ACS is in the final stages of selecting an attorney who will ask an Administrative Hearing Judge at ADOI to order proper interpretation and enforcement of the chiropractic insurance equality law, ARS 20-461(B).

ACS has been trying to gain proper enforcement for years with litigation and legislation, but has been hampered by lack of sufficient resources and lack of unity in the profession. Finally, ACS has sufficient resources to move forward. An expert in insurance law has analyzed the entire matter and concluded that existing law prohibits the current high copayments, coinsurance and deductibles for chiropractic care. Therefore, ACS is moving forward as quickly as possible. Members receive detailed updates via email.

In other news, ACS has posted a 10 page letter from Charles Bassett, VP of Government Relations of BCBS, dated November 2007, and sent only to House Health Committee Chairman Bob Stump. This letter was disclosed to ADOI a few weeks ago in response to a complaint filed against BCBS by Dr. Immerman. It makes wild and remarkable statements which have not been seen in writing since pre-Wilk v. AMA days. The Federal Court ruled in this lawsuit that the AMA and health insurers like some BCBS plans had conspired to "contain and eliminate" the chiropractic profession in violation of federal Sherman antitrust laws.

Mr. Bassett admitted that chiropractic patients curtailed care after BCBS raised copays and deductibles. Then he claimed this proved the care was not medically necessary, and that if people really needed the care then they would have found a way to pay for it. He characterized all chiropractic as only "feel-good" care that insurers should not be "mandated" to cover. He noted the existence of peer-reviewed indexed scientific journal articles on chiropractic but then wrote that BCBS does not pay any attention to such studies and only relies on its internal "data" which, of course, it will not release for independent analysis. The entire Bassett letter is posted at www.AZChiropractors.org.

A few days after ACS received a copy of the Bassett letter, the Kaiser Family Foundation and researchers from the University of Chicago and Georgetown University, published a study in August 2008: "The Medicare Part D Coverage Gap: Costs and Consequences in 2007." According to the AP 08/21/08, "Many people in Medicare with diabetes, high blood pressure and other chronic conditions stop taking their medicine when faced with picking up the entire cost of their prescriptions, researchers say." See http://www.kff.org/medicare/upload/7811.pdf. Of course, Mr. Bassett has written that BCBS does not rely on independent scientific studies and so there would probably be no interest there for these research findings. But this study proves that patients with serious medical problems stop treatment when they cannot afford their medication.

The chiropractic care not received because of exorbitant BCBS copays and deductibles was medically necessary. Mr. Bassett was sorely mistaken. Scores of real people have suffered. ACS is exploring legal means to hold BCBS accountable.

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 Offers Best Practices Document to Profession for Comment

Frequency and duration care guidelines very reasonable

by Karen R Jacobson, DC
AZ/ICA Assembly Representative

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 requesting a Special Formal Audit of the Arizona Chiropractic Board to detail what Judge Miller, in the case of Dr. Pratt, called "excessive, arbitrary and capricious' discipline. ACS has alleged such Board misconduct is widespread.

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 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 are allowed to do more than just a few passive modalities. 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.

High Quality Health Insurance for All Pre-Existing Conditions for ACS Members, Their Families and Employees

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 and family members 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 has been sent to ACS members advising how to enroll. If you need quality health insurance and are not a member, join today.

You can now get new patients by joining ACS since we have launched our popular online Find-A-Doc search engine for members. The ACS webpage appears high on the list when Internet searches are performed for Arizona chiropractors or chiropractic. To join ACS and be listed on this highly valuable referral search engine, go to www.AZChiropractors.org and complete an application. ACS is ready to help you today!

Attention members: If you have not yet done so, send ACS a note stating that you would like to be listed on the Find-A-Doc search engine. Don't miss out on this valuable new patient opportunity.

            
Since 1997, I have testified as an expert witness in 53 trials in Superior Court, primarily in Maricopa County. I have also had my deposition taken as an expert witness on 35 occasions, and testified in 14 arbitrations. I must keep a current list of all cases in which I have testified in order to qualify as an expert in federal court, thus I know the actual numbers. Courts have qualified me as an expert witness in the areas of chiropractic care, clinical biomechanics, injury causation and accident reconstruction.

In total, there have been 102 cases in ten years involving actual live testimony. In addition, I have been retained to write rebuttal reports in hundreds of cases that have not gone to trial. I am typically asked to analyze the opinions of defense biomechanical engineers and accident reconstructionists who argue there was not enough force to cause the injuries diagnosed by the doctors. I am also asked to review IME reports by defense orthopedic surgeons, chiropractors and other medical experts. I base all of my opinions on the most up-to-date peer-reviewed scientific literature.

I can help you because of this experience. Many doctors have questions about personal injury cases but they do not know who to turn to for answers. With my Arizona specific experience over the past ten years, there is not much I have not seen. I have been cross-examined by every major insurance company lawyer in this state multiple times. I have worked for some of the smartest lawyers around and learned a lot from them.

Typical questions include: What is the right way to examine a PI patient? How should you document your cases? What is a reasonable program of care? How can you defend your care in court with scientific evidence and guidelines? How should you handle yourself in deposition and court? How do you predict permanent impairment and need for future care?

I have the answers to these questions, not based on just books and seminars, but also based on actual experience in the trenches in Arizona. I do not know of any other chiropractor who has had close to the amount of live testimony experience that I have had in the past 10 years. Also toss in 20 years of hands-on clinical practice caring for PI patients.

Up to now, my expertise in PI has been known only to ACS members. The ACS webpage has a section on MedicoLegal News which posts a number of newsletters I have written which were sent to hundreds of attorneys. I have dozens more on my computer. I also have scanned copies of the journal articles needed to accompany your reports and make them scientific and valid.

 Now it's time to take this information to the next level. If you are an ACS member and would like help, email or call with your questions. If you are not a member and would like help, join today.

For 10 years I have been in the middle of a legal shooting war over PI. I have lived through it and, hopefully, learned a thing or too. I'm glad to share what I know. And don't forget about the offer to help create MD-DC relationships that I made in the August newsletter. It's still there too.

Calmness in our Lives - The Lighter Side

We are passing this on to you because it definitely works and we could all use little more calmness in our lives. By following simple advice heard on the Dr. Phil show, you too can find inner peace.

Dr. Phil proclaimed, 'The way to achieve inner peace is to finish all the things you have started and have never finished.' So, I looked around my house to see all the things I started and hadn't finished, and before leaving the house this morning, I finished off a bottle of Merlot, a bottle of Zinfandel, a bottle of Bailey's Irish Cream, a bottle of Kailua, a package of Oreos, the remainder of my old Prozac prescription, the rest of the cheesecake, some Doritos and a box of chocolates. You have no idea how freaking good I feel right now.

NBC Newsman Tim Russert and
The Failure of Modern Cardiology

Veteran NBC newsman Tim Russert probably did not have to die. Modern medical allopathic cardiology failed him. It has, in fact, failed in general. It's time for chiropractors to step in.

The doctors said Mr. Russert had "asymptomatic coronary artery disease, but it was well-controlled with medication and exercise, and he had performed well on a stress test in late April." Every thinking person can see that the disease was obviously not well-controlled with the medication and exercise, and that passing a stress test was no guarantee of being free of risk of heart attack in the near future. This reflects the complete failure of modern cardiology.

Medical cardiology teaches that it is "normal" to have cholesterol at 200 or below, even though science has proven that 1/3rd of heart attacks occur when cholesterol is between 150 and 200. The so-called "experts" don't have the sense to tell people they must get their levels below 150, not 200, to be heart attack-proof. The government agencies won't make this proclamation broadly and clearly. Why? Because the only way to get cholesterol below 150 is to eat a plant-based diet with no animal foods including dairy. The meat and dairy industries exert enough influence over the government that we will never hear general advice to eat a plant-based diet, even though it is the only way to become heart attack-proof and not follow in Tim Russert's footsteps at the tragic young age of 58. This was, in all likelihood, completely preventable.

Chiropractors have conquered the spine. Now the time has come for us to take on the heart. No one else is out there telling the truth from the scientific literature. The public is dying, literally, as they wait for us to do it. The number one and number three killers in the U.S. are heart disease and strokes, respectively. Clearly, the existing system is an abysmal failure. It's time that chiropractors stepped in.

The U.S. economy can't stand anymore of the same. The cost burden of interventional cardiology has broken the bank. When you wrap the expense of coronary bypass surgery and angioplasty into the price of a Detroit automobile, you make it noncompetitive against the Toyota's of the world.

We must find another way. Fortunately, we have. Scientists have now proven that it is possible to reverse atherosclerosis with lifestyle changes alone. Dean Ornish, M.D., was the first to do pre- and post-angiograms on human beings which proved reversal without drugs. His original research was published in the Journal of the American Medical Association. There are Atherosclerosis Reversal Centers at a number of major academic centers around the country. As a student at the National University of Health Sciences, I wrote a literature review article discussing all of the animal and primate research and human clinical experiences to date. It was published in the March, 1980 issue of the Journal of the American Chiropractic Association and is posted at http://azchiropractors.org/free-reports-and-articles.html.

Atherosclerosis reversal with diet does not work for everyone. Some patients are going to need bypass surgery or angioplasty. But research proves that many of the patients who are scheduled a few weeks out can forego these procedures if they comply with an Ornish-type program for only one month. A chiropractor can administer this program on an out-patient basis. I have been doing it for decades.

A leading surgeon from The Cleveland Clinic recently reported that patients are oftentimes quite angry with their cardiologists for not telling them they could avoid the knife (actually a high speed saw) if they went on a pure plant diet for a month. Imagine their further surprise when they hear the good news from their chiropractor!

As a result of chiropractic intervention, many cardiac patients will be able to avoid surgical intervention. Large self-insured employers who pay for those $100,000 bypass surgeries out of their own bank accounts will have a choice. Do you think they would prefer to spend less than $5000 on a supervised healthy diet program to clean out miles of arteries rather than just a few inches? The answer is a resounding "YES!"

There are no products to buy. The cure is in the produce department of the grocery store. The instructions are found in a $12 book from Amazon called Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure (Paperback) written by Caldwell Esselstyn, M.D. of The Cleveland Clinic in 2007. It is truly as simple as that. You will find all of the references to the modern peer-reviewed scientific literature indexed by the National Library of Medicine. You will find diet plans and recipes. The book is very brief and easy to read. The Ornish books are also excellent and available through any retailer. I will be glad to provide personal direction to any DC who is a member of ACS.

You have always helped the heart by optimizing nerve flow to this precious and vital organ. Now, let's lead chiropractic to another level, that of optimizing blood flow to the heart and addressing America's number one public health calamity and epidemic: Cardiovascular disease.

House Health Committee Chair Bob Stump Received 25 Contributions from BCBS Shortly After Stakeholders Meeting with Chiropractors in 2007

Special New Announcement About
ACS New Member Benefits

ACS members have a unique life in practice among Arizona chiropractors. When they get into a jam, they pick up the phone and get Dr. Immerman on the line. He has been licensed here since 1980 dealing with every challenge faced by chiropractors. He has come up with answers to just about every problem. He is available to members to provide solutions full-time, 9-6 PM, M-F, 50 weeks per year. He also responds to member's emails usually within a few minutes.

ACS gets a lot of questions about collecting from health insurance companies, working with PI attorneys, handling PI cases, testifying, rebutting IME reports, dealing with Chiropractic Board issues, PPO and HMO questions, etc. We invite you ask us any chiropractic-related question.

Recently we have added MD-DC relationship consulting to the mix. We guide members in how to develop relationships with MDs and DOs that result in referrals to DCs, and opportunities for DCs to practice in the same office as the MDs or DOs. We have top notch attorneys to refer you to who know exactly how to set up the legal framework so you don't get in trouble like some have in the past.

Dr.  Immerman in the past 10 years has given testimony 101 times in Arizona personal injury cases.  With these legal appearances combined with writing nearly 1,000 rebuttal reports to IMEs and low speed impact experts, he freely shares what he has learned with members. This includes a vast library of all the up-to-date peer-reviewed journal articles on chiropractic, PI and many other health-related subjects which every forensic expert witness must have to be effective.

ACS members find an active partner in ACS. After all, Dr. Immerman is still licensed and has been for 28 years. He is the only chiropractic association or society leader in Arizona that does not see patients and only works full-time for the profession. He is available 50-60 hours per week by phone and email to members. He is available to help you in any way that he possibly can. That is his primary function. If you are not yet a member and are tired of trying to "go it alone", come on in from the wilderness and join ACS. Go to www.AZChiropractors.org for a membership application.

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