|
The Former Website of the Long Beach Chiropractic District
|
|
|
|
Memorandum to: ACA Members, ACA Board of Govenors, House
of Delegates and Other Interested Parties In this report: 1. WHAT HAPPENED TO THE PHYSICAL THERAPISTS? WHAT HAPPENED TO THE PHYSICAL THERAPISTS? Last Monday, the American Physical Therapy Association(APTA) sent out a press release indicating that it had successfully stopped the bill (HR 2792) that included the chiropractic provision in the Veterans Administration. I find it interesting that the physical therapists would claim success in stalling a major $9 billion veterans bill that included a $350 million dollars chiropractic provision. Fortunately, the next day the House passed the VA bill with our chiropractic provision in tact. Anyone who has ever tried to push chiropractic legislation on a local or national level has to be impressed that Congress would pass a chiropractic provision scored at $350 million. While the bill was being debated, Congressman Jerry Moran (R-KS), chairman of the Veterans Affairs Committee, made specific reference to the chiropractic provision emphasizing the direct access provision in the bill. The House knew what it was voting for, and despite the price tag which we think is inflated, was willing to support the legislation. But I can't emphasize enough, this is only the first step in our battle. We have to get the Senate to provide this provision. The physical therapists, the osteopaths, the AMA, and the American Association of Family Physicians will be out in force. Be mindful of the fact that we have spent the last year working the House. They understand the problem we have with the Veterans Administration. The Senate, however, does not have the same experience with this, and the opposition will be using the difficult argument that the chiropractic provisions will take away from something else. CONGRESSMAN FILNER GOT IT RIGHT Following the passage of this legislation, a government affairs staff person with the APTA expressed concern in an interview with the Hill News that the chiropractic provision would divert funds from the specialty programs that the bill aims to bolster. The article pointed out, however, that no member of Congress spoke out against this provision when it was considered by the House. Congressman BobFilner (D-CA) put it all into prospective when he said that the physical therapists were simply trying to protect their turf. Amen! MCANDREWS & DALY VS. TRIGON, ROUND 2 Trigon Blue Cross/Blue Shield filed a very angry and strident response to ACA's Motion for Partial Summary Judgment. In its response to the court, Trigon's attorneys claim that ACA's Motion is "another 'timewaster' because it entirely lacks merit, but it also is based on deceptive conduct by the Plaintiffs." Trigon also asked the court to sanction the ACA attorneys for the filing of the Motion. Trigon attorneys claim that they did not specifically answer ACA's allegations of conspiracy contained in its original complaint because Trigon's answer "contained a general denial, a number of specific denials and an affirmative defense which denied any conspiratorial conduct between Trigon and the national Blue Cross/Blue Shield Association." The ACA has pointed out to the court in its motion that federal rules require Trigon to specifically answer all of the allegations, which Trigon did not do. Those allegations that are not specifically denied are considered "admitted to" under applicable law. The Trigon attorneys also accuse ACA attorneys of "deception" and stated that the ACA attorneys had intentionally "misled" the court by not disclosing to the court that the plaintiffs would continue to consider the national Blue Cross/Blue Shield Association as a conspirator with Trigon despite the voluntary dismissal of the national Blue Cross/Blue Shield Association from the lawsuit. The Trigon attorneys stated, "Even more troubling than plaintiffs' conscious disregard of Trigon's unambiguous denials of the conspiracy allegations is the fact that they have deceived both the court and Trigon concerning their intentions to pursue the claim that Trigon and the national Blue Cross Blue Shield Association had allegedly conspired. Plaintiffs' deception had the effect of causing Trigon to state in its answer that no further response was required to the particular allegations." George McAndrews' response is as follows: a) ACA is merely following proper pleading procedures established under applicable court rules and case law. b) Ignoring the issue of conspiracy because the national Blue Cross Blue Shield Association is no longer a party is like ignoring the actions of the Taliban if Osama Bin Laden is no longer alive. Things are getting interesting.( See last weeks EVP Weekly Report for further background information regarding this matter) FEDS ALSO HAVE PROBLEMS WITH TRIGON OIG Eyes Trigon's Administrative Costs WASHINGTON, D.C., Oct. 19 (Medical Newswire) In its most recent audit of Medicare contractor administrative costs, the HHS Office of Inspector General found problems with more than $3.4 million of the total $48.8 million in admin costs claimed by the former fiscal intermediary of Trigon Blue Cross/Blue Shield from 1997 to 1999. The watchdog agency says the troublesome claims were unallowable, unallocable, unreasonable or unapproved by the Centers for Medicare & Medicaid Services. Key problem areas related to core business costs, core business termination costs and data center transition and termination costs. Trigon disputes a substantial portion of the OIG's findings. THIS WEEK'S HIGHLIGHTED GROUP The Nebraska Chiropractic Physicians Association submitted a check for $7,501 to the National Chiropractic Legal Action Fund, bringing its total to $30,001. This makes their total contribution the second highest among state associations.. CODING COMMITTEE ACTS With the approval of the ACA Board of Governors, ACA's coding committee plans to respond with "high interest" to the AMA about the development of E/M administrative codes for use by doctors of chiropractic. This code set will be used to report sports physicals, pre-employment screening, school admission situations, etc., by a physician. It is felt that this set of codes should be available to doctors of chiropractic as physician-status providers. The ACA will respond to the AMA and will also plan a survey to obtain the data necessary to support chiropractic use of the codes. It is expected that the survey will be completed in Spring/Summer 2002. MEDICARE SINGLE CONVERSION FACTOR: A PROBLEM FOR ALL PROVIDERS A week ago, representatives of ACA's Government Relations staff attended a meeting at the AMA with other health care providers regarding problems with the Medicare Single Conversion Factor. All the major health care groups attended. The conversion factor is the dollar amount that is multiplied by the relative value for a specific service that results in the Medicare dollar amount of payment for the service. A few years ago there were three different conversion factors, with the lowest dollar amount conversion being applied to the chiropractic manipulation service. After lobbying Congress, a single conversion factor was established which was higher than the lowest conversion factor, resulting in a step up in reimbursement for chiropractic services and a step down for many other services (particularly surgical services). The single conversion factor is in part tied to GNP, so when the economy declines so does the conversion factor, even in the face of rising overall health care costs. Naturally, the feds are projecting a significant drop in GNP, which could translate into a 3 to 5% slide. After a comprehensive review of the problem, HCFA concluded that it did not have the statutory authority to correct the problem requiring that a legislative solution would be necessary. But a legislative solution will not be easy. The AMA indicated that it has no hard data to backup the issue, nor did it have specific legislative language in mind, leaving it up to congressional staffers to come up with the language. Not a pretty picture…but we will weigh in on this issue, as other health providers will do. We will have two goals: a) To join other health care organizations to find a fix for this problem. b) To make sure that whatever the solution, we not be placed back where we were the third rung on the reimbursement ladder. ACA LEADERSHIP ON THE ROAD Last weekend, ACA president Daryl D. Wills, DC, traveled to Canada where he meet with the president of the Canadian Memorial Chiropractic College. He spoke to 150 of the freshman students at the school.. He also took the opportunity to explore the possibility of increasing ACA membership in Canada to the point where they could be represented at ACA's House of Delegates meeting. While in Canada, Dr. Wills participated in the meeting of the High Country Chiropractic Knights. The Knights group is a nonpolitical organization with no affiliation to any other chiropractic entity. Their purpose is to advance the chiropractic profession through presentations, visitations and roundtable discussions. The same weekend, ACA chairman James D. Edwards, DC, attended the homecoming of Parker College of Chiropractic, and was the featured speaker at the president's dinner, at which over 150 doctors and spouses were in attendance. Georgia delegate John Dull, DC, was active this past weekend at the convention of the Georgia Chiropractic Association. He spoke to the general session of the convention, which was attended by over 300 people. He sponsored an ACA membership lunch that drew 47 doctors, presented an ACA Journalism award to the Georgia Chiropractic Association and manned an ACA booth the entire weekend. This doctor does his job. ONE-STOP SHOPPING FOR PRACTICE PROMOTION To save you time and money, we've packaged effective ad slicks, sample news releases, patient fact sheets, sample speeches and more into one practical binder for your use all year long. You'll turn to this resource again and again. Big discount for ACA members. To order, go to http://www.lighthousemarket.net/acastore/product.asp. This message is being sent to you as a courtesy from the Executive Vice President of the American Chiropractic Association. If you wish to be removed from this list, simply send a message to mailto:kpark@amerchiro.org and change the subject to read "REMOVE - EVP Report." |
|
|
.
 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
|
