Following the American Chiropractic Association’s (ACA) investigation of certain chiropractic managed care networks, these networks are beginning to take action.

In a recent letter to an insurance company, American Specialty Health (ASH)—one of the networks in question—refutes statements from the ACA, claiming that there is a high satisfaction rating among chiropractors in its program, and that each chiropractor has voluntarily chosen to participate in their network.

“Technically, participation is voluntary; in reality, doctors feel that they have no choice,” says ACA’s Executive Vice President Kevin Corcoran, CAE. “They can either participate and receive at least a pittance in reimbursement, or opt out and receive absolutely nothing.”

ACA President Richard Brassard, DC, says that when ASH is ready to really talk, the ACA legal team will discuss the possible settlement of these issues.

The ACA also wrote a letter to American Chiropractic Network (ACN), requesting that the network place an immediate moratorium on further terminations under its “professional improvement program” and reinstate the DCs who have been terminated.

In a follow-up letter, ACN asked the ACA to reveal the names of the DCs who had responded to the ACA’s data-collection campaign and to provide specific details about the complaints. The ACA refused, stating privacy concerns and doctors’ fears of retaliation by ACN.

“I don’t believe you understand the degree of fear and misapprehension your policies have caused,” George McClelland, DC, the ACA’s immediate past chairman, wrote in a letter to ACN. “Doctors are fearful of losing their practices and their livelihood, and therefore are extremely reluctant to have their names revealed to your organization. Therefore, unfortunately, you were not able to dispel our concerns. Rather, our concerns are heightened with every call we receive or complaint we obtain.”

In another action, the ACA sent a letter to the director of Managed Care Certification and Surveillance of the New York State Department of Health, challenging a petition by ACN to manage the chiropractic benefit of Oxford Health Plans.

In the letter, the ACA states that DCs throughout the country, particularly in New York, have complained about the practices and policies of ACN.

The ACA stated that the benefits that have been promoted and paid for by employers are being denied, and that this is a detriment to the patient’s health.

Results of a study conducted at the Spine and Sport Foundation of San Diego show that a supervised exercise program, combining resistance training to strengthen the muscles of the lower back with exercises designed to improve flexibility and coordination may help treat people with chronic back pain.

The group of 314 workers with chronic back pain who participated in the 8- to- 15-week exercise program showed improvement in their ability to move and had less pain. The study found that the active exercise program worked better than popular passive back remedies, such as ultrasound, electrical stimulation, and hot packs. The study also found that after completing the rehabilitation program, two thirds of the workers who were deemed “unemployable” before embarking on the exercise program improved enough after the program to become “employable.”