Current and Former Board Members Allegedly Disposed of Patient Records in Outside Trash
Without Shredding, Incinerating or Redacting - ACS Posts Evidence
ACS has been supplied with redacted medical records that ACS has been told were retrieved in their unredacted form from the outside trash of former Chiropractic Board member Craig Seitz, DC, and current members Dianne Haydon, DC and Steven Baker, DC. ACS was told these records were retrieved at the request of a "group of concerned chiropractors" who were concerned about misconduct by the Chiropractic Board, and who wanted to determine if Board members were in compliance with the same laws they were enforcing.
These medical records were turned into the Board as 1100 complaints against the three DCs in 2006. The Board dismissed the complaints since they were filed anonymously, even though the Board routinely processes complaints filed anonymously against other DCs. Many believe this is an obvious double standard. Where else could these records have come from other than the doctors' outside trash? None of the Board members reported a burglary. The scores of patients certainly did not turn in their own records simultaneously to the Board. It is ACS' conclusion that the Board's dismissal of these 1100 complaints was an outrageous cover-up of possible massive wrong-doing. There may be significant public corruption involving other Board personnel in the cover-up. Various legal authorities are now investigating. Read the documents posted on the ACS webpage at www.AZChiropractors.org and make your own assessment. Then watch the ACS email newsletter and webpage for breaking news.
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Special Thanks to Members of the ACS President's Club
Many thanks to our visionary members who contribute $279 per month to help ACS work hard for chiropractic progress. These doctors are premier members of the ACS President's Club. Special thanks to Drs. Rob van Zweeden, William Zeiler, Leo Rayburn, Trevor Penny, Shaun and Nikki Miglore, E.J. Strandlund, Randall Widmaier, Gregg Friedman, Angelo Pisano, Tracy Peruch, Jeff Raiffie, Randy Leraaen, Jeff Rebarcak, Josh and Jenna Haggard, and an anonymous DC. Please join these leaders today! ACS can do so much more for chiropractic with additional support! |
| The Arizona Chiropractic Society is here to serve you! |
ARIZONA
CHIROPRACTIC
SOCIETY
3515 E. Carol Avenue
Phoenix, AZ 85028
VOICE 602.368.9496
FAX 602.368.8954 |
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Dear Arizona Chiropractor and other interested party,
This is your April 2008 ACS email newsletter. Please forward this to any of your fellow Arizona chiropractors or anyone else who would benefit from the information here. Also, please feel free to contact us with any questions or, if you wish to no longer receive these important communications, click the unsubscribe link at the bottom.
Through out this eNewsletter you'll find various sponsors for our efforts. Please support our sponsors and be sure to tell them that you saw their ad in the ACS eNewsletter.
Warm regards,
Alan M. Immerman, D.C.
President & Executive Director
602.368.9496
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ACS and Sen. Gray Revive
Copay Bill the House
ACS and Senator Linda Gray have revived the copayment/deductible legislation by bringing it back to life as SB 1048 SE in the House. Ace ACS lobbyist Debra Brimhall Pearson worked closely with strong chiropractic supporter Speaker Jim Weiers, and now the bill is alive and moving again. It is scheduled for a hearing April 2, 2008 in the House Natural Resources and Public Safety Committee. If you want to know the outcome, sign up for the ACS newsletter at www.AZChiropractors.org. SB 1048 SE has already passed the entire Senate. This means that the bill must only pass the House and then gain final approval by the full Senate. It does not need to pass another Senate committee. Then, once passed by the Senate, it goes directly to the Governor. If signed, the bill becomes law, and in a few short months copays and deductibles for chiropractic care will be set at primary care physician levels, not specialist levels. Your patients will finally be able to afford to use their insurance in your office again. ACS will have achieved its goal of insurance equality in Arizona, and patients will have health care freedom of choice. This is what ACS set out to accomplish when it brought this issue to Senators Gray and Rios in the fall of 2006, shortly after BCBS dramatically raised copays and deductibles for chiropractic. None of this success will happen, however, without continuing hard work on your part. Passing this bill in the face of opposition by the entire insurance and business community in Arizona is impossible without participation by you and your patients. Only ACS has a powerful grassroots effort aimed at involving scores of doctors and patients. As a result of the ACS effort, legislators are hearing from hundreds of patients stating that SB 1048 SE must pass this year. This grassroots effort is expected at press time to lead to the presence of hundreds at the April 2 hearing at the House. These overwhelming numbers, created solely by ACS, will vastly increase the chances of success. To become part of the ACS grassroots network, sign up for ACS newsletter at www.AZChiropractors.org There will still be plenty of opportunities to get involved in the next few weeks and months. |
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Balance Billing in Personal Injury Cases...
Setting the Record Straight
by Steven Pincus, Esq., ACS PI Expert Attorney
When a medical provider has been paid by health insurance, can this provider expect the balance of their bill to be paid in a personal injury settlement? YES! -- under the right circumstances. Here's how it works.
The first question to ask is, "Is the medical provider under contract with the health insurance?" If "no," the query is over and the provider is entitled to have their entire bill paid. If "yes," the next question is, "Does the contract prohibit the provider from balance billing the patient?" If "no," the query is over and the provider is entitled to have their entire bill paid. If "yes", then the provider is entitled to balance bill IF it has recorded a lien pursuant to ARS 33-931; but it must forgo the applicable percentage of attorney's fees as a reduction in the balance remaining (ie. Common Fund Doctrine). Generally the attorney's fee will be 1/3, so the provider may collect 2/3 of the balance bill.
Certain Law Firms representing injured patients do not understand this. Sometimes such a Law Firm will pay you 2/3 of your balance bill - even though you were not entitled to any portion of it. This would arise where the health insurance is under contract with you, does prohibit balance billing, and you have forgotten to record a lien. Here, you are only legally entitled to what the insurance company has paid you -- and nothing more. Of course, if you are paid monies not legally owed to you, we must advise you to return them.
Accordingly, RECORDING LIENS pursuant to ARS 33-931 is crucial to preserving your right to be paid even when the health insurance prohibits balance billing; albeit at generally 2/3 of the balance bill remaining.
I have bolded the word "recorded" herein, as a signed contractual lien will not get your balance bill paid. There is a vast difference between a contractual lien, and a recorded lien. Both are of value to you; but each for different reasons.
In short, you work hard to earn a living, you deserve to be paid -- and protecting your income by utilizing liens correctly is crucial to keeping your bottom line profitable. There are attorneys out there who do not understand lien laws, balance billing laws - and will take the position you are not allowed to be paid. Don't let such threats from attorneys take money away from you that is rightfully yours.
To be sure you are protecting your income by correctly utilizing liens in your practice, please give us a call. You can reach our Tempe office by calling 480-777-2599, and our Tucson office by calling 520-888-2599. Our attorneys will be happy to help you assure you are being paid what is rightfully yours. |
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ONLY ACS!
Only ACS has a grassroots political program. ACS constantly alerts its hundreds of members and non-members when key legislators need to be contacted by patients and doctors. As a result, these legislators receive tons of emails and phone calls, and hundreds of patients and doctors show up to legislative hearings. Without this input, there would be no hope of the copay/deductible bill passing.
Only ACS has confronted the Chiropractic Board over its gross mistreatment of state chiropractors. ACS is completely independent of the Board and does not have an office across the hall as does another association. Nor does ACS support the current Board DCs as does another association. If you want Board reform and replacement, ACS is your organization. As a direct result of ACS, the Board no longer disciplines licenses for record keeping violations. Doctors are only ordered to take CE classes with no black marks placed on their licenses. This is a huge change for the better.
Only ACS has a full-time veteran licensed DC at your service to answer all of your questions on any chiropractic issue. Other organizations have paid staff that cannot match any DC's expertise and experience. The DCs running other organizations are busy all day long caring for patients.
Only ACS has developed written powerful specific position papers to convince legislators to support the chiropractic copay/deductible bill. These papers are abstracted below, and printed in full at www.AZChiropractors.org <http://www.AZChiropractors.org> , Legislative page. Without these documents, passage of the copay bill would be hopeless.
Only because of ACS' intervention are CAs allowed to do more than just a few passive modalities. The CA rules were amended because of ACS to include the words "and is not limited to . . ." Without ACS, you would have been required to personally administer all active rehab. |
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What is the Most Effective Way to Argue for the Copay/Deductible Bill?
These are the position papers sent to legislators aimed at persuading them to vote yes on SB 1048 SE. Use them in your contacts with legislators. All have been sent to members previously via email. In the newsletter, we will only print short abstracts. For the full text, go to www.AZChiropractors.org.
Position Paper One: SB 1048 SE does not convert Chiropractors into primary care physicians. It only requires that copays and deductibles be set at the same level as those for primary care physician services.
Here's the point: a doctor of chiropractic, under current law, is a portal of entry provider who performs exams to determine the propriety of a regimen of chiropractic care or to form a basis for referral of patients to other health care professionals, or both. Nothing in SB 1048 SE affects this status or standing since SB 1048 SE only affects Title 20, the insurance laws. The above-listed statute is in Title 32, professions and occupations. SB 1048 SE cannot and does not make chiropractors PCPs. Did the insurance company lobbyists tell you these laws are in two different titles? This argument is a diversionary tactic to distract you from the real issue at hand: health care freedom of choice.
Position Paper Two: Let's now address the impact of SB 1048 SE on health insurance premiums. First we must establish some rules. We ask that the Committee rely only on data from peer-reviewed research studies published in journals indexed by the National Library of Medicine, a branch of the U.S. Government. We ask that the Committee not rely upon data either from chiropractic organizations or from insurance companies that has not been independently peer-reviewed, verified and published.
The scientific peer-reviewed indexed literature is clear. In 2004, the Archives of Internal Medicine, a journal published by the American Medical Association and not by chiropractors, released a UCLA study of almost two million health plan participants. They found that when chiropractic was added to a health plan, there was a reduction in hospitalizations, surgeries, MRIs and x-rays. This led to an overall decrease in cost of 25% per episode of low back pain, the most common condition treated by chiropractors, and a condition almost as common as the common cold itself. Since we back up everything we say, we will supply a copy of the study to any party that requests it. We have supplied this study to the Legislature for the past two sessions, and our opposition has never provided a peer-reviewed published rebuttal study. This is for only one reason - there isn't one.
Here's the point: passage of SB 1048 SE will reduce overall health care costs and health insurance premiums by giving patients an option that involves a much lower technology, non-surgical, outpatient approach that has been proven to be both clinically effective and cost effective. The only parties that will be harmed are those who wish to have a monopoly in the health care marketplace and exclude the competition, the doctor of chiropractic. Please vote yes on SB 1048 SE and give your constituents some freedom of choice in health care. They don't always want to be forced to take pain pills when simple and safe chiropractic adjustments will often do the job.
Position Paper Three: Is SB 1048 SE a "mandate"? In some ways yes, in other ways no.
SB 1048 SE is only a mandate if you consider every law you pass to be a mandate. The truth is, of course, that every law you pass is a mandate. You are mandating, or requiring, someone to do something. That is a mandate. For that matter, every one of the 2500 insurance laws in ARS Title 20 is a mandate. So yes, in this way, SB 1048 SE is a mandate.
This bill is not, however, a mandated benefit such as the autism bill. It does not require insurers to cover any condition such as autism that they do not already cover. Every prospective chiropractic patient is already in the medical/surgical system receiving full treatment at the present time in the form of physical therapy, medications (anti-inflammatory drugs, opiates, muscle relaxants), injections, surgery, etc. Insurance companies are already spending all of the money today on treatment that they will ever have to spend. In fact, research sent to you yesterday proves that when patients choose chiropractic the costs will go down!
Position Paper Four: Where do we stand on monopolies in the marketplace in America? Monopolies are illegal. When found, they are broken up by state and federal governments.
Twenty years ago, Ma Bell (AT&T) was judged to be monopoly. The Federal Government broke the company into a number of competitive parts to protect consumers. Prices were lowered. The marketplace was repaired.
Guess what? The same happened in the late 1980s with the American Medical Association. The AMA was ordered by a Federal Court to stop trying to destroy its competition in violation of the Federal Sherman Antitrust Law. The specific competition named in the 1987 Permanent Injunction Order was the chiropractic profession. The full Order is attached for your review since, as usual, we always back up everything we say.
The AMA was convicted of having engaged in a decades old "illegal boycott and conspiracy to contain and eliminate the chiropractic profession" merely because it was an economic competitor. The AMA was ordered to never again repeat such conduct. The US Supreme Court refused to overturn this ruling in the early 1990s. It stands today.
Of particular interest to SB 1048 SE is this fact: the court case revealed that the AMA persuaded the insurance industry and particularly Blue Cross Blue Shield plans not to cover chiropractic as part of the AMA's effort to destroy its competition. Read the attached short memo from the FTC in 1979 which was an exhibit in court. Over the twenty years I have been fighting for insurance equality at the Legislature, BCBS has always been the greatest offender. They are leading the charge against SB 1048 SE. Their copayments and deductibles for chiropractic are higher than any other insurance company in Arizona. A coincidence? Considering the history, I think not.
Please also review the memo from the Arizona Medical Association about its attendance at a national AMA meeting in 2006. Near the end it states the ArMA Delegation to the AMA extends "its appreciation to BC/BS of Arizona for its support, and, in particular, to Dr. "Redacted", its Senior Vice President, Medical Affairs, and Chief Medical Officer, as well as extend our congratulations to U of A medical student, Kendall Allred, who was, during this meeting, was elected Vice Chair of AMA-MSS." The close, special and unique relationship between the medical profession and BCBS clearly continues. We do not see this same relationship with other insurance companies.
Medical doctors are trained in allopathic medicine and surgery. They are trained to believe that when people are ill, the best solutions are drugs and surgery. They are not trained to believe that chiropractic adjustments, physiotherapy, rehabilitation, proper nutrition, exercise therapy, and other such natural methods, are useful or effective. When MDs control insurance plans, as they do today, they steer patients towards drugs and surgery by setting copays and deductibles lower for drugs and surgeries and higher for all other treatments. If you believe insurance companies should be able to direct care, and that MDs should have a monopoly in the health care marketplace, vote no on SB 1048 SE. If you believe patients should be able to choose the type of care they want and the type of licensed health care provider they see, vote yes on SB 1048 SE. If you believe in Health Care Freedom of Choice, vote yes on SB 1048 SE. This is an antitrust and monopoly issue at its root.
Position Paper Five: Please read the following short Cato Institute position paper. It explains that free markets in the medical system that include all licensed health care providers reduce costs. SB 1048 SE, an antitrust, anti-monopoly bill, will increase participation by Chiropractors and therefore reduce costs following the logic of this position paper.
Cato Policy Analysis No. 246
December 15, 1995
The Medical Monopoly:
Protecting Consumers Or Limiting Competition?
by Sue A. Blevins, a writer and health policy consultant based in Boston.

Executive Summary
Nonphysician providers of medical care are in high demand in the United States. But licensure laws and federal regulations limit their scope of practice and restrict access to their services. The result has almost inevitably been less choice and higher prices for consumers.
Safety and consumer protection issues are often cited as reasons for restricting nonphysician services. But the restrictions appear not to be based on empirical findings. Studies have repeatedly shown that qualified nonphysician providers--such as midwives, nurses, and chiropractors--can perform many health and medical services traditionally performed by physicians--with comparable health outcomes, lower costs, and high patient satisfaction.
Licensure laws appear to be designed to limit the supply of health care providers and restrict competition to physicians from nonphysician practitioners. The primary result is an increase in physician fees and income that drives up health care costs.
At a time government is trying to cut health spending and improve access to health care, it is imperative to examine critically the extent to which government policies are responsible for rising health costs and the unavailability of health services. Eliminating the roadblocks to competition among health care providers could improve access to health services, lower health costs, and reduce government spending. |
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One Doctor Speaks Out About Those Who Will Not Help Out Their Own Practice and Profession by Joining a State Association
by Ken Krieger, D.C.
I had to send this and let the profession know I'm so frustrated with these doctors who won't help out their own profession . . . I believe, what you will read does say it all! I was MAD when I wrote this, and that's why the language was used the way it was . . . sorry.
Dear Dr. Anonymous: You need to get your ASS in gear, and give support for those that make it possible for YOU to have a great living with chiropractic. I believe that's all that needs to be said. The ball is in your court. When you come to me whining about insurance, and deductibles, and "they aren't covering this, or that", I'll blow you off because you wouldn't partake in doing this LITTLE thing to help YOUR profession by joining. You can part with the LITTLE to receive a lot in the long run. I'M DONE!
One more thing.....send this to your sniveling brother who is so full of fear that he won't part with a few measly dollars to help his own practice out, and just go out and spend, spend , spend on horses, and trucks and all the bulls**t of life and not even lift a finger to help his profession out. That truly tells me all I need to know about what controls his life! He's money hungry, and could care less about the public who needs chiropractic, and will reap his just reward someday! He'll be the first in line to ask the question . . ."well, what the hell did our chiropractic organizations do for us, they just left us hanging out to dry!" I'll laugh when I hear that out of him! He has his chance right NOW to do what is needed for HIS profession that affords him ALL he has . . . to go out & spend money for, not only his pleasure, but to provide for his family. It's time for HIM to s**t or get off the pot, the ungrateful p***k!
I wonder where someone's priorities in life are. Chiropractic affords them a GREAT living, yet when they don't get on board, I believe they take it totally for granted. "Oh, someone else will do it for me!" I was ALWAYS a "giver" to the profession that I loved so much...and you know what that did for me? It helped make me successful, and VERY appreciative! I thank you for all your efforts........you are a stalwart for the profession.
Regards....Ken
The Arizona Chiropractic Society is your statewide non-profit chiropractic association. Join today and help us help you. DO NOT BE A NON-MEMBER OF ACS. ACS is fighting for the copay/deductible bill. Now is the time to get off the sidelines. If not now, when? Act today! Go to www.AZChiropractors.org for a membership application. |
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ACS Adds Special
NEW MEMBER BENEFITS
ACS has a list of "Special Treasures," publications that have been assembled and that are available on request only to ACS Members by email. This list is constantly being updated so check back regularly! The following is a list of the ACS Special Treasures:
1. Personalized advice on how to collect from insurance companies after all of your usual methods have been tried and failed.
2. Arizona Chiropractic Board of Examiners monthly minutes
3. Dr. Preston Long rebuttal package: Dr. Long is one of the most active defense IME DCs in Arizona. The ACS rebuttal package contains scores of references to journal articles, guidelines from various nations in the world regarding chiropractic, an analysis of the safety of chiropractic, information from the Chiropractic Board regarding Dr. Long and excerpts from Dr. Long's past depositions. If you want to win a battle with Dr. Long, this is the package you need.
4. Timely Payment of Claims, Adjudication and Adjustments: Complete instructions for exactly what to do when insurers do not pay in a timely manner.
5. Record Keeping as Mandated by the Chiropractic Board: ACS has nailed down the most accurate information in Arizona regarding what is required by the Board in terms of record keeping. This includes a sample daily progress note that was approved by the Board's auditor after a chiropractor was disciplined, educated in the Board-approved record keeping class, and audited by the Board-approved auditor.
6. Medical Records Protocol: All chiropractors are required by law to have a proper Medical Records Protocol on file in their offices. ACS retained an expert health care law specialist in 2006 to draft its Protocol which is available to members.
7. Health Care Appeals Process: THE system to follow in Arizona to get medical necessity denials overturned. ACS explains the complicated steps in easy terms so that you can use the program today in your office to increase collections.
8. Grievance Letters: These formal and legal letters are simply the best way to get an insurers' focused attention and to get your bills paid. ACS explains the entire Grievance process and shows you how to incorporate it into your practice.
9. Complete instructions for what to do when an insurer states that your fees are above the usual and customary fee schedule for your area.
10. Complete instructions for how to file a wide variety of complaints against any type of insurance company.
11. Personalized advice regarding whether you should join managed care networks including BCBS PPO, ACN, ASHN and many others. Each practice has its own needs, and ACS can help you determine what will work best in your office.
NEW: 12. Key ERISA self-funded plan tools. When your patient works for a company with more than 500 employees, the health plan is almost always self-insured and exempt from state regulation. Find out how to appeal claims denials from the Arizona Department of Insurance and the U.S. Department of Labor. Learn how you can force ERISA plans to tell you exactly what you need to tell them to get them to pay claims.
NEW: 13, Small Claims and Justice Court Lawsuit Instructions: Some offices have found that filing lawsuits on behalf of patients is an inexpensive an easy way to get your case in front of an impartial judge who will usually rule against an insurance company. Knowing this, almost all insurers will settle when sued according to some doctors. ACS has complete instructions.
NEW: 14. How to Search the National Library of Medicine: The Arizona Chiropractic Board requires that your practice methods be based on peer-reviewed and indexed scientific journal studies. ACS now provides complete instructions for how to access such studies on the Internet by searching the National Library of Medicine. Then, ACS provides a recommendation for a specific medical library to order studies from which is quick, reliable and inexpensive.
NEW: 15. Referrals to ACS' choice of an excellent attorney to represent Chiropractors before the Arizona Chiropractic Board. ACS has referred dozens of doctors over a period of many years to this attorney, and has only received very positive feedback. This attorney does not advertise to the profession. He does not need to. ACS receives no remuneration or any type of gain for these referrals, other than the satisfaction of knowing that the doctors are receiving fine legal attention.
16. Much more to come! Membership is very valuable! Join today by going to www.AZChiropractors.org and filling out an application. We will email you the above-listed documents very quickly! You can transform your practice almost overnight. |
Important Notices
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