cross/Blue Shield. In those states in which physical therapy is within the scope of practice of doctors of chiropractic, you should be able to be reimbursed for providing physical therapy under both the basic and standard options federal employee health plans. If you are having difficulty in utilizing any of the codes set forth below, please send us your EOB. FEP covers the following procedure codes, provided the service is within the provider's scope of licensure:

97001 Physical Therapy Evaluation; 97002 Physical Therapy Re-Eval; S9131 (HCPCS) PT in the home, per diem; 97010 Hot/Cold Packs; 97012 Mechanical Traction; 97014 Electrical Stimulation; 97016 Vasopneumatic Device; 97018 Paraffin Bath; 97020 Microwave; 97022 Whirlpool; 97024 Diathermy; 97034 Contrast Bath; 97035 Ultrasound; 97036 Hydrotherapy; 97039 Physical Therapy Treatment; 97110 Therapeutic Exercises; 97112 Neuromuscular ucation; 97113 Aquatic Therapy/Exercises; 97116 Gait Training Therapy; 97504 Orthotic Training; 97520 Prosthetic Training; 97530 Therapeutic Activities; 97532 Cognitive Skills Development; 97533 Sensory Integration; 97542 Wheelchair Mgmt Training; 97545 Work Hardening; 97546 Work Hardening Add-on; 97026 Infrared Therapy; 97028 Ultraviolet Therapy; 97032 Electrical Stimulation; 97033 Electric Current Therapy; 97124 Massage; 97139 Physical Medicine Procedure; 97140 Manual Therapy; 97150 Group Therapeutic Procedures; 97703 Pros! thetic Checkout; 97750 Physical Performance Test; 97799 Physical Medicine Procedure

6. BEYOND THE CALL OF DUTY

The 2004 program in Las Vegas was a success for NCLAF in part because we had volunteers and staff that were willing to spend ten-hour days covering the NCLAF booths and distributing materials to over 8,000 attendees. On two occasions, we had to place pledge forms on over 8,000 chairs in under 40 minutes. It was tough work…but I want to recognize the following dedicated individuals:

Dr. J. FlynnDr. Dr. SpotoDr. MadisonDr. StisoDr. HammDr. Sam Mark McClellandBobbi WillsDarlene Flynn ManceauxJoanne GentilePeggy KrippendorfDr. Olga GazonasDr. VaughnDr. Janelle Whitehead Cohenne HansonDave HaasAl Jameossanaie Wills-Beal BealJama FiscusJanet Trevino RichterMarc Person FoxClifford ThaiJeannie Kim OlsenNeal BerryDon VuongJill VongACA Board of GovernorsACA Staff

7. ACABizDoc GENERATES HOT TOPICS

ACABizDoc, ACA's new listserve dedicated to practice management, has been generating interest from members on a number of hot topics. DCs have sought answers and provided advice on all-cash practices, Medicare and workers’ compensation, marketing a new practice, and how to approach a local college sports team:

EXAMPLE:

Q: I am also attempting to get involved with a local college as a team chiropractor for some of their sports. I do not have a CCSP as of yet although I did spend 3 years as a student athletic trainer through undergrad and chiropractic college (at Life they had NAIA level collegiate sports teams). Any advice from yourself or anyone else as to how to approach them regarding becoming a team chiropractor would be greatly appreciated.

A: As to approaching the local college find out what is going on there first. I know the ATC for a pro football team that has a staff chiropractor, the poor ATC gets letters every week from some other chiropractor telling him how he can help the team. They may have already had a DC working with them and that may have soured them on the relationship. Also find out what you can about their team MDs. If they are anti-chiropractic you may be sunk. Reconnaissance is very important. Finally, if they are interested get an agreement in writing about responsibilities. There was an incident that happened where a DC was friends with a college coach who made him the "team chiropractor" but nothing was set up with the athletic department. This DC got lots of publicity about being so-and-so college's team chiropractor. As a result, the team MD and Athletic Director found out and decided to try to get chiropractic banned from collegiate sports. Fortunat! ely, the meeting where they attempted this a DC was able to diffuse the situation.

A: I learned long ago to work WITH others in a team approach. ATC's and the MD's/DO's, PT's or even OT's involved in the care of athletes are wonderful when we as DC's don't try to tell them we know everything and how to treat everything. I always did what we do best, look for biomechanical aberrations, adjust them or treat them chiropractic and then refer them to the appropriate person/s for what ever they need that you can't provide. This even includes taping and modalities. It is not that I could not tape or perform modalities but this way, you get the others involved in the treatment and care and become a "team" player. Discussing philosophy or the differences we encounter amongst ourselves is of no interest to the other members of the team, you are there to help. They generally do not like people who always want their photos taken with the stars, want autographs, have their names in the paper with these photos and use your affilia! tion to make money as your primary objective. I am not saying you should never ask for an autograph or have a photo made with someone but be prudent about it. Do you have a topic on the "business of chiropractic" you would like to discuss with other ACA members? Whether you are an experienced or new practitioner, ACA encourages you to take advantage of this free electronic chiropractic networking forum. Find out what has worked for others or share what you have learned about successfully managing your business challenges by registering today and posting your topic here http://ww3.chirolists.com/mailman/listinfo/acabizdoc.

8. CAN’T ACCESS THESE LINKS?

Some of you have been unable to download my PDF links. To view these file types, you need Adobe's Acrobat Reader. This is a free utility available at www.adobe.com. If you need further assistance viewing anything referred to in this report, please e-mail me at gcuneo@....

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If you do not wish to receive further e-mail promotions, Click Here to be removed. DO NOT REPLY to this message. The e-mail address in which you are subscribed is rcross@.... Copyright 2002. All rights reserved.