ACA Targets Managed Care Network Practices
As part of its ongoing campaign to correct and put an end to what it says are wrongful practices of certain chiropractic managed care networks, the American Chiropractic Association (ACA) is asking DCs to provide additional information. As part of this effort, ACA retained the services of a class action law firm to assist in the collection and analysis of this information.“For too long, there has been a misguided perception within the profession that ACA somehow condones the unfair practices of certain chiropractic networks,” says Donald Krippendorf, DC, ACA president. “In reality, the ACA strongly denounces these practices and needs your support and information to put an end to what we view as unconscionable activity by these groups.” Over the past 3 years, DCs have completed “managed care data collection” forms detailing their negative experiences with chiropractic networks. According to the data collected by the ACA, DCs are most troubled by the actions of American Chiropractic Network (ACN), American Specialty Health Plans (ASHP), and Landmark Health Care, which routinely denied requested treatment and improperly reduced and denied reimbursement, putting the patients and the quality of care at risk. The ACA is gathering information on wrongful practices such as: automatic down coding or limiting physician discretion in the planning of care; bundling or incorporating the submitted current procedural terminology (CPT) code into another submitted CPT code; improper utilization review, including refusal to recognize coding modifiers; and performance-management issues. The ACA is asking DCs to identify the carriers that are the biggest offenders. For more information, go to www.acatoday.com/insurance/managed_care/resourcesheet.shtml. |
Study: Chiropractic Care is on the Rise
Researchers from Ohio State University have found that the use of complementary and alternative medicine (CAM) among consumers has risen steadily over the past few years.
The researchers used data from the 2000 Health and Retirement Survey conducted by the University of Michigan, in which 848 people responded to questions about their use of alternative medicine, including chiropractic, acupuncture, massage therapy, breathing techniques, herbal medicine, and meditation.
“We live in an age where the patient is more informed than ever,” says Robert Bartosh, DC, Bartosh Chiropractic, Sports Injury and Rehab Clinic, SC, Danville, Ill. “As a result, they are realizing that the cause of their condition must be removed rather than just quelling its symptoms, and that there is the potential for obtaining and maintaining one's health, and they are starting to say no to drugs. Patients also realize that departure from drugs and the arrival to health can be accomplished with chiropractic care.”
As indicated by 43% of respondents, chiropractic care was the most frequently used form of CAM. The research also found that 65% of respondents who indicated that they were in “poor health” were more likely to use alternative medicine they considered preventive or curative. In addition, 63% of respondents who reported feeling dissatisfied with their health care tried CAM.
Chiropractic Named One of Top Ten Jobs
What are the top 10 jobs to pursue in the next 5 years? According to an article in Fast Company magazine, chiropractic is one of them, ranking at number four.
“I think with the wellness revolution and the baby boomers coming of age, chiropractors should do well,” says Lynne Sullivan, DC, Sullivan Chiropractic Health Center, Pleasanton, Calif. “Our biggest challenge will be in getting the message of what chiropractors really do to the general public.”
As more and more people are turning to alternative, holistic health care, the job growth for the chiropractic profession looks solid, according to the article. In addition, the article states, the profession is growing in reputation with health insurance companies recognizing the benefits of chiropractic care.
“If the public understood that chiropractic wellness care is a lifestyle and not just a treatment for a specific alignment, the percent usage would go up,” Sullivan says. “The public needs to understand that regular chiropractic care would not only make them feel better, but would help improve their overall health and quality of life.”
Medicare Project Makes Change
The American Chiropractic Association (ACA) announced that due to the pending litigation against the Centers for Medicare & Medicaid Services (CMS) by the National Association of Athletic Trainers, all “incident-to” requirements on DCs in the demonstration areas of the CMS demonstration project have been temporarily rescinded. This announcement means that chiropractic assistants of DCs participating in the demonstration project can perform “incident to” therapy services.In April, CMS began a 2-year demonstration project to expand Medicare coverage of chiropractic services in Maine, New Mexico, the northern Illinois area (including 23 counties in Illinois and Scott County, Iowa) and 17 counties in Virginia. DCs in those areas can offer Medicare Part B patients an expanded array of services they are currently allowed to provide by state law but were not previously covered by Medicare. The ACA disagrees with the project’s “incident to” regulations, which would require all office staff providing and billing Medicare for incident-to therapy services to have received physical therapy training from a program recognized by the American Medical Association or American Physical Therapy Association. The US District Court in Dallas is expected to rule on whether the “incident to” requirements can go into effect on or before July 22, 2005. If the court allows the CMS manual provisions to take effect, anytime a physical therapy service is provided “incident to” the service of a chiropractor, the person who furnishes the service must be a qualified physical therapy practitioner. |
Mark Your Calendars
The Sherman College of Straight Chiropractic’s second annual International Research and Philosophy Symposium (IRAPS) will take place October 22–23, 2005, in Spartanburg, SC. The symposium will feature keynote speaker Bob Blanks, PhD, World Chiropractic Alliance Researcher of the Year.
The conference invites research papers focused on the philosophical and scientific aspects for the neurophysiological components of the vertebral subluxation. Subtopics include, but are not limited to: neurological models that are pertinent to the interference component of the vertebral subluxation; deductive reasoning pertinent to the interference component of the vertebral subluxation; concepts and models pertaining to the mental impulse; tools for analyzing the neurological component of the vertebral subluxation; differentiation between neuropathy and vertebral subluxation; differentiation between misalignment and vertebral subluxation; and neurological interference related to vertebral subluxation and methods of assessing its impact on health.
A $250 cash award will be granted to the authors of one philosophy research paper and one scientific research paper.
For more information on the symposium, visit www.sherman.edu/iraps.
New Hampshire Representative Introduces Tricare Bill
Congressman Jeb Bradley (R-NH) has introduced the Chiropractic Tricare Bill (HR 1594), which would establish a permanent chiropractic benefits program in the federal Tricare health system for military dependents and retirees.
“The chiropractic profession is very fortunate to have legislators like Representative Bradley, who know our profession and the unique benefits we can provide in a highly effective and low-cost manner,” says Gary Walsemann, DC, International Chiropractic Association board member.
The bill, titled the “Chiropractic Health Parity for Military Retirees and Dependents Act,” calls for the inclusion of chiropractic services, including diagnostic x-ray tests, correction, management of vertebral subluxations, or neuromuscular conditions, and does not include the use of drugs or surgery. It specifies that those services may be provided only by a doctor of chiropractic and that “A covered beneficiary may select and have direct access to a doctor of chiropractic without referral by another health practitioner.”
“It is absolutely critical that the eight million people covered by Tricare be granted the same rights as the rest of the American population, including the availability of chiropractic services,” says Terry A. Rondberg, DC, World Chiropractic Alliance president.
The bill will be implemented no later than December 31, 2005.
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