|SB 1048 SE Dead as Chiropractic Copay Bill -- ACS Searching for Other Vehicle|
SB 1048 SE is now dead as the chiropractic copay bill. There is no need for further calls to House NRPS Committee members, or to come to the meeting on April 9, 2008. This is because we were unable to get enough committee members to commit to vote yes before the deadline for posting the agenda for the committee. It is also because the Governor just vetoed Senator Gray's partial birth abortion ban bill. To save the lives of nearly born fetuses, Senator Gray has no choice but to use SB 1048 to amend on a different version of the partial birth abortion ban bill which she has good reason to believe the Governor will sign. There is not a single chiropractor who cannot understand her feeling that a ban on the killing of nearly born fetuses is more important than the copay bill. This is obviously a no-brainer as far as priorities.
This does not mean we are giving up for 2008. Far from it. Far, far from it. This session will not adjourn until the end of June. Between now and then, there will be many bills moving through the process. It will be possible for us to attach our copay language to at least one of these bills. There will not be much advance notice. Stay tuned for urgent notices of legislative action alerts. In the interim, find your own legislators by going to www.azleg.gov and clicking on How do I find my legislator. Follow the directions and identify your two state representatives and one state senator (not U.S.). Regularly send them emails and make calls explaining how important the copay/deductible is to you, and how you want them to find some way this session to get it passed, even if they have to amend it onto another bill creatively. Tell them you want them to work with Debra Brimhall Pearson NOW to solve this problem. Be adamant. Be insistent. Be persistent. And call and email every few days. That's what the forty insurance company lobbyists do - bombard and barrage them. We must do the same if we are to win. We are 2.5 months from the finish line. Keep on truckin'!
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!|
3515 E. Carol Avenue
Phoenix, AZ 85028
|Dear Arizona Chiropractor and other interested party,|
This is a special mid-month update from ACS. 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.
Alan M. Immerman, D.C.
President & Executive Director
Rep. Anderson Confronts BCBS -- Testimony and Policy on PPO Participation Conflicted
State Rep. Mark Anderson, a candidate for U.S. Congress for CD 5, has challenged BCBS in a letter regarding the contradiction between the testimony of a BCBS lobbyist and the policy of BCBS as expressed in letters to some Arizona chiropractors. In testimony before the Senate Health Committee on 01/31/08, Charles Bassett, a lobbyist for BCBS, stated that BCBS "was opening up its PPO network to any chiropractor who could pass credentialing." This was said even though Mr. Bassett had previously been supplied with copies of letters from BCBS regarding up to four chiropractors stating that they had been denied admittance to the network only because it was "adequate" with no mention of any problem with credentialing. The BCBS "no-join" letters supplied to Mr. Bassett well in advance of the hearing are posted http://azchiropractors.org/legislative.html
. It is unlawful to knowingly provide false testimony to the Legislature.
Following the hearing, Dr. Immerman, ACS President, sent an email to certain legislators asking for an investigation of this matter. Rep. Anderson was the only one to take action. You will find a copy of his letter, the BCBS response, and the Bassett testimony http://azchiropractors.org/legislative.html. After reading this material, you will not be surprised to learn that Rep. Anderson has been the ACS Legislator of the Year many times because of his dedication to the Chiropractic cause, nor that ACS has endorsed Rep. Anderson for U.S. Congress in the primary for CD 5. Please send Mark a thank you to email@example.com.
|ACS and Senator Gray Negotiating Limits on Copayments Relative to Overall Payment|
One possible way to solve the copayment problem is to do what the New Jersey Department of Insurance has done. A new regulation limits copayments to no more than 50% of the payable amount. If, for example, the insurance company allows $50 for a service, the copayment could not exceed $25. Higher copayments, according to the NJ Insurance Department, lead to an "illusory" benefit where policyholders pay premiums but get no benefit whatsoever.
Beginnng today, April 8, 2008, Senator Linda Gray has begun to negotiate a percentage cap on copayments to form a basis for an amendment to be passed this year. ACS brought this idea to Sen. Gray. You can review the entire NJ regulation at www.state.nj.us/dobi/proposed/prn08_16.pdf. ACS will keep you abreast of all developments as usual.
Arizona Chiropractor files class action suit against United HealthCare, Ingenix, American Express, AT&T, Citigroup, Delta Air, Citigroup, Delta Air, Discount Tire, GM, Home Depot, IBM, MetLife, Proctor & Gamble, Qwest, Revlon, Southwest Airlines, Wells Fargo Banks, and others for denial of needed care and improper payments
Arizona chiropractor Dr. Thomas Blankenbaker, operating as Spinedex Physical Therapy, has filed a class action ERISA lawsuit against United HealthCare, Ingenix, Inc. and scores of the largest self-insured employers in Arizona. The lawsuit alleges failure to pay for medically necessary decompression VAX-D services, and paying out of network rates at fraudulently low levels.
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.
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.
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.