BCBS of AZ has responded to the ACS complaint regarding discriminatory copayments for chiropractic care with a full denial that any state law has been violated. ADOI has agreed with this decision and closed the complaint as of 7/29/08. Therefore, ACS will soon file for an Administrative Hearing at ADOI. At the Hearing, ACS will ask the judge to order ADOI to properly interpret and enforce the ACS insurance equality law, ARS 20-461(B). ACS' attorneys believe this will result in an order leading to significantly lower copayments, coinsurance and deductibles for chiropractic care. If ACS is not successful at the Administrative Hearing level, ACS is prepared to take this matter to Superior Court and beyond. The full statements from BCBS and ADOI are available to ACS members upon email request.

Included in the response from BCBS is a letter written from a BCBS lobbyist to a legislator in November 2007. This letter admitted that many chiropractic patients curtailed care after copays and deductibles dramatically increased, but then made the remarkable and wild claim that this proved the care was "not medically necessary" and was only "feel-good" care. The BCBS lobbyist wrote that if patients' pain was real then they would have found some way to continue care. 

The time for fruitless meetings and negotiations as planned by others is clearly over. Also, there is no need to pass a new law since ADOI has confirmed that the existing 1990 ACS insurance equality law prohibits current discrimination. Only legal action will result in proper interpretation and enforcement of the law. Only ACS is planning legal action to resolve this problem.

At the request of ACS, Senators Rebecca Rios and Linda Gray have sent a letter to Arizona Attorney General Terry Goddard asking that he enforce the chiropractic insurance equality law. There has been no response yet from his office. The letter is posted at www.AZChiropractors.org.

Our sponsors are very special to ACS. They help make it possible to bring our written and electronic information to you. They help pay for the ink and postage! Won't you please consider them when you need a service or product? We obviously wouldn't do business with them if we didn't think they were good folks. Please be sure to give them a look. They are supporting your profession and deserve your gratitude for that.

ACS Joins Class Action ERISA Lawsuit Against United Healthcare and Ingenix

Don't miss breaking news -- sign up for the free monthly ACS e-newsletter at www.AZChiropractors.org, and check the frequently updated website regularly. Go to the homepage at the upper left corner, enter your email address, and strike enter. Then you will be in the loop.

Also, ACS posts Arizona Chiropractic Board meeting minutes on the ACS Chiro Board webpage for all to see. Now you can finally learn what the Board is doing every month at its meetings. ACS wants the profession to see exactly how the Board is (mis)behaving.

ACS Accomplishments

ACS advocacy has resulted in Rep. Mark Anderson, candidate for U.S. Congress in CD5, requesting a Special Formal Audit of the Arizona Chiropractic Board so that all dirty laundry will finally be aired. Mark has been ACS Legislator of the Year many times of his 14 year career at the Capitol.

ACS brought the issue of discriminatory copays and deductibles to the Arizona Legislature. Without ACS, there would have been no legislative effort to halt the discrimination. Also, ACS is the only organization planning legal action against ADOI to enforce existing insurance equality law.

ACS has confronted the Chiropractic Board over its gross mistreatment of state chiropractors. As a direct result, the Board has cleaned up some of its most egregious excesses. ACS joined in the successful 2007 Dr. Pratt lawsuit against the Board which led a judge to throw out almost all of the Board's discipline, and taught the Board a lesson well deserved about the consequences of unbridled power.

ACS passed a law in 2006 banning Chiropractic Board members from continuing to perform IMEs and claims reviews for insurance companies.

Because of ACS' intervention, 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.

ACS has a full-time veteran licensed DC at your service to answer all of your questions on any chiropractic issue. There is no claims denial problem we cannot address based on 28 years of experience in Arizona.

New Guaranteed-Issue Health Insurance Plan for Members

In a first for any state chiropractic association in Arizona history, ACS has signed an agreement to provide an association-based health insurance plan to member chiropractic businesses. This is a guaranteed-issue plan which means that, other than a 90 day waiting period, all employees will be able to be insured. Businesses with one or more employees are eligible. The insurer is the very high quality carrier CIGNA of Arizona. High deductible HSA plans are available, along with choice of PPO or HMO plans. Options are available in all areas of Arizona.

Here is the difference between a guaranteed-issue plan and one subject to medical underwriting. For almost all chiropractors, when they try to buy health insurance, both they and their employees and family members must go through medical underwriting. All pre-existing conditions will be excluded. This is in contrast to going to work for a large employer like Honeywell where you join a group plan that does no underwriting and covers all of your pre-existing conditions.

The ACS Small Business Health Insurance Plan is a guaranteed-issue plan which means no medical underwriting. After a 90 day waiting period, all employees and family members can get coverage for all pre-existing conditions. Prior to now, this has been almost unheard of in Arizona. ACS has literally discovered a "gold mine" for members.

This is the best small business health insurance plan in Arizona, available at a discount to ACS members. A special email will be sent to ACS members advising how to enroll. If you need quality health insurance and are not a member, join today. For more information, call or email ACS.

FREE 3 CE HOUR PROGRAM:
"The ABC's of Lumbar Spine MRI"

On August 28, 2008, Dr. Terry R. Yochum, world-renowned chiropractic radiologist consultant, will be providing an informative lecture "The ABC's of Lumbar Spine MRI." This free lecture is approved for three hours of Arizona CE credit. Location is the Doubletree Paradise Valley Resort, 5401 N. Scottsdale Rd., Scottsdale. Time: 7-10 PM. Seating is limited and pre-registration is required by either calling or emailing Shannon Barrow at SBarrow@eSMIL.com or 480.425.4146.

Dr. Yochum is brought to you by Scottsdale Medical Imaging Ltd. (SMIL), a premier provider of imaging services in the valley with ten locations, and a new sponsor of ACS and its newsletter. Dr. Yochum will be writing a "Chiropractic Correlation Report", when requested, on patients referred to SMIL for an MRI, as a compliment to SMIL's usual detailed radiology report.

In 2004, United HealthCare (UHC) asked the Arizona Legislature to enact a new law to greatly facilitate its ability to review and cut chiropractic claims. UHC felt that the chiropractic insurance equality law passed by ACS in 1990-1991, ARS 20-461(A) 17 and B, stood in its way. At a critical juncture, AAC lobbyist Barry Aarons stated the AAC's opposed position was neutral, thus causing the bill to pass.

The law UHC wanted changed required that utilization review be applied equally to MDs, DOs and DCs. UHC wanted to single out DCs but could not under the extremely well crafted ACS law. Therefore, in 2004, UHC persuaded legislators to introduce SB 1094 Unfair Claims; Medical Necessity Review. (See http://www.azleg.gov/, click Change Sessions, go to 2004, Bills, SB 1094.)

Both ACS and AAC immediately joined in denouncing this legislation. Both knew that intense UHC utilization review would result in significant problems with payments as chiropractors were singled out for "special" attention. Both groups instructed their lobbyists to adamantly oppose this legislation.

On 02/09/04 Wayne Bennett, DC, then co-chair of the AAC Public Policy Committee, told members in an email they should say the following to legislators: "The passage of this legislation would facilitate discrimination against chiropractic services and a reduction of care for our patients . . .  The Arizona Department of Insurance concurs with that observation!" ACS sent many of the same alerts to its members.

In a complete surprise to both ACS and AAC, Activator Methods International testified in favor of the bill at the Senate Health committee hearing on 02/12/04. AMI is controlled by Dr. Arlan Fuhr, a former AAC leader and current leading supporter. An Activator attorney told legislators AMI supported SB 1094 and that it had 800 members in Arizona. Both ACS (then ICP) lobbyist Debra Brimhall and AAC lobbyist Barry Aarons testified in opposition. The 02/12/04 minutes can be found at http://www.azleg.gov/FormatDocument.asp?inDoc=/legtext/46leg/2R/comm_min/Senate/021204+HEA%2EDOC.htm. Dr.  Fuhr has been asked repeatedly why he supported the UHC legislation when the leaders of AAC and ACS were strenuously opposed. He has never responded.

AAC lobbyist Aarons began to help United HealthCare and AMI, and not the AAC and the chiropractic profession, after SB 1094 passed the Senate Health Committee and headed to the full Senate for a vote. Here is the evidence.

Sen. Barbara Leff voted against SB 1094 in the Senate Health Committee on 02/12/04 after she heard testimony against the bill from the ACS and AAC lobbyists. But when the bill came up for a vote by the full Senate on 03/02/04, Sen. Leff voted yes. Here is her explanation for why she changed her vote.

In a 03/09/04 email, Sen. Leff wrote: "I voted against the UHC Bill in committee but by the time it got to the Floor and was amended, the Chiropractic Association (AAC) no longer opposed it."  She has said Mr. Aarons told her the AAC was neutral, not opposed.

Sen. Carolyn Allen, the Chair of the Senate Health Committee and the prime sponsor of the bill, made a floor speech on 03/02/04. She stated that the AAC was no longer opposed to the bill based on what she was told shortly beforehand by Barry Aarons. She then voted yes on that basis.

On 06/17/04, then-Sen. Mark Anderson confirmed that Sen. Allen had stated to the full Senate that Mr. Aarons was the source of information regarding the AAC's supposedly new neutral position on SB 1094. Also on 06/17/04, then-Rep. Karen Johnson, Chair of the House Rules Committee, confirmed that Mr. Aarons had told her the AAC was neutral on SB 1094, and so she did not need to continue to hold the companion bill in her committee. Holding the bill had the effect of killing the measure prior to this time. Following Mr. Aarons' information about the new AAC position, Rep. Johnson released the bill from committee over the objections of ACS, thereby permitting it to pass into law.

According to these four legislators, Mr. Aarons' position on SB 1094 shifted from one of total opposition to neutrality. At the same time, however, the position of Mr. Aarons' client, the AAC, did not change at all. In an 11/03/04 email, Wayne Bennett, DC stated: "I was the Co-Chairman of the AAC Public Policy Committee during the last year when the 1094 battle was being fought. I was on the Public Policy committee for several years prior to that time, and was involved in the long, drawn out battle on this issue from its ugly beginning. I was personally present at most of the meetings involving 1094, including those with Barb Leff. I can tell you without any uncertainty that the AAC was never, at any point in time, from beginning to end, EVER, neutral on 1094. You can check this out for yourself. If you look at the records of every committee meeting in the House and Senate where this issue was debated (from beginning to end) you will see that the AAC is ON RECORD as having opposed the bill."

Mr. Aarons denied he told any legislator the AAC had changed position to neutral on SB 1094. On 03/12/04, ACS was told in an email from the AAC that "Barry assures me that his message is and has been the message that we crafted, drafted, and reaffirmed as I passed on to you. He says that he has never told any legislative entity that the AAC is "neutral" on the bill. I believe him."

The integrity of the four sitting legislators named as sources for this report is beyond question. There is no doubt that Sen. Leff told the truth when she wrote the AAC (through its lobbyist) advised it no longer opposed SB 1094. Sen. Allen is one of the most highly esteemed legislators in Arizona. She sponsored the AAC's AHCCCS bill two years ago and the ACS Chiropractic Board bill this year. No one doubts her word when she stands up in the Senate and says a certain lobbyist, in this case Mr. Aarons, informed her that his client, the AAC, is neutral on her bill. One's word is everything at the Capitol. Then there is Sen. Johnson, retiring this year after 12 years, and Rep. Anderson, retiring after 14 years to run for the U.S. Congress. All four stated, one in writing, that Barry Aarons said "it is fine to vote yes on SB 1094, go right ahead, AAC does not object." Two no votes changed to yes in the Senate as a direct result, and this provided the margin of victory. The bill then passed into law. The will of both ACS and AAC was defeated.

Mr. Aarons served for some period of time, and possibly during the legislative session of 2004, as a member of the Activator Methods Business Advisory Panel. AMI joined with UHC to support SB 1094 against the opposition of both ACS and AAC. Also, Mr. Aarons was in the lobbyist business with former registered lobbyist Judi Hamilton, now married to Dr. Fuhr. These connections may help explain, but never justify or excuse, Mr. Aarons' and Dr. Fuhr's joint effort to help UHC.
    
Arizona chiropractors have been slammed in the pocketbook following passage of the 2004 law. Every DC has to struggle to get paid by UHC and all other insurers now that chiropractic can be legally singled out for utilization review. This was illegal prior to 2004. The landmark ACS chiropractic insurance equality law prohibited such discrimination. ACS and AAC had the bill stopped before Mr. Aarons gave legislators the green light to cause it to pass. Arlan Fuhr and AMI had already provided great encouragement for passage. This is intolerable and so the truth must be known, especially since obstructionist and uncooperative behavior has been Mr. Aaron's modus operandi ever since. Mr. Aarons is still the lobbyist for the AAC but has yet to explain why he helped UHC in 2004 achieve its goal of weakening chiropractic insurance equality law in Arizona. ACS finds no reason to trust this behavior will not be repeated in the future. This is one key reason why ACS must maintain a strong presence at the Legislature.

The California Court of Appeals has excluded testimony by an insurance company expert who concluded there was not enough force in an automobile accident to cause the injuries diagnosed by the patient's doctor after the trauma. This is a landmark case since it was decided in an appellate court and may serve as a precedent in California. The case is Harrison v. Smith, A114436, First Appellate District, Division Five, California Court of Appeals. ACS has posted the case on its webpage on the MedicoLegal News page. Dr. Immerman has qualified as an expert in clinical biomechanics and accident reconstruction more than 40 times in Arizona Superior Court as a rebuttal witness to defense experts. For more information, contact ACS.

Get New Patients by Joining ACS

Chiropractor's License Revoked for Fracturing Ribs But X-Rays Show No Rib Fractures - Appeal Alleges Board Vendetta

In another story stranger than fiction, the Arizona Chiropractic Board has revoked the license of a chiropractor for fracturing the ribs of a patient when the actual x-rays do not show any fractures. The chiropractor has filed for a rehearing of his case. His attorney has made many allegations including a personal vendetta against him by the Board, in particular Dr. Steve Baker.

The motion for rehearing is posted on the ACS webpage for you to read in its entirety. It would be almost comical if it were not true and if the entire livelihood of a licensed physician was not hanging in the balance. Read and weep about the ongoing conduct of your Chiropractic Board. Stay tuned for another legal entity to independently take a look at a Board action and likely throw it out, just as occurred last year in the Dr. Paul Pratt matter, also posted on the ACS webpage. This Board continues to operate with the complete blessing of the AAC which just ran a notice in its journal congratulating AAC member Dr. Dianne Haydon for her second five year appointment to the Board. In sharp contrast, ACS has asked the Governor to remove Dr. Haydon from her post.

Chiropractors' Most Valuable Untapped New Patient Source

ACS New Member Benefits Package

ACS has a list of member benefits which we call the "Special Treasures" They are documents created by ACS just for Arizona chiropractors to address issues that arise in everyday practice. They are the answers to the most common problems faced in your office. The following is a current list:

1. Personalized advice on how to collect from insurance companies and attorneys after all of your usual methods have been tried and failed.

2. Dr. Preston Long rebuttal package, plus help with rebutting any unfair IME report.

3. Timely Payment of Claims, Adjudication and Adjustments: Complete instructions for exactly what to do when insurers do not pay in a timely manner.

4. 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.

5. Medical Records Protocol: All chiropractors are required by law to have a proper Medical Records Protocol on file in their offices.

6. 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.

7. 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.

8. Complete instructions for what to do when an insurer states that your fees are above the usual and customary fee schedule for your area.

9. Complete instructions for how to file a wide variety of complaints against any type of insurance company.
10. Personalized advice regarding whether you should join managed care networks including BCBS PPO, ACN, ASHN and many others.
 
11. Key ERISA self-funded plan tools.

12. 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.

13. How to Search the National Library of Medicine.

14. Referrals to ACS' choice of an excellent attorney to represent Chiropractors before the Arizona Chiropractic Board.

15. 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.