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District 3 Meeting - HOW DYNAMIC MOVEMENT GUIDES THE DECISIONS IN YOUR PRACTICE

 

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Several Long Awaited Proposed Health Reform Regulations Released

Several long awaited proposed regulations that govern implementation of the Patient Protection and Affordable Care Act (PPACA) provisions were released by the Department of Health and Human Services (HHS) on Tuesday. These regulations are intended to provide detailed guidance regarding implementation of the 2010 law. Of special note--starting in Jan. 2014--it will be illegal for an insurer to discriminate due to pre-existing conditions in denying coverage. It is estimated that this one provision will provide insurance options for some 129 million Americans. In addition to the pre-existing conditions exclusion, insurers will not be able to discriminate based upon gender, occupation, claims history or health status for the purpose of raising premiums.

Additional Standards were also laid out in this week's proposed rule that relate to issuers' determinations of essential health benefits and their value. PPACA requires payers in the individual/small group markets to include within their plans core essential benefits. ACA is following this development closely and is active nationally on behalf of the profession. Be sure to look for ACA comments on these proposed rules in future editions of Week in Review. If you haven't yet decided to contribute to CHAMP, consider these national proposals and how they will affect you. Follow health care reform here.

 

Chairman Beloten Announces New Medical Treatment Guidelines for Workers’ Compensation

After continued conversations and meetings with the New York State Workers' Compensation Board, we are now able to confirm updates to the Medical Treatment Guidelines.

Effective February 1, 2013, regulatory changes will be made to the Medical Treatment Guidelines [MTGs] allowing for, among other things, maintenance care for chronic back and neck pain.  This is exciting news indeed!

Regulatory modifications to the MTGs include the following:
  • The new Carpal Tunnel Syndrome MTGs have formally been adopted. 
  • A new maintenance care program has also been adopted, allowing up to 10 visits per year for chronic pain for patients who have reached maximum medical improvement (MMI) and have a permanent disability. 
  • Variance Request transmission requirements are being clarified and simplified in order to reduce the number of technical violation rejections. Details regarding these changes will be released as they become available. 
  • Carriers are now permitted to grant a portion of a variance request. Providers and patients will have the right to request a review of any denied portion of the request. This new allowance provides an opportunity for providers and carriers to reach a compromise, resulting in a reduction in unnecessary litigation due to complete denials. 
It has been noted that, by far, the majority of variance requests (nearly 80%) submitted by providers have been for maintenance care for patients with chronic pain. The Medical Advisory Committee (MAC) continues to develop a chronic pain MTG. In the meantime, the MAC has agreed that some maintenance care (including chiropractic, physical therapy, and occupational therapy) should be available to patients with chronic pain who have received benefit from such treatment in the past. 

Accordingly, the revised MTGs will allow for up to 10 visits for maintenance care per year for patients who have reached maximum medical improvement (MMI) and have a permanent disability. These guidelines will apply to all claims effective February 1, 2013, regardless of the date of accident or the date of disablement.

Additional clarification is expected regarding the definition of “10 visits” (i.e. multiple body sites, CPT codes, and multiple provider types).  However, this is a move in the right direction and is a welcome change to the way workers’ compensation claims are currently administrated.

It is clear how beneficial these changes will be for injured workers and their providers:  The need for variance requests will be minimized or even eliminated for many patients; Employed patients will not have to lose time from work to attend hearings on denied requests; Recurrences of symptoms and exacerbations will be minimized, resulting in a better quality of life for our patients.

We anticipate that the Workers’ Compensation Board will continue to have open dialogue with the NYSCA and other vested organizations as we work together to serve the best interests of our patients and providers.

For more information, please see the official website of the New York State Workers Compensation Board:  http://www.wcb.ny.gov/content/main/SubjectNos/sn046_497.jsp

 

NYCC’s 2012 Fall Classes welcomed 208 new students

The NYCC Admissions Department welcomed 208 new students in its September classes: 122 students representing 23 states, Puerto Rico, Canada and South Korea in the chiropractic program, 32 in the acupuncture master’s programs, 29 in the on-line Master of Science in Applied Clinical Nutrition (MSACN) program, and 25 in its on-line Master of Science in Human Anatomy & Physiology Instruction (MSHAPI) program.

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National Government Services Upcoming Webinars on Chiropractic Services

National Government Services Upcoming Webinars on Chiropractic Services

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NYCC President Sadly Announces Passing of Faculty Member, Dr. Lillian Ford

 

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The New York Times Prints ACA's Letter to the Editor

On Sept. 3, The New York Times printed "Too Young to Have a Stroke? Think Again," about the risk of stroke among younger people, which stated that "Other activities that can cause a carotid tear are those that involve sudden neck jerks, including scuba diving, golf and tennis, as well as chiropractic manipulation and bending the head sharply back (the so-called beauty parlor stroke)." ACA President Keith Overland, DC, quickly responded with a letter to the editor that was printed on page 4 of the Science Times section of the Sept. 11 edition. Dr. Overland's response highlighted research published in the medical journal Spine, which concluded that the risk of vertebrobasilar artery stroke associated with a visit to a chiropractic physician is no different than the risk of stroke following a visit to a primary care physician, and that any observed association between stroke and cervical manipulation or primary care visits is most likely linked to patients with undiagnosed vertebral artery dissections seeking care for neck pain or headaches prior to their strokes.

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ACA to Court: N.M. Chiropractic Physicians Should Have Right to Self-Determination

The American Chiropractic Association (ACA) today filed an amicus curiae (friend of the court) brief in the New Mexico Court of Appeals, supporting the expertise of chiropractic physicians in that state and their right to self-determination.
 
ACA was compelled to file the brief after the International Chiropractors Association (ICA) joined forces with the New Mexico Board of Pharmacy and the New Mexico Medical Board in a December 2011 memorandum to the court, requesting a halt to efforts by the New Mexico Board of Chiropractic Examiners to create an advanced practice training and certification program for chiropractic physicians.
  
In making its argument in favor of allowing New Mexico chiropractic physicians to chart their own course in this matter, ACA's brief informs the court about the extensive educational background and training that chiropractic physicians receive today from accredited U.S. chiropractic colleges.
 
The brief also points out that ACA is the nation's largest and preeminent chiropractic professional association, and that its long-established policy has been to recognize that local doctors are best equipped to determine matters of scope.
 
"It is ACA's opinion that the New Mexico Board of Chiropractic Examiners should be given the same respect as other state boards and allowed to determine what is best for chiropractic physicians and patients in that state. We object in particular to actions by the ICA, as well as the state's pharmacy and medical boards, to interfere with the will of chiropractic physicians in New Mexico and the needs of their patients," said ACA President Keith Overland, DC.
 
It is uncertain at this time when the court will make its final ruling on the issue.

For more information, visit www.acatoday.org/NMbrief.












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New York Chiropractic College makes Honor Roll: Chronicle of Higher Education’s “Great Colleges to Work For”

Seneca Falls, NY: New York Chiropractic College employees know the College is a great place to work, and the Chronicle of Higher Education agrees! For the fourth year running NYCC earned a place on the Chronicle’s roll of “Great Colleges to Work For” alongside such notables as Duke University, University of Michigan and Notre Dame. Qualifying marks in more than four categories merited placement on the Chronicle’s select “Honor Roll” for the third year in a row. NYCC excelled in ten of the eleven available assessment categories - adding collaborative governance, teaching environment and senior leadership to last year’s seven winning classifications.

The program - nowone of the largest and most respected workplace-recognition programs in the country - distinguishes colleges for best practices and policies. After reviewing 46,946 surveys submitted by administrators, faculty members, and professional support staff members from 294 participating institutions, only 42 make it to the Honor Roll.

“To earn a place on the Chronicle’s select ‘Honor Roll’ for three consecutive years is truly an outstanding distinction! Students unquestionably benefit whenever quality instruction is delivered by satisfied faculty members and a customer-oriented staff,” said NYCC President Dr. Frank J. Nicchi.

More about NYCC and its graduate programs is available at www.nycc.edu





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Physiotherapists In The United Kingdom Gain New Power

This past month in the United Kingdom, physical therapists gained the right to prescribe medications independently.

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Performing Independent Chiropractic Examinations (ICEs)

There are a number of considerations of which you should be aware when performing independent chiropractic examinations (ICE):

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Multidisciplinary Practices

The health care professions constantly evolve. A variety of forces, sometimes in competition with one another, continue to shape and reshape the methods, procedures and the manner in which health care is provided to the public.

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Combating Fraud and Abuse in Medicare & Medicaid

As Medicare Contracted Advisory Committee Representative for NY, Dr. Lupinacci and I have been receiving many complaints regarding Medicare. As CAC reps, we work closely on these issues with the ACA. We also get many questions as to what we are doing to stop some of the unfair treatment we receive in Medicare. Dealing with CMS and the rules and regulations governing Medicare is a national issue, we wanted to share a communication from ACA with you:

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Doctors of Chiropractic Answer London's Call

With a little more than 24 hours until the opening ceremony of the London Olympic Games, it's worth remembering that in 1979, track and field star Dwight Stones broke barriers and thrust chiropractic care into the Olympic spotlight in an interview on national TV, where he spoke about the important work being done by Leroy Perry, DC.

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Dr. Jessica Grandal, wife of Dr. Alan Friedman Member District 7

 

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Big Win in Texas

The District Court of Travis County, 250 Judicial District withdrew its opinion and judgment dated April 5, 2012, and substitute the following in its place. The motion for rehearing filed by appellee Texas Medical Association is denied.

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Supreme Court Upholds Health Reform Law

ACA Will Continue to Fight for Patient Access to Chiropractic as Law is Fully Implemented 

Arlington, Va.- On June 28, 2012, the U.S. Supreme Court, in a controversial 5 to 4 decision, declared the Patient Protection and Affordable Care Act (PPACA) to be constitutional, including the much disputed "individual mandate" provision which requires individuals to purchase health insurance coverage. According to the American Chiropractic Association (ACA), the long-awaited court decision removes legal obstacles to the full implementation of the law on a timeline very close to what was planned when PPACA was signed into law in March 2010.



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Are You Suffering from Back Pain?

The following link is a chiropractic public service announcement produced by the WestHartford Group, a chiropractic think tank dedicated to the advancement of the chiropractic profession.

Are You Suffering from Back Pain?


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NYCC and University of Rochester Medical in Pain Education Collaboration

An unusually broad collaboration of health professionals from the greater Rochester area has been selected by the National Institutes of Health (NIH) to help lead the nation’s assault on pain.

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Congressional Committee Calls Chiropractic

Members of the House Armed Services Committee have approved the inclusion of a strong, pro-chiropractic directive in their official committee report accompanying the FY 2013 National Defense Authorization Act. The committee language asserts that services provided by doctors of chiropractic (DCs) for our nation's men and women in uniform is of "high quality" and has become a "key" benefit within the military health care system. Read relevant pages from the committee report here.

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