Re: Trimet and FMLA

[Guest guest]

,

There used to be a law in Medicare that required DCs to have a recent X-ray (1-yr) to substantiate the need for adjusting. I wrote letters to Ron Wyden. I got a response with a staffer who said they were unaware of any insurance carrier requiring unnecessary radiation (that's the way I put it) to justify payment for care. I had stated that it was a medical risk as well as a financial burden on a population that could least afford it. I would suggest that you site the Medicare laws in a professional way, saying that Federal guidelines have been established that no longer require physicians to do this because it's a medical risk to un necessarily radiate patients. That we have taken oaths to 'do no harm'. ANd that there are ample ways to determine a subluxation without x-ray, however, if you feel an x-ray is needed, you'll absolutely order one. I was able to convince legislators that requiring x-rays based on medical specialty title, rather than medical necessity is POOR medicine and places patients at great risk. Feel free to use some of this terminology if you wish. And if you do so, may I request that you cc your letter to this list, and every legislator in your district. Make sure Trimet knows / sees the cc . They most likely have a NON-medical person creating that rule.

Minga Guerrero DC

PS once creates this letter; I think we can all parrot the sentiment - with her permission and if she chooses to do this.

Trimet and FMLA

I have a patient who has a chronic facet syndrome that flares up a couple times per year to the point that he is unable to sit or stand for longer than a few minutes. The flareups typically last a couple of days. He has done extensive rehab with me, an orthopedist and a physical therapist and has experienced significant improvement over the past couple years. Even with treatment, he experiences these flareups, which have decreased from once every 2 weeks to once every 2-3 months.

Trimet is pretty picky about its drivers taking time off work and demanded that this patient get his doctor to fill out the FMLA paperwork for intermittent medical leave. He asked me to fill out his FMLA paperwork which I gladly did a couple years ago. Trimet accepted the intermittent leave request from me in 2009 without a problem. This year, they say that they require an x-ray taken within the last 12 months showing a spinal subluxation in order to accept the leave request if it is submitted by a chiropractor. The told me on the phone that if the paperwork was submitted by an other provider, it would be accepted as is and would not require additional documentation with the x-ray. Has anyone else dealt with this? It seems awfully discriminatory to me.

McCabe, DC, CCSP

Cedar Mill Chiropractic Clinic

[Guest guest]

Wasn't that overturned some years ago? Xprays haven't been required for some time now.

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com

lauren_mccabe@...; From: AboWoman@...Date: Wed, 20 Apr 2011 18:13:24 -0400Subject: Re: Trimet and FMLA

,

There used to be a law in Medicare that required DCs to have a recent X-ray (1-yr) to substantiate the need for adjusting. I wrote letters to Ron Wyden. I got a response with a staffer who said they were unaware of any insurance carrier requiring unnecessary radiation (that's the way I put it) to justify payment for care. I had stated that it was a medical risk as well as a financial burden on a population that could least afford it. I would suggest that you site the Medicare laws in a professional way, saying that Federal guidelines have been established that no longer require physicians to do this because it's a medical risk to un necessarily radiate patients. That we have taken oaths to 'do no harm'. ANd that there are ample ways to determine a subluxation without x-ray, however, if you feel an x-ray is needed, you'll absolutely order one. I was able to convince legislators that requiring x-rays based on medical specialty title, rather than medical necessity is POOR medicine and places patients at great risk. Feel free to use some of this terminology if you wish. And if you do so, may I request that you cc your letter to this list, and every legislator in your district. Make sure Trimet knows / sees the cc . They most likely have a NON-medical person creating that rule.

Minga Guerrero DC

PS once creates this letter; I think we can all parrot the sentiment - with her permission and if she chooses to do this.

Trimet and FMLA

I have a patient who has a chronic facet syndrome that flares up a couple times per year to the point that he is unable to sit or stand for longer than a few minutes. The flareups typically last a couple of days. He has done extensive rehab with me, an orthopedist and a physical therapist and has experienced significant improvement over the past couple years. Even with treatment, he experiences these flareups, which have decreased from once every 2 weeks to once every 2-3 months. Trimet is pretty picky about its drivers taking time off work and demanded that this patient get his doctor to fill out the FMLA paperwork for intermittent medical leave. He asked me to fill out his FMLA paperwork which I gladly did a couple years ago. Trimet accepted the intermittent leave request from me in 2009 without a problem. This year, they say that they require an x-ray taken within the last 12 months showing a spinal subluxation in order to accept the leave request if it is submitted by a chiropractor. The told me on the phone that if the paperwork was submitted by an other provider, it would be accepted as is and would not require additional documentation with the x-ray. Has anyone else dealt with this? It seems awfully discriminatory to me. McCabe, DC, CCSPCedar Mill Chiropractic Clinic

[Guest guest]

Yes, It was overturned following my letters to Ron Wyden. I've been a DC since 1984, and can't recall the exact year it got overturned. I think in the 1990's? That's my point. FOr some reason, is being hit with an archaic and, I think, dangerous precedent. It warrents another professionally crafted reminder, IMHO.

Minga

Trimet and FMLA

I have a patient who has a chronic facet syndrome that flares up a couple times per year to the point that he is unable to sit or stand for longer than a few minutes. The flareups typically last a couple of days. He has done extensive rehab with me, an orthopedist and a physical therapist and has experienced significant improvement over the past couple years. Even with treatment, he experiences these flareups, which have decreased from once every 2 weeks to once every 2-3 months.

Trimet is pretty picky about its drivers taking time off work and demanded that this patient get his doctor to fill out the FMLA paperwork for intermittent medical leave. He asked me to fill out his FMLA paperwork which I gladly did a couple years ago. Trimet accepted the intermittent leave request from me in 2009 without a problem. This year, they say that they require an x-ray taken within the last 12 months showing a spinal subluxation in order to accept the leave request if it is submitted by a chiropractor. The told me on the phone that if the paperwork was submitted by an other provider, it would be accepted as is and would not require additional documentation with the x-ray. Has anyone else dealt with this? It seems awfully discriminatory to me.

McCabe, DC, CCSP

Cedar Mill Chiropractic Clinic

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[Guest guest]

Just for grins I am checking to find out what year Medicare discontinued the exclusive x-ray requirement. I will let you know.

J. Holzapfel, DCAlbany, Oregon541-928-4060

----- Trimet and FMLA

I have a patient who has a chronic facet syndrome that flares up a couple times per year to the point that he is unable to sit or stand for longer than a few minutes. The flareups typically last a couple of days. He has done extensive rehab with me, an orthopedist and a physical therapist and has experienced significant improvement over the past couple years. Even with treatment, he experiences these flareups, which have decreased from once every 2 weeks to once every 2-3 months. Trimet is pretty picky about its drivers taking time off work and demanded that this patient get his doctor to fill out the FMLA paperwork for intermittent medical leave. He asked me to fill out his FMLA paperwork which I gladly did a couple years ago. Trimet accepted the intermittent leave request from me in 2009 without a problem. This year, they say that they require an x-ray taken within the last 12 months showing a spinal subluxation in order to accept the leave request if it is submitted by a chiropractor. The told me on the phone that if the paperwork was submitted by an other provider, it would be accepted as is and would not require additional documentation with the x-ray. Has anyone else dealt with this? It seems awfully discriminatory to me. McCabe, DC, CCSPCedar Mill Chiropractic Clinic

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