Greeley, Colo.—On May 7, two directors of the National Board of Chiropractic Examiners (NBCE), were honored by the Federation of Chiropractic Licensing Boards (FCLB) who bestowed upon them the 2009 George R. Arvidson Award for Meritorious Service. This award is the highest individual honor presented annually at the FCLB annual meeting. NBCE President Dr. Vernon R. Temple was honored by the FCLB for his exceptional leadership, innovation and service to chiropractic. Dr. Temple was first elected to serve the National Board as District III director in the year 2000. Since then, Dr. Temple has also served on the NBCE Executive Committee as secretary and vice president. He was elected as president of the board in 2007 and will continue in that role until May 2010. Dr. Temple is a graduate of Palmer College of Chiropractic in Davenport, Iowa, and has been in practice in Vermont since 1978. He is a diplomate of the American Board of Chiropractic Orthopedists. He is a former chairman of the Federation of Chiropractic Licensing Boards and has also served as president of the Vermont Board of Chiropractic Examination and Regulation. NBCE Director Dr. Oliver R. Smith, Jr., and outgoing president of the FCLB received an Arvidson Award for his work in financially stabilizing the FCLB and strengthening the organization’s focus. Dr. Smith previously served as president, vice president, treasurer, and District IV director of the FCLB. He served as and NBCE director from 2005-2009 and was elected as director-at-large on the NBCE board in May 2009. He is a past president of the Texas Board of Chiropractic Examiners and received the Keeler Plaque Award in 1997 as an outstanding chiropractic practitioner in Texas. Dr. Smith is a graduate of Texas Chiropractic College. Headquartered in Greeley, Colo., the NBCE is the international testing organization for the chiropractic profession. Established in 1963, the NBCE develops, administers and scores legally defensible, standardized written and practical examinations for candidates seeking chiropractic licensure throughout the United States and in many foreign countries.

BLOOMINGTON, Minn. – The College of Chiropractic at Northwestern Health Sciences University awarded 72 students with doctor of chiropractic degrees during a commencement ceremony on April 17, 2009. The auditorium was filled with students, family members and friends attending the graduation ceremony. Graduates hailed from 13 different states, two Canadian provinces, and one other foreign country. Bachelor of science degrees were also awarded to 22 of the new graduates. The commencement address was delivered by Mary Jo Kreitzer, PhD, RN, FAAN, founder and director of the Center for Spirituality & Healing, University of Minnesota. Anthony Lawther, a Northwestern student and valedictorian from the graduating class, delivered the student greeting. The presidential greeting was presented by Mark Zeigler, DC, president of Northwestern. Northwestern Health Sciences University offers a wide array of choices in natural health care education including chiropractic, Oriental medicine, acupuncture, therapeutic massage and human biology. The University has nearly 900 students on a 25-acre campus in Bloomington, Minnesota.

SENECA FALLS – New York Chiropractic College president Frank J. Nicchi, DC, MS, was recently elected president of the Association of Chiropractic Colleges, (ACC) a consortium of some nineteen chiropractic colleges located in the United States, Canada and New Zealand. According to David O’Bryon, JD, the association’s executive director since 1996, the organization assists its member institutions by providing leadership in chiropractic education, research and service. Nicchi’s election took place during the 2009 Association of Chiropractic Colleges-Research Agenda Conference (ACC-RAC) held in Las Vegas on March 12th. Nicchi has been a member of the ACC Board of Directors since September, 2000 and was previously the organization’s vice president, treasurer and chair of the institutional statistics committee. “I am honored to be the president of the ACC,” Nicchi said. “It’s a vital organization that advances scholarly activity within the chiropractic academic community and promotes high standards throughout the profession.” Dr. Nicchi also serves on the Board of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) as the ACC representative. This year’s conference also saw the election of Fabrizio Mancini, DC, president of Parker College of Chiropractic in Dallas, as vice president and Richard G. Brassard, DC, president of Texas Chiropractic College in Pasadena, TX, as secretary/treasurer. The fourth member of the executive committee is ACC past-president Carl Cleveland III, DC, of Cleveland Chiropractic Colleges–Kansas City and Los Angeles.

GREELEY, Colo.—On May 8, the National Board of Chiropractic Examiners (NBCE) held its Annual Board Meeting in conjunction with the Federation of Chiropractic Licensing Boards’ (FCLB) 83rd Annual Educational Conference in Hollywood, CA. At the meeting, NBCE delegates elected Dr. Paul N. Morin (ME) as District III Director, replacing Dr. Mary-Ellen Rada (NJ). The delegates re-elected Dr. Norman E. Ouzts, Jr. (SC) as District V Director. Dr. Robin R. Lecy (SD), District I Director; Dr. Donna L. Craft (MI), District II Director; and Dr. Theodore J. Scott (UT), District IV Director will continue their terms. NBCE Directors-at-Large Dr. Vernon Temple (VT), and Dr. N. Edwin Weathersby (AZ) were re-elected to their at-large positions. Dr. Oliver Smith was elected as a new at-large director and NBCE Director-at-Large Dr. Richard L. Cole (TN) will continue his term. The two remaining positions on the 11-member NBCE Board of Directors are filled by the president and vice-president of the Federation of Chiropractic Licensing Boards: Dr. Daniel Saint-Germain (Quebec, Canada) and Dr. Lawrence O’Connor (NJ), respectively, were appointed to serve on the NBCE Board of Directors. The Executive Committee was then elected by the board. Dr. Vernon Temple was re-elected as President, Dr. N. Edwin Weathersby as Vice President and Dr. Theodore Scott as Treasurer. Dr. Richard L. Cole was elected to the Executive Committee as Secretary. Headquartered in Greeley, Colo., the NBCE is the international testing organization for the chiropractic profession. Established in 1963, the NBCE develops, administers and scores legally defensible, standardized written and practical examinations for candidates seeking chiropractic licensure throughout the United States and in many foreign countries.

Members should be aware; the FTC has developed Red Flag Rules which require “creditors” – including health care providers -- to conduct a risk assessment to determine if they have accounts at risk for identity theft. These rules went into effect in November, 2008 with an implementation date of May 1, 2009. The AMA disputed the FTC’s inclusion of health care providers as creditors, but the FTC determined that health care providers do fall within the ambit of the rules. According to the Equal Credit Opportunity Act, a “creditor” is “any person who regularly extends, renews or continues credit.” “Credit” is defined as a “deferment of payment for goods or services rendered.” For health care providers, this means every time you submit a health insurance claim to an insurance carrier first, and then bill the patient for co-payments or deductibles after services are rendered you are deferring payment and thus are acting as a “creditor.” Medical identity theft occurs when an individual seeks care using the name or insurance information of another person. This can result if false billing and potentially life-threatening corruption of a patient’s medical records. The bottom line comes in assessing risk in your practice of possible identity theft. The FTC requires that office practice’s have written policies in place – an “Identity Theft Prevention Program” -- and a plan to “prevent and mitigate” the effects of identity theft. If you have a small practice in which all your patients are known to you or your staff, you are at lesser risk and may only need an initial copy of a state issued photo ID that is checked at each visit to ensure that the patient is who he/she says she is. There is greater risk in a large multi-doctor office or facility. It would also be required to have a procedure in place in the event that you are notified by a state or local agency that the consumer’s identity has been misused. In order to assist the membership with implementation of the Red Flag Rules, the NYSCA has put together a “Model Identity Theft Prevention Program” for members. In addition to all the information and contacts you would need in case of identity theft, this includes a “turn key” manual that only requires you to fill in your office information. They do require you to have a meeting to explain the new procedures to your staff. Everything else is done for you. Many groups are selling packages for $100 or more; as a member benefit, the Red Flag Rules package can be downloaded from the NYSCA website free-of-charge. Download your copy, fill in the information and be in-compliance by the May 1, 2009 deadline. Membership has its privileges. Sincerely, Mariangela Penna, DC President, New York State Chiropractic Association GO TO MEMBERS ONLY TO VIEW THE “Model Identity Theft Prevention Program” by clicking on the link below:

Red Flags Rule Enforcement Delayed Three Months Due to Congressional pressure supported by ACA, the Federal Trade Commission announced today it will delay enforcement of the new "Red Flags Rule" until August 1, 2009. This will give creditors and financial institutions more time to develop and implement written identity theft prevention programs. ACA will continue to monitor this important policy and support members in compliance. More information on the Red Flags Rule

The Virginia Chiropractic Association (VCA) and the Virginia Society of Chiropractic (VSC) announced their intent to unite into a single entity and the formation of a Unification Committee. The unification will create a single, more influential association in the Commonwealth of Virginia that will better serve chiropractic doctors, patients, and the profession as a whole. The goal is to reduce duplication, allowing the profession to devote more resources and expertise to public policy, education, legal and legislative initiatives. Over the past several years, the organizations have begun collaborating more and more frequently, assisting each other in legislative activities and conducting joint educational programs. Both presidents accepted honorary memberships in the other organizations and face-to-face meetings and conference calls between the two Boards and staff became regular occurrences. The Unification Committee is charged with fleshing out the myriad of organizational, operational, and legal details and considerations involved in bringing the two groups together. In addition, it will outline a plan to provide a framework for the rules that will govern the organizations during the consolidation period, thereby ensuring a smooth transition.

Seneca Falls: Saturday, April 4, New York Chiropractic College held commencement exercises in the campus Athletic Center and conferred degrees upon 44 candidates in its Doctor of Chiropractic program. The commencement address was delivered by Carl S. Cleveland III, DC, who has served as president of Cleveland Chiropractic College since 1981 and is a noted author, educator and international lecturer. A fourth generation chiropractor, Dr. Cleveland is the grandson of the college’s founders, Dr. Carl S. Cleveland, Sr. and Dr. Ruth R. Cleveland and he has served as president for the Association of Chiropractic Colleges and for the Council on Chiropractic Education. Valedictorian, Robert James Sedlor addressed his classmates and Catherine Elizabeth McArdle was salutatorian. During the ceremony, the eighth annual convocation of the American College of Chiropractors recommended the following to be enlisted as Fellows: Carl S. Cleveland, III, DC; NYCC Board of Trustees member George M. McCllenad, DC; NYCC faculty member Vincent F. Loia, DC (NYCC 1981); and Ms. Laurie Reynolds, Executive Assistant to the President of NYCC and Executive Secretary to the NYCC Board of Trustees. For further information about New York Chiropractic College’s degree programs please visit

The May 2009 issue of Consumer Reports Magazine reports the results of its recent survey of more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. About 80 percent of U.S. adults have at some point been bothered by back pain. The Consumer Reports Health Ratings Center recently surveyed more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. More than half-said pain severely limited their daily routine for a week or longer and 88 percent said it recurred through the year. Many said the pain interfered with sleep, sex, and efforts to maintain a healthy weigh… This article is the archived version of a report that appeared in May 2009 Consumer Reports Magazine. Read the entire Consumer Reports Magazine report by clicking on the link below: Consumer Reports Magazine Reports on Aching Backs

Doctors beware: There are many rumors within the chiropractic profession about Medicare policies. ---Did you know that you still have to bill Medicare if you are a non-participating (non-par) physician? ---You still have to follow Medicare documentation requirements if you are non-par? ---You are still subject to reviews if you are non-par? There is no visit cap for chiropractic in Medicare? Read the MLN matters article by clicking on the link below:

WASHINGTON, D.C. —During a conference call today with reporters, Senator John D. (Jay) Rockefeller IV (D-W.Va.), Chairman of the Senate Finance Subcommittee on Health Care, and Congressman Joe Courtney (D-Conn.), Member of the House Education and Labor Committee, announced the introduction of the Pre-existing Condition Patient Protection Act that would end insurance discrimination against those who live with pre-existing or chronic illness. “We have 133 million Americans living with chronic illness – insurance companies should no longer be allowed to reap profits by denying care to sick Americans,” said Senator Rockefeller. “We as a nation can no longer stand by and continue to allow this practice to occur. These medical services are not optional, and most times, they are not affordable without insurance. Our system is broken—which is why we must eliminate the ability of insurers to deny coverage for pre-existing conditions in every single market. The time for serious action is now.” “It is wrong and impractical to commit ourselves to health care reform without addressing the faulty and ill-advised pre-existing condition exclusion,” stated Congressman Courtney. “This discriminatory practice prevents millions of hardworking Americans from changing or finding new jobs and in this economy that is just plain wrong. Senator Rockefeller and I agree that it is time for the most advanced nation in the world to have a world-class health care system that is fair and affordable.” Background The Pre-existing Condition Patient Protection Act will eliminate pre-existing condition exclusions in all insurance markets, a major step forward for the 133 million Americans living with at least one chronic condition. Eliminating pre-existing condition exclusions is a priority of the Obama Administration and Senator Rockefeller and Congressman Courtney plan to work closely with President Obama to enact this vital legislation. Insurance market reform must be a central part of comprehensive health reform. Both Senator Rockefeller and Congressman Courtney believe that all individuals should have access to comprehensive, meaningful, and affordable health insurance coverage—and this legislation is a critical component of achieving that goal. Summary of the legislation ****The Pre-existing Condition Patient Protection Act is a bill to protect consumers excluded from receiving health insurance coverage due to a “pre-existing condition.” ****The Pre-existing Condition Patient Protection Act would require the Secretary of Health and Human Services to submit a report to Congress on the extent of adverse selection (i.e. which happens when less healthy people disproportionately enroll in a risk pool) that occurs because insurers can no longer exclude patients with pre-existing conditions. This report must include data from private insurers on the characteristics of their insured population. This new reporting requirement would provide transparency on the true mix of patients and patient claims experience among private insurers; and ****Require the Government Accountability Office to submit a report to Congress addressing the impact of this legislation on reducing the number of uninsured and underinsured, as well as its effect on the affordability of health insurance coverage. This is meant to highlight both the positive impact this new policy will have on making coverage more accessible for individuals with chronic conditions, but also recognize that without further regulatory changes, coverage may not be affordable for these individuals. ****The Pre-existing Condition Patient Protection Act of 2009 has been endorsed by twenty-two organizations, including: American Autoimmune Related Diseases Association; American Heart Association/American Stroke Association; Association of Black Cardiologists, Inc.; Association of Community Cancer Centers; Breast Cancer Network of Strength; Children’s Cause for Cancer Advocacy; Congenital Heart; Information Network; Dermatology Nurses’ Association; First Focus; International Myeloma Foundation; Lung Cancer Alliance; Lupus Foundation of America; Mended Little Hearts; National Association of Pediatric Nurse Practitioners; National Patient Advocate Foundation; Oncology Nursing Society; Ovarian Cancer National Alliance; Pediatric Stroke Network, Inc.; Sarcoma Foundation of America; Sudden Cardiac Arrest Association; The Leukemia & Lymphoma Society; and The Wellness Community.

Federal Trade Commission (FTC) regulations stating that financial institutions and creditors are required to develop and execute written identity theft prevention programs otherwise known as the “Red Flags Rules,” are slated to go into effect May 1, 2009. Until recently, there was much ambiguity regarding the regulations and questions were raised as to whether physician offices fell under the FTC red flags guidelines. In February, the FTC issued a statement clarifying that Identity Theft Red Flag Rules do indeed apply to physicians including doctors of chiropractic. Read the FTC statement by clicking on the link below:

BLOOMINGTON, Minn. – Jonathan Williams, DC, MEd, EMT-B, DABCI, CCSP, an associate professor at Northwestern Health Sciences University, recently wrote a book with guidelines for athlete injuries and return to play (RTP) recommendations. “My hope is that coaches, athletic trainers, and chiropractic physicians will be able to use the book to make rational decisions about when athletes should be put back in the game,” Dr. Williams says. “Hopefully by using this book, progression of athlete injuries can be prevented.” The 31-page-book, titled “Emergency Care of the Injured Athlete and Return to Play” contains signs and symptoms, treatments, and RTP recommendations for a range of conditions including bee stings, concussions, and heat-related syndromes. Dr. Williams says the idea for the book came out of a necessity. “I was looking around at different organizations for RTP ideas, and nobody had them,” he explained. Dr. Williams is currently teaching the Sports Medicine courses at Northwestern, and directs the Sports Medicine Clinic at St. Agnes Schools in St. Paul, Minn. He also coordinates the chiropractic doctors who cover St. Agnes high school varsity athletic games. The book will be sold at the University’s bookstore for approximately $11, and orders for the book were taken during Northwestern’s chiropractic homecoming which took place Feb. 5-7, 2009. Dr. Williams says the book will also be sold on the University’s website. Northwestern Health Sciences University offers a wide array of choices in natural health care education including chiropractic, Oriental medicine, acupuncture, therapeutic massage and human biology. The University has nearly 900 students on a 25-acre campus in Bloomington, Minnesota.

Vitamin C Intake and the Risk of Gout in Men Abstract A Prospective Study Background Several metabolic studies and a recent double-blind, placebo-controlled, randomized trial have shown that higher vitamin C intake significantly reduces serum uric acid levels. Yet the relation with risk of gout is unknown. Methods We prospectively examined, from1986 through 2006, the relation between vitamin C intake and risk of incident gout in 46 994 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout. Vitamin C intake was assessed every 4 years through validated questionnaires. Results During the 20 years of follow-up, we documented 1317 confirmed incident cases of gout. Compared with men with vitamin C intake less than 250 mg/d, the multivariate relative risk (RR) of gout was 0.83 (95% confidence interval [CI], 0.71-0.97) for total vitamin C intake of 500 to 999 mg/d, 0.66 (0.52-0.86) for 1000 to 1499 mg/d, and 0.55 (0.38-0.80) for 1500 mg/d or greater (P < .001 for trend). The multivariate RR per 500-mg increase in total daily vitamin C intake was 0.83 (95% CI, 0.77-0.90). Compared with men who did not use supplemental vitamin C, the multivariate RR of gout was 0.66 (95% CI, 0.49-0.88) for supplemental vitamin C intake of 1000 to 1499 mg/d and 0.55 (0.36-0.86) for 1500 mg/d or greater (P < .001 for trend). Conclusions Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout. Authors Affiliations: Division of Rheumatology, Department of Medicine, Arthritis Research Centre of Canada, Vancouver General Hospital, University of British Columbia, Vancouver, Canada (Dr Choi); Channing Laboratory (Drs Choi, Gao, and Curhan) and Renal Division, Department of Medicine (Dr Curhan), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston (Drs Gao and Curhan). Dr Choi is now with the Rheumatology Section, Clinical Epidemiology Unit, Boston University School of Medicine, Boston. Arch Intern Med. 2009;169(5):502-507.

After carefully listening and reviewing member comments, the Foundation for Chiropractic Education and Research has opened its popular new DCConsult® website to all at no cost. The former subscription only site has been revamped, with a new emphasis on the needs of the practicing clinician. Driven by two major search engines anyone can now visit www.DCConsult.com and instantaneously run a search for the most current research abstracts. A click of a button and the site immediately translates from English to Spanish, French, German, Italian or Portuguese. For the past two years, it has been the goal of the FCER’s Board of Trustees to provide easy access for the profession to the literature, articles, links, educational products and more. DCConsult is now the globally recognized repository of such information. From South Africa, Evalie K. Heath, DC writes, “This is Wonderful news. A Very Big Thank you for your new policy to make DCConsult available to everyone at no cost. DCConsult will be a wonderful tool for ALL Chiropractors to access chiropractic articles, research and news. Those of us in more remote areas of the Earth (remote from Chiropractic schools and centers of research) and especially those in areas with economic difficulties greatly appreciate this decision.” Dr. Heath goes on to encourage colleagues in Uganda, South Africa, Nambia, Mozambique, Mauritius, Kenya, Ghana, Ethiopia, Congo: “Dear Africa Members, DCConsult opens the world of Chiropractic information to our very finger tips. Please enjoy this new privilege. Please inform all of your members and colleagues.” FCER’s President, Dr. Charles Herring stated, “As long as new research and articles emerge – DCConsult will never be finished. Information, as well as translations are being added as quickly as possible. The web site will continually change – so visit often.” FCER Vice President, Dr. Ronald Evans explains, "Moving DCConsult into the open access domain has not been without significant challenges. Newer site designs require more data to keep content current. FCER/DCConsult is seeking volunteer expertise to make the content more robust in several ways: 1) Contribution of original Evidence Based Medicine/Evidence Based Principles (EBM/EBP) material, 2) Abstract mining from any source germane to chiropractic science, 3) Book/Textbook recommendations for a website book list, and 4) Occasional chiropractic research consultancy. Never before in the 65-year history of this foundation has the need been greater for the chiropractic profession to step forward and assist with a project of this global magnitude." Coming soon is a FCER Member only section offering free audios, patient handouts and other downloads especially for those who financially support FCER activities. DCConsult would not be possible without the support of Standard Process Inc., National Board of Chiropractic Examiners, Future Health Inc., Academy of Chiropractic Orthopedists, American College of Chiropractic Consultants, College on Forensic Sciences and others. The Foundation for Chiropractic Education and Research celebrates its 65th Anniversary in 2009. FCER is a 501(c)3 not-for-profit foundation with a mission To promote the health and well being of humanity by encouraging and supporting research and education relative to the field of chiropractic care, and to provide information needed to document and improve chiropractic healthcare capacity worldwide. DCConsult directly aligns with FCER’s mission and is worthy of your support.

SENECA FALLS – New York Chiropractic College today announced that it, in cooperation with Community Health magazine and The Finger Lakes Times, will host its Eighth Annual Women’s Health Symposium, Saturday, March 28, 2009, on the NYCC campus on Route 89 in Seneca Falls. The 2009 keynote speakers include Mary Balliett, DC, assistant professor at NYCC; Donna Finando, MS, LAc, LMT; and Natali Cher, MD, DO. Sponsored in part by M&T Bank, the symposium also will feature a trade show and professional vendors. This year’s topic, “Wellness At Home,” focuses on important health issues regularly faced by families and will provide the public with insights to help build better communication with their healthcare providers. A second track is also provided for healthcare professionals that will speak to the topic, “Helping Your Patients Help Themselves” and teaches practitioners effective methods of patient education. Continuing education credits are awarded - 6 chiropractic postgraduate or 6 AOM PDA points – all other professionals should check with their accrediting agencies. Members of the public are charged $10 per person. Attendance includes a continental breakfast, admission to the lecture, fact-filled note pack, gift tote, and a luncheon featuring a panel discussion with guest speakers that include NYCC faculty Jason Wright, MS, LAc, NCCAOM, and Robert Ruddy, BS, DC. Registration/check-in on the day of the event begins at 8:00 AM. Registration for the professional track is $110, and includes all of the above plus 6 postgraduate credits. Due to the popularity of this event, pre-registration is strongly recommended. For more information, directions to New York Chiropractic College, or to register, please visit the college’s web site at www.nycc.edu/WHS. Because seating is limited, it is advised to pre-register as soon as possible.

(Arlington, Va.) -- The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) today expressed support for newly introduced legislation in the U.S. House of Representatives designed to codify chiropractic as a covered service through the Department of Veterans Affairs (VA) health care system. Representative Bob Filner, D-Calif., introduced HR 1017 late last week. The bill, which is similar to legislation introduced in 2007, specifically requires the VA to have a doctor of chiropractic on staff at all VA medical facilities by 2012. It also amends the current statute, the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001, ensuring that chiropractic benefits cannot be denied. “The ACA and ACC applaud the work of Rep. Filner as he continues to advocate for both chiropractic and our nation’s veterans,” said ACA President Glenn Manceaux, DC. “Veterans want, need and deserve access to chiropractic care, and it is our goal to ensure that chiropractic is ultimately available and accessible at every major VA health care facility.” Further, ACC President Dr. Carl Cleveland III noted, “The chiropractic educational community welcomes the opportunity to position its graduates and the profession to serve our nation’s veterans, and this legislation allows veterans’ easier access to chiropractic care. With a reported 49 percent of eligible veterans returning with neuromusculoskeletal issues, the need for expanded access to chiropractic services has never been more crucial.” Through previous congressional action, chiropractic care is now available at 32 VA facilities across the country; however, in the more than 120 facilities without a chiropractor on staff, the chiropractic care benefit Congress authorized for America’s veterans remains virtually non-existent. Detroit, Denver, and Chicago are a few examples of major metropolitan areas without a doctor of chiropractic available at the local VA medical facility. According to ACA Vice President of Government Relations John Falardeau, without a congressional directive, further expansion to VA facilities will be on a case-by-case basis and will be excruciatingly slow. The ACA believes that integrating chiropractic treatment into the VA health care system would not only be cost-effective, it would also speed the recovery of many of the veterans returning from current operations in Iraq and Afghanistan. A January 2009 report from the Veterans Health Administration indicates that over 49 percent of veterans returning from the Middle East and Southwest Asia who have sought VA health care were treated for symptoms associated with musculoskeletal ailments – the top complaint of those tracked for the report. HR 1017 has been referred to the House Committee on Veterans’ Affairs. To view the full text of HR 1017, click here. Contact your Member of Congress and urge them to cosponsor HR 1017.

CIGNA Signs Agreement to Deliver Fair Rates to Patients Nationwide; Will Contribute $10 Million to New, Independent Database Cuomo Also Announces Intent to Sue Rochester-Based Excellus for Defrauding Consumers by Manipulating Rates, Relying on Outdated Information Attorney General Andrew M. Cuomo today announced further expansion of his historic reform of the national healthcare reimbursement system. Cuomo has reached an agreement with CIGNA (NYSE: CI), one of the nation’s ten largest health insurers, in his ongoing drive to end industry-wide conflicts of interest and generate fair reimbursement rates for working families nationwide. CIGNA will end its relationship with the defective Ingenix database, as well as pay $10 million to a qualified nonprofit organization that will establish a new, independent database to help determine fair out-of-network reimbursement rates for consumers. The agreement today with CIGNA brings the total dollar amount secured by Attorney General Cuomo for the new database to over $80 million. Attorney General Cuomo also announced that his office has served a five-day notice of intent to sue Excellus Health Plan (“Excellus”) for defrauding consumers and patients across Upstate New York by manipulating reimbursement rates for out-of-network services. Rochester-based Excellus is the largest not-for-profit insurer in New York State, and is the largest insurer in the Rochester and Syracuse areas. Excellus and its affiliates serve nearly two million people in 31 counties, with approximately 872,000 members in Rochester, 549,000 in Syracuse and Central New York, 289,000 in Utica, and 165,000 in Buffalo, where it operates as Univera Healthcare (“Univera”), one of the Buffalo area’s three largest insurers. Cuomo's case against Excellus includes information provided by the Syracuse Post-Standard newspaper showing that Excellus was under-reimbursing the Post-Standard's employees, who were members of Excellus. “Today’s agreement with CIGNA is the latest domino to fall in our industry-wide sweep of the healthcare reimbursement system and brings us another step closer to complete reform,” said Attorney General Cuomo. “Unfortunately, on the same day, we have another company that has continued to stand squarely in the way of our efforts. The bottom line is that Excellus failed to satisfy promises made to its members to deliver fair rates and give patients what they paid for. Let this notice today serve as a firm reminder to other insurers who have not yet resolved this problem - we will not hesitate to pursue legal action against companies that defraud patients.” Earlier this month, Attorney General Cuomo announced sweeping reforms to end the manipulation of reimbursement rates at the expense of patients across the country. After a year-long investigation revealed that the health insurance industry relied on a defective database to set rates, Cuomo reached groundbreaking agreements with UnitedHealth Group Inc. (“UnitedHealth”) (NYSE: UNH), the owner of the Ingenix database and the second-largest insurer in the country, along with Aetna (NYSE: AET), the nation’s third-largest health insurer. After those initial agreements, Cuomo brought his reform efforts to Upstate New York, securing agreements with the Schenectady-based MVP Health Care/Preferred Care as well as Independent Health and HealthNow, both Buffalo-based insurers. Attorney General Cuomo’s investigation concerned allegations that as a subsidiary of UnitedHealth, Ingenix had a vested interest in helping set rates low, so companies could underpay patients for out-of-network services. The investigation revealed that the database intentionally skewed “usual and customary” rates downward through faulty data collection, poor pooling procedures, and the lack of audits, meaning consumers were forced to pay more than they should have. The investigation found the rate of underpayment by insurers ranged from ten to twenty-eight percent for various medical services across the state. The Attorney General found that having a health insurer determine the “usual and customary” rate - a large portion of which the insurer then reimburses - creates an incentive for the insurer to manipulate the rate downward. The establishment of a new database, independently owned and operated by a nonprofit organization, is designed to remove this conflict of interest. Under the agreement secured with UnitedHealth, the database of billing information operated by Ingenix will close. UnitedHealth also agreed to pay $50 million to a qualified nonprofit organization that will establish a new, independent database to help determine fair out-of-network reimbursement rates for consumers throughout the United States. Cuomo’s agreement with Aetna, which will also end their relationship with Ingenix, secured another $20 million for the database. Today’s agreement with CIGNA, which insures 12 million people nationwide, brings the total dollar amount to $80 million. Under the terms of the agreement: • CIGNA will pay $10 million toward a new, independent database run by a qualified nonprofit organization; • The nonprofit will own and operate the new database, and will be the sole arbiter and decision-maker with respect to all data contribution protocols and all other methodologies used in connection with the database; • The nonprofit will develop a website where, for the first time, consumers around the country can find out in advance how much they may be reimbursed for common out-of-network medical services in their area; • The nonprofit will make rate information from the database available to health insurers; • The nonprofit will use the new database to conduct academic research to help improve the health care system; • The nonprofit will be selected and announced at a future date. Cuomo also announced today that he has served a five-day notice of intent to sue Rochester-based Excellus for defrauding consumers across the state. During the investigation into the use of the Ingenix databases, the Attorney General has uncovered a trove of e-mails pointing to an egregious scheme by Excellus to defraud its members by using obsolete fee schedules to reimburse members for out-of-network care. The investigation has found that, for at least the past fifteen years, Excellus has used years-old fee schedules to reimburse consumers for out-of-network claims, saving itself countless dollars which should have been paid to consumers. Because medical costs rise substantially every year, the use of old fee schedules hurts consumers by paying them substantially less than they are owed. For every year by which the fee schedule is outdated, the harm to the consumer is compounded. For many years, Excellus has relied on pricing information that was as much as nine years old. Furthermore, emails and other internal communications secured by the Attorney General’s Office during the investigation show that Excellus employees were aware of their outdated rates and did nothing to correct the problem or pay members what they were owed. “In some of the most egregious evidence of fraud we have seen in this investigation, these emails reveal that not only did Excellus use outdated UCR fee schedules, but it made zero effort to fix the problem and pay members what they deserved. The company’s own internal communications show total disregard for the effect their skewed rates were having on hard-working families, especially across Upstate New York where Excellus controls the lion’s share of the health insurance market,” said Cuomo. According to a 2007 market report by the American Medical Association, Excellus controls 57 percent of the Rochester market for commercial health insurance and 66 percent of the PPO (“preferred provider organization”) market there; 42 percent of the Syracuse market for commercial health insurance and 97 percent of the HMO (“health maintenance organization”) market there; 27 percent of the Binghamton market for commercial health insurance and 80 percent of the HMO market there; and 15 percent of the Ithaca market for commercial health insurance and 100 percent of HMO market there. The Attorney General’s industry-wide investigation into rate manipulation began in February 2008, when Cuomo announced that he had issued subpoenas to the nation’s largest health insurance companies that use the Ingenix database, including Aetna, CIGNA and WellPoint/Empire BlueCross BlueShield (NYSE: WLP). To date the investigation is ongoing. Jeff Kang, M.D., Chief Medical Officer for CIGNA, said: "CIGNA commends the Attorney General’s efforts to bring greater transparency to the pricing of health care services and we are pleased to partner in the creation of an independent not-for-profit organization to administer the new database. We recognize the Attorney General’s concern that there are inherent conflicts of interest related to the Ingenix database and expect that this new database will further enable people to make informed choices about their health care purchases.” Nancy Nielsen, M.D., President of the American Medical Association (AMA), said: “The American Medical Association commends CIGNA for committing today to the groundbreaking insurer settlements arranged by New York Attorney General Andrew Cuomo. In the wake of these agreements, the AMA calls upon all health insurers to reject the fatally flawed Ingenix database. Health insurers who truly recognize the importance of restoring their damaged relationships with patients and physicians should commit to the solution proposed by Attorney General Cuomo without delay.” Michael H. Rosenberg, MD, President of the Medical Society of the State of New York (MSSNY), said, “Attorney General Andrew Cuomo has taken another important step in propelling state and national healthcare reform and leveling the playing field with managed care organizations. Just a month after negotiating the first agreement, Attorney General Cuomo has managed to achieve what MSSNY and the AMA sought for more than eight years. With CIGNA joining United, Aetna, MVP, HealthNow and Independent Health - in abandoning the flawed Ingenix system - patients and physicians will now have the assurance of a viable and transparent reimbursement system for out-of-network services. At a time of great economic distress, this is a major step forward in the assurance of quality health care delivery.” Chuck Bell, Programs Director of Consumers Union, said: “Attorney General Cuomo's sweeping national investigation of the previously obscure Ingenix database has lifted the veil on this appalling financial rip-off, and created a new framework for a fair, consumer-friendly solution. Today's announcement shows that national insurers are coalescing behind a comprehensive, industry-wide strategy to reform the way that out-of-network charges are calculated, so consumers will be paid fairly.” The agreement announced today is the result of an investigation by Deputy Chief of the Health Care Bureau James E. Dering, Senior Trial Counsel Kathryn E. Diaz, and Assistant Attorneys General Brant Campbell and Sandra Rodriguez, under the direction of Linda A. Lacewell, the head of the Attorney General’s Healthcare Industry Taskforce. In January, Cuomo also issued a report on his investigation, “Health Care Report: The Consumer Reimbursement System is Code Blue.” The report highlights the conflicts of interest and other defects in the current system and calls for the reforms announced today. To access the report, get consumer tips for out-of-network care, or to file a complaint, please visit http://www.oag.state.ny.us.

Late last week, the U.S. House and Senate approved the long-debated $787 billion economic stimulus package. Included in the final legislation, which is to be signed by President Obama this week, are the following items of interest to the chiropractic profession: