America’s veterans are one step closer to gaining expanded access to chiropractic services after the U.S. House of Representatives passed legislation on May 23 that includes a provision to expedite expansion of the chiropractic benefit through the Department of Veterans Affairs (VA) health care system. The bill was approved 421:1. The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) lobbied successfully for passage of the bill, HR 1470, which requires the VA to have a chiropractor on staff at no fewer than 75 major VA medical centers before the end of 2009 and for all major VA medical centers to have a chiropractor on staff before the end of 2011. “I am proud that ACA and ACC spearheaded the advocacy efforts in support of HR 1470,” said ACA President Dr. Richard Brassard. “The health and well-being of our nation’s veterans is one of America's most important obligations. This legislation builds and expands on ACA’s previous work with Congress and will greatly improve the availability of chiropractic care to veterans young and old.” Congressman Bob Filner (D-Calif.), a strong supporter of extending chiropractic care benefits to military retirees as well as active-duty personnel, worked closely with the ACA in securing support for the legislation. As Chairman of the House Veterans Affairs Committee, Rep. Filner’s leadership was essential to securing House passage of the bill. According to remarks contained in the March 12, 2007, Congressional Record, Rep. Filner said that when writing the legislation he worked closely with “chiropractic patients, particularly our veterans, who know the benefits of chiropractic care and bear witness to the positive outcomes and preventative health benefits of chiropractic.” “I also was pleased to work with the American Chiropractic Association (ACA), the nation’s largest chiropractic organization and the national voice of doctors of chiropractic and their patients,” Rep. Filner said. Through previous congressional action, chiropractic care is now available at 30 VA facilities across the country; however, in the more than 120 facilities without a chiropractor on staff, the chiropractic care benefit that 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 facility. ACA leaders believe 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 2006 report from the Veterans Health Administration indicates that nearly 42 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 malady of those tracked for the report. HR 1470 is now headed to the Senate for consideration.

The New York State Chiropractic Association provides this information to you upon the request of, and as a courtesy to, the NYS Insurance Fund In its continuing effort to use technology to benefit policyholders, claimants and medical providers, New York State Insurance Fund CEO/Executive Director David P. Wehner announced that NYSIF has developed a state-of-the-art process for the electronic receipt of medical bills and accompanying reports. “I’m proud to announce medical bills are now being received without paper. This will definitely speed the bill-paying process while at the same time increasing accuracy. It’s a win for everyone. I congratulate our claims and information technology departments for their excellent work,” CEO Wehner said. NYSIF has selected two vendors, the Atlantic Imaging Group and P2P Link, to process bills and reports from providers and transmit them electronically to NYSIF where they will be logged-in and evaluated in an automated bill payment process. The new service is presently limited to bills submitted by providers using form CMS-1500, formerly known as HCFA-1500, or on a New York State Workers’ Compensation Board form C-4. NYSIF pays approximately 1.5 million bills per year. CEO Wehner says electronic receipt will ensure expedited and timely payments to medical providers and eliminate the need for them to place phone calls inquiring about the status of bills. “This represents a major improvement in customer service and provides more productive time for NYSIF’s claims professionals. CEO Wehner noted that NYSIF has been in the vanguard of insurance carriers finding innovative ways to integrate technology with the insurance business and the payoff has been remarkable for both the fund and its business partners. “Electronic receipt of bills is another major step forward.” The number of bills received electronically is expected to increase steadily as medical providers become familiar with the process and recognize its benefits. For additional information, contact Mr. Bob Lawson at 518 -437-3504

Insurance committee recently submitted a letter to Aetna which we hoped would persuade Aetna to re-assess their new 2007 PPO In-Network fee schedule. In the letter, we raised the five issues noted below: 1. Notification of Fee Schedule Changes: Fees were reduced without proper notification to your chiropractic panel members. Should participating doctors have advance notice to their fee schedule? If Aetna’s profitability falters, are Aetna’s salaried employees given notice prior to their reduction in salary or benefits? Even if there is found to be no legal obligation, is there no moral compulsion to treat in-network providers fairly? 2. Parasitic vs. a Symbiotic Relationship with Aetna Providers: Are In-network providers considered as members of the Aetna team? According to an Aetna press release (Feb. 8, 2007; found on the web at http://www.aetna.com/news/2007/pr_4thquarter2006_earnings.htm), there was a 29% increase in net operating income in 2006 vs. 2005. Why penalize members of your team, who in part, were responsible for this success? Philosophically, the survival of any provider contract should be predicated on a symbiotic relationship. If provider fees become predatory, then the relationship becomes parasitic and is doomed to failure. The desire to obtain short term financial gains may have dire long-term consequences, and the fall off may be precipitous rather than gradual. 3. Disproportionate Cutbacks in Chiropractic Reimbursement: Why were Aetna’s In-Network chiropractic codes reduced by 28%, while therapies and modalities were only lowered by 8 to 10%? Was this meant to be a direct assault on chiropractic? Is this in line with a pay-for-performance concept? Is this backed by the current literature or just performed at the whim of an anti-chiropractic stand by Aetna? If on the other hand, it is Aetna’s long-term goal to eliminate the chiropractic panel, then I see nothing wrong with your present tactics. Is Aetna’s long-term goal to eliminate the chiropractic panel? 4. Maintaining quality of care and subscriber enrollment: Being that there is no change in reimbursements to out-of-network providers (who receive ‘Reasonable & Customary”), are there any concerns as to attracting and keeping a high quality of provider within the Aetna network? I would think that a higher quality of provider leads to a higher patient satisfaction and more enrollees. A loss of good chiropractors from the panel can result in an attrition of Aetna enrollment (a reversal from the current trend). 5. Foster Team Spirit or Animosity & Resentment: In light of the fact that Aetna’s recent trend is toward greater (rather than lesser) profitability, In-network providers feel discouraged and betrayed by a lowering of their fee schedule. Both Aetna and Aetna’s providers are faced with increasing costs of operation; but whereas Aetna appears to be doing better, the same can not be said for their providers. The reduction just adds insult to injury, and fuels resentment as we care for your Aetna subscribers. Are In-Network providers considered part of Aetna’s team, or are we to be Aetna’s adversaries? The NYSCA has recently brought similar issues to another major carrier in the New York region, and they have agreed to return the fee schedule to the 2006 schedule. We sent a broadcast fax to all the chiropractors in NYS applauding the responsiveness of this Insurance Carrier. We will anxiously await your responses (or lack there of) so we can inform NYS chiropractors as to where Aetna stands on these issues discussed. Unfortunately, we just got word that Aetna will not change the new fee schedule, and Aetna has made a conscious decision not to respond to our letter as it can only lead to dissension. Many members are concerned that NYSCA is not fighting for our survival. Can members please send constructive suggestions as to how we might deal with situations such as this?

ABSTRACT Objective. To determine if conservative treatments (manual therapies, physical medicine methods, medication, and patient education) relieved pain or improved function/disability, patient satisfaction, and global perceived effect in adults with acute, subacute, and chronic mechanical neck disorders (MND) by updating 11 systematic reviews of randomized controlled trials (RCT).

We would like to congratulate Gerald Stevens D.C, M.S., M.P.H., a member of NYSCA District 17, on his recent second research award at the ACC-RAC conference in Phoenix, March 2007. His research paper is entitled “Demographic and Referral Analysis of a Free Chiropractic Clinic Servicing Ethnic Minorities”. The paper analyzed the population characteristics of people attending a free ethnic minority clinic and how these individuals were referred into our facility. It is his hope that others can use this information to build similar clinics in the future. The paper is currently under review for publication in the Journal of Manipulative Physiology and Therapeutics (JMPT). Dr. Stevens is a clinician at the Depew Health Center, New York Chiropractic College and at SUNY Buffalo. He has two masters degrees in public health and pathology. Dr. Stevens is active in the chiropractic section of the American Public Health Association (APHA). Additionally, he active in the community forming collaborations with the American Heart Association, American Diabetes Association and American Cancer Society. On top of all this he is an avid traveler, hiker and camper.

Abstract BACKGROUND Disclosing errors to patients is an important part of patient care, but the prevalence of disclosure, and factors affecting it, are poorly understood. OBJECTIVE To survey physicians and trainees about their practices and attitudes regarding error disclosure to patients. DESIGN AND PARTICIPANTS Survey of faculty physicians, resident physicians, and medical students in Midwest, Mid-Atlantic, and Northeast regions of the United States. MEASUREMENTS Actual error disclosure; hypothetical error disclosure; attitudes toward disclosure; demographic factors. RESULTS Responses were received from 538 participants (response rate = 77%). Almost all faculty and residents responded that they would disclose a hypothetical error resulting in minor (97%) or major (93%) harm to a patient. However, only 41% of faculty and residents had disclosed an actual minor error (resulting in prolonged treatment or discomfort), and only 5% had disclosed an actual major error (resulting in disability or death). Moreover, 19% acknowledged not disclosing an actual minor error and 4% acknowledged not disclosing an actual major error. Experience with malpractice litigation was not associated with less actual or hypothetical error disclosure. Faculty were more likely than residents and students to disclose a hypothetical error and less concerned about possible negative consequences of disclosure. Several attitudes were associated with greater likelihood of hypothetical disclosure, including the belief that disclosure is right even if it comes at a significant personal cost. CONCLUSIONS There appears to be a gap between physicians’ attitudes and practices regarding error disclosure. Willingness to disclose errors was associated with higher training level and a variety of patient-centered attitudes, and it was not lessened by previous exposure to malpractice litigation. Lauris C. Kaldjian1, 2 , Elizabeth W. Jones1, 3, Barry J. Wu4, Valerie L. Forman-Hoffman1, 3, Benjamin H. Levi5 and Gary E. Rosenthal1, 3 (1) Division of General Internal Medicine, Department of Internal Medicine, 1-106 MEB, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA (2) Program in Biomedical Ethics and Medical Humanities, University of Iowa Carver College of Medicine, Iowa City, IA, USA (3) Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center, Iowa City, IA, USA (4) Department of Internal Medicine, Hospital of St. Raphael, New Haven, CT, and Yale University School of Medicine, New Haven, CT, USA (5) Departments of Humanities and Pediatrics, Penn State College of Medicine and Hershey Medical Center, Hershey, PA, USA

Seneca Falls, NY: New York Chiropractic College conferred the Doctor of Chiropractic degree upon 49 graduates Saturday, March 31, 2007, during its commencement ceremony held in the college’s Athletic Center. Dr. Frank J. Nicchi, president of NYCC, commented on the new graduates: "I’ve come to know a number of students in this graduating class. And while they will be missed, I anticipate great things from them!" Richard G. Brassard, D.C., a leader and innovator in the field of chiropractic, delivered the commencement address. A graduate of Palmer College of Chiropractic, Dr. Brassard currently serves as the President of Texas Chiropractic College and President of the American Chiropractic Association (ACA). Dr. Brassard was one of four individuals inducted as Fellows into the American College of Chiropractors (ACC). NYCC Board of Trustees member, Robert E. Daley, Ph.D., past U.S. Olympic Team Head Athletic Director, Edward J. Ryan, III, M.S. and Lee C. Van Dusen, D.C., D.A.B.C.O, Assistant Vice President of Institutional Quality and Assessment at NYCC were also inducted in a ceremony presided over by Thomas R. Ventimiglia, D.C., F.A.C.C., President of the ACC. The ACC was chartered under an Act of Congress in 1924 and is composed of chiropractors, educators and scientific investigators throughout the United States whose field endeavor lies within the domain of chiropractic. Its primary purpose is to encourage research and advance the philosophy, science and art of chiropractic. Additionally, Michael A. Mestan, D.C., D.A.C.B.R., Interim Vice President of Academic Affairs at NYCC, was selected as a Fellow of the International College of Chiropractors, an organization that promotes the philosophy, science and art of chiropractic and includes among its members, individuals who have shown themselves to be significant contributors to the development of the science of chiropractic. Brent Lindsay Moyer, class valedictorian, had the honor of addressing the assembled audience. Andrew Haynes Hancock was the class salutatorian. Awards were presented to select members of the graduating class. Class President Eoin Christopher Gregory received the Alumni Class President Award, the Lloyd E. Henby Distinguished Service Award and a Distinguished Service Award. Lance Jarrod Loomis, Class Treasurer, was presented with the D.D. Palmer Award and the Distinguished Service in Basic Sciences Award. The Diagnostic Imaging Award went to Sybil Ann Coburn, who also received a Distinguished Service Award. Distinguished Service Awards were also presented to Christopher John Arma and Laurissa Constance-Swaine Simms. The Ernest G. Napolitano Memorial Award was presented to Sarah Anne Harkins. Irum Hussain received the Frank E. Dean Memorial Award. Eric A. Steffen received the Frank P. DeGiacomo Technique Award. The recipient of the Libero A. Violini Distinguished Service Award was Michael V. Rockefeller. The Lorraine Welch Memorial Award went to Kimberly M. Carozzi and the Heath Center Award winners were Nathan A. Bukuts (Depew), Susan Leigh Szot (Levittown) and Jennifer Kelly Bollinger (Seneca Falls). For further information about New York Chiropractic College’s degree programs in chiropractic, acupuncture and Oriental medicine, and applied clinical nutrition, visit the college’s Web site at:

National Government Services, Inc. recently discovered a claims processing system problem that affected all Medicare Part B New York claims received on, or in process on, April 23, 2007 and April 24, 2007. The affected claims were denied incorrectly with remittance advice denial message CO-56, “claim/service denied because procedure/treatment has not been deemed ‘proven to be effective’ by the payer.” National Government Services is treating this problem with the highest priority and is in the process of identifying all claims that have been affected by this error. All impacted claims will be reprocessed. We recommend that you resubmit your claims if you received the CO-56 denial, but wait for National Government Services to perform the claim adjustments. We apologize for any inconvenience this may have caused. CPT codes, descriptions, and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.

Palmer College of Chiropractic will host Homecoming 2007 on its Davenport, Iowa, campus Aug. 9-11. The program features a variety of continuing education sessions as well as the traditional and some new social events, along with a vendor expo filled with the latest chiropractic products and services. This year’s theme is “Look Inside,” and refers to some exciting additions to Palmer’s Davenport Campus, as well as the healing, compassion and knowledge that chiropractors can find within themselves and at Palmer. There will be a dedication ceremony on Aug. 10 for the new Palmer College of Chiropractic Academic Health Center, a 50,000-square foot, state-of-the-art clinic and clinical learning resource center. The Palmer Homecoming 2007 schedule features some new events, including special day tours for spouses and guests at area attractions such as the Quad-City Botanical Center, the new Figge Museum in Davenport and the Lavender Crest Winery. There also will be several options to choose from during “Palmer Night” on Aug. 10: music at the River Music Experience, a movie at the IMAX Theatre or a dinner cruise on the Mississippi River. Continuing education sessions will be presented by top-notch speakers in the chiropractic community, including Drs. Casey Crisp, Daniel Drubin, Will Evans, Joan Fallon, Cheryl Hawk, Keith Kramer, Tracey Littrell, Dennis Marchiori, Ian McLean, Bill Moreau, Dan Murphy, Robert Rakowski, Jeremy Rodgers, Frank Sovinsky and Dan Weinert; along with Ms. Christine Crisp, Mr. Bill Esteb, Frank Mitvalsky, J.D., Ms. Judith Siebert and John Slover, J.D. The closing session features a motivational presentation by “The Chalk Man,” Sam Glenn. Chiropractors may earn up to 16 hours of continuing education credit pending state board approval. Chiropractic Technologists may acquire up to seven hours of radiology credit. Topics to be covered include: patient-centered spine care; profitability; radiology (for D.C.s and C.T.s); the science of chiropractic subluxation and neurology; dilemmas and dialogues; nutritional strategies; chiropractic and autism, ADD and ADHD; the science of wellness; the biggest subluxation in chiropractic; the doctor-patient relationship; extremities evaluation and management; real world solutions for the chiropractor’s dilemma; and basic and advanced estate planning strategies. The full schedule and registration information for Palmer Homecoming 2007 are available online at:

(Arlington, Va.) A new literature review finds evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation, according to a March/April 2007 report in the Journal of Manipulative and Physiological Therapeutics (JMPT). According to Howard Vernon, DC, PhD, the review’s chief author, “The results of the literature review confirm the common clinical experience of doctors of chiropractic: neck manipulation is beneficial for patients with certain forms of chronic neck pain.” As part of the literature review, Dr. Vernon and his colleagues reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported to remain unchanged, and all groups showed positive changes up to 12 weeks post treatment. No trial reported any serious adverse effects. This literature review did not include studies involving patients with acute neck pain, neck and arm pain, neck pain due to whiplash, or those with headaches. In this review, chronic neck pain was defined as being a minimum of 8 weeks duration. Researchers also found that mobilization therapy was beneficial in improving patients’ pain levels, with many achieving full recovery after six to seven weeks of treatment; however, the current evidence did not support a similar level of benefit from massage therapy. Neck pain is a very common complaint – approximately 15 percent of women and 10 percent of men are estimated to have chronic neck pain at any one time. According to a report issued by the National Board of Chiropractic Examiners, 18 percent of chiropractic patients list neck pain as their chief complaint. Spinal manipulation, also called a chiropractic adjustment, is the main therapeutic procedure performed by doctors of chiropractic. The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile. Chiropractors practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment. Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints. In addition, a significant amount of evidence shows that the use of chiropractic care for certain conditions can be more effective and less costly than traditional medical care. The Journal of Manipulative and Physiological Therapeutics, the premier biomedical publication in the chiropractic profession and the official scientific journal of the American Chiropractic Association, provides the latest information on current research developments, as well as clinically oriented research and practical information for use in clinical settings.

Seneca Falls, NY: Karen A. Bobak, D.C. was selected to serve as New York Chiropractic College’s Acting Dean of Chiropractic, effective beginning May 1. Acting Dean, Bobak will oversee the day to day operation of the Doctor of Chiropractic program, including academic planning, curriculum development, faculty hiring and associated budgets as they relate to the program. Dr. Bobak’s appointment comes on the heels of a nationwide 15-week search that attracted applications from throughout the country. A search team comprised of faculty, staff and administration made recommendations to Michael Mestan, D.C., Interim Vice President of Academic Affairs, who thereafter conducted interviews with qualified prospects. Dr. Bobak received her Bachelor of Arts in Biology from Canisius College in Buffalo, New York in 1982, and the Bachelor of Science degree from National College of Chiropractic in Lombard, Illinois, in 1984. Awarded a Doctor of Chiropractic degree from National in 1986, Karen was licensed in New York, and has since managed a private practice in the Rochester. Affiliated with NYCC since 1994 as an adjunct professor, Bobak joined NYCC’s full time faculty in 1999 and was promoted to assistant professor in 2003, teaching coursework in technique and has also served as Technique Team Leader in the Chiropractic Clinical Sciences department. She remains active in a variety of academic and search committees, and her scholarly activity includes participation in NYCC’s 2006 Research Symposium, and involvement in numerous research and faculty development consortia. Executive Vice President Mestan is pleased at Dr. Bobak’s steady growth and development throughout her employment at the College, and he feels confident she will continue to “demonstrate outstanding leadership” in her new position.

The NCMIC Group, Inc. has contributed $100,000 to the Foundation for Chiropractic Progress to support the national initiative to educate the general public about the benefits of chiropractic care. This most recent donation makes a total of $400,000 committed by the NCMIC. About NCMIC Group, Inc. For more than 60 years, NCMIC has served as the nation’s largest provider of chiropractic malpractice insurance, insuring more than 36,500 doctors. Their core business consists not only of malpractice coverage, but also includes financial products and other affiliated insurance products. "A public relations campaign to raise the awareness of the benefits of chiropractic, supported by the profession, can have a huge impact on the profession both today and in the future,” said Dr. Louis Sportelli, NCMIC President. "Whether doctor or vendor we all have a direct interest in the success of this public relations campaign. The profession must make contributions and view this program as a long-term investment in the future." About the Foundation for Chiropractic Progress A non-profit corporation, the Foundation for Chiropractic Progress exists to increase the number of people who seek chiropractic treatment and to educate consumers about this conservative, effective form of treatment. “The Foundation challenges the profession to match the commitment level of NCMIC,” said Kent Greenawalt, Foundation Chairman. “We need every doctor to contribute the equivalent of just one adjustment a month to ensure success.” Every dollar received from vendors and doctors will go directly to the advertising/public relations campaign. We invite you to join the Foundation and build on the positive press of this campaign. If you wish to make a pledge and/or contribution to the Foundation, please visit www.foundation4cp.com. Contributions are also received at P.O. Box 560, Carmichael, California 95609-0560.

Save the date. NYSCA’s fall convention scheduled for Friday, September 28th. – Sunday, September 30th, 2007 at Six Flags Great Escape Lodge & Indoor Water Park on beautiful Lake George, New York. Program to include Hospital Protocol Prerequisites with a minimum of 12 credit hours of continuing education. The Lodge room rate is $159.00 per Standard Suite per night (up to 4 people in the suite) which will include admission to the indoor water park. Our attendees will also receive the discounted admission rate of $15.00 per person to the Great Escape Amusement Park located directly across the street from the Lodge. This weekend is October-fest at the Park and there will be exciting special events for everyone. We will be holding a picnic on Saturday at the Park for the group with great food and fun for all. Don’t miss your chance to come to Lake George in the early fall, see the foliage, visit the exhibitor booths, receive your continuing education credits and the kids (both big and small) will just love it! Please visit their website to view the resort and watch your mail for the convention schedule and registration form. Make your Lodge reservations early as this event will sell out quickly! Six Flags Great Escape Lodge & Indoor Water Park 89 Six Flags Drive, Queensbury, New York 12804 Lodge Reservations: 518-824-6060 (Mention NYS Chiropractic for the Group Rate)

ABSTRACT Objective To examine the effects of reduction in dietary sodium intake on cardiovascular events using data from two completed randomised trials, TOHP I and TOHP II. Design Long term follow-up assessed 10-15 years after the original trial. Setting 10 clinic sites in 1987-90 (TOHP I) and nine sites in 1990-5 (TOHP II). Central follow-up conducted by post and phone. Participants Adults aged 30-54 years with prehypertension. Intervention Dietary sodium reduction, including comprehensive education and counselling on reducing intake, for 18 months (TOHP I) or 36-48 months (TOHP II). Main outcome measure Cardiovascular disease (myocardial infarction, stroke, coronary revascularisation, or cardiovascular death). Results 744 participants in TOHP I and 2382 in TOHP II were randomised to a sodium reduction intervention or control. Net sodium reductions in the intervention groups were 44 mmol/24 h and 33 mmol/24 h, respectively. Vital status was obtained for all participants and follow-up information on morbidity was obtained from 2415 (77%), with 200 reporting a cardiovascular event. Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94), with similar results in each trial. In secondary analyses, 67 participants died (0.80, 0.51 to 1.26, P=0.34). Conclusion Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events. Nancy R Cook 1*, Jeffrey A Cutler 2, Eva Obarzanek 2, Julie E Buring 1, Kathryn M Rexrode 1, Shiriki K Kumanyika 3, Lawrence J Appel 4, Paul K Whelton 5 1 Brigham and Women's Hospital, Harvard Medical School, Boston, MA 2 National Heart, Lung, and Blood Institute, Bethesda, MD 3 University of Pennsylvania School of Medicine, Philadelphia, PA 4 Johns Hopkins University, Baltimore, MD 5 Loyola University Health System, Maywood, IL

Please be advise that an article in the May issue of SELF magazine that examines the purported link between vertebral artery dissection and chiropractic cervical manipulation. The story will not be available on newsstands until next week, but it is already posted online. Read the story by clicking here. While the views of ACA spokesperson Dr. William Lauretti, an expert on the topic of vertebral artery dissection, are included in the article, the piece is overwhelmingly negative and details the stories of several patients -- particularly a 43-year-old mother of four who believes her stroke was caused by a chiropractic adjustment. In its official response issued this morning, ACA explains to the editors of SELF magazine that the article needlessly alarms current and potential chiropractic patients about a safe, effective and appropriate treatment for those with common forms of neck pain and headache. Moreover, there is no definitive evidence that chiropractic manipulation is the cause of vertebral artery dissections. To read ACA’s full response, clicking here. Patient Communications Patients, staff and colleagues may ask you about this article. To help combat any negative publicity that might occur in your community as a result of this article, ACA is offering the following information: Chiropractic &; Stroke: Key Messages What are the Risks of Chiropractic Neck Adjustments? By William J. Lauretti, DC Chiropractic Manipulation & Cervical Artery Dissection. A JACA article by Michael T. Haneline, DC, MPH, and Gary Lewkovich, DC NCMIC’s CVA Monograph Executive Summary & Warning Signs Poster Patient Education Page: Chiropractic &; Headaches Research Excerpts that Show the Positive Benefits of Chiropractic Care ACA is also asking doctors of chiropractic to monitor SELF’s blog where readers can discuss the story. Doctors and chiropractic patients are encouraged to post positive messages about the benefits of manipulation. To visit the blog, click here.

The New York State Senate today confirmed Governor Eliot Spitzer’s nomination of Eric R. Dinallo as the 39th Superintendent of the New York State Insurance Department. Superintendent Dinallo has been serving as Acting Superintendent since January 2007. “I am honored to have been confirmed as Superintendent of the Insurance Department. I thank Governor Spitzer for nominating me and the Senate for its unanimous vote. I am proud to join the excellent staff of the premier state insurance regulator,” Superintendent Dinallo said. “I pledge to the people of New York State that the Insurance Department will strive to ensure that consumers, both individuals and businesses, are fully informed, have access to the insurance products they need at reasonable prices and are treated fairly in the claims process. The Department will work equally hard to ensure there is a favorable climate in New York for the insurance industry to prosper and grow, including a level playing field. Finally, the Department will strive to regulate in innovative and efficient ways that provide all of the above,” said Superintendent Dinallo. Superintendent Dinallo joined the Department from Willis Group Holdings. Since 2006, he had been General Counsel for the company, the world’s third largest insurance broker. A member of the Partners Group, the company’s global executive management committee, he was the primary legal advisor on value creation matters. His responsibilities included supervising General Counsels, Global Compliance and the Internal Audit Department, as well as implementing corporate strategies, policies and procedures to ensure the effective management of regulatory and litigation matters. From 2003 to 2006, Superintendent Dinallo was the Managing Director, Global Head of Regulatory Affairs for Morgan Stanley. He designed and led top-to-bottom reviews of conflicts and business practices, achieving a major shift in the firm-wide regulatory strategy. At Morgan Stanley, Superintendent Dinallo chaired the Global Conflicts Committee and was the Managing Director on the Law Department Diversity Committee. He was also a member of the Franchise Committee and the Operational Risk Group. Superintendent Dinallo served at the Office of Attorney General Eliot Spitzer from 1999 to 2003. As Chief of the Securities Bureau, he was charged with combining that bureau with the Real Estate Finance Bureau. The resulting Bureau was named the Investment Protection Bureau to reflect its focus, and Mr. Dinallo was named its first Chief. In that capacity, he led the reinvigorated Bureau’s investigations into the Wall Street Cases – conflicts of interest in the financial services industry, including research analyst cases and the spinning of hot initial public offerings. He produced more than 40 major civil and criminal matters, and led the Bureau through the beginning of the mutual fund industry investigations. Before joining the Attorney General’s office, Superintendent Dinallo served as an Assistant District Attorney in the New York County District Attorney’s office from 1995 to 1999. He had primary responsibility for securities fraud and white collar and insider trading investigations and trial. From 1991 to 1995, Superintendent Dinallo was a Litigation Associate with the Manhattan law firm of Paul, Weiss, Rifkin, Wharton & Garrison. From 1990 to 1991, the Superintendent clerked with the Honorable David M. Ebel of the United States Court of Appeals, Tenth Circuit in Denver. Superintendent Dinallo earned a Bachelor of Arts degree in philosophy from Vassar College in 1985, followed by a Master of Arts degree from Duke University School of Public Policy in 1987. In 1990, he earned his law degree from New York University where he was New York University Law Review and Essay Editor and a member of the Order of the Coif. Superintendent Dinallo lives in Manhattan with his wife, Priscilla Almodovar, and children Robert and Amelia. The Superintendent of Insurance is responsible for the monitoring and regulation of more than 1,000 insurance companies with total assets exceeding $4 trillion. The position also includes oversight responsibility for more than 100,000 brokers, agents and financial intermediaries and the management of more than a thousand Department employees. The Superintendent also acts as Receiver of insolvent insurance companies through the New York Liquidation Bureau.

Effective spring quarter 2008, Sherman College of Straight Chiropractic will raise its entering grade-point average (GPA) requirement (currently 2.5 on a 4.0 scale) by one-tenth of a point each year, until the entering GPA reaches 3.0 in 2012. The college’s Board of Trustees approved the policy in early March. The proposal to increase the entering GPA requirement initiated from faculty recommendations and from several discussions in meetings of the college’s Academic Affairs and Institutional Effectiveness Committees. The increased admission standards were also discussed extensively with student representatives, academic deans and the Enrollment Services office, and they reflect the rising qualifications needed for students to be academically successful at Sherman. The first incremental increase in spring 2008 will bring the required entering GPA to 2.6. “Our goal in adopting this policy is to attract students who are adequately prepared for the rigor of the academic program at Sherman College,” says Vice President for Academic Affairs Jon Schwartzbauer, D.C. “It is only appropriate that the requirements associated with admission to Sherman College be aligned with the expectations students will encounter when they enter the doctor of chiropractic program,” Schwartzbauer explains. Increasing the entering GPA requirement specifically addresses an objective of the college’s Strategic Plan to “increase student quality in the recruitment process by using indicators of student success to evaluate candidates.” Included in the college’s definition of student success are (1) completing the doctor of chiropractic degree program in 14 quarters and (2) passing all four parts of the National Board of Chiropractic Examiners’ tests before graduation. The Council on Chiropractic Education (CCE) currently requires a minimum entrance GPA of 2.5 for students enrolling in all chiropractic colleges. A study of entrance data for Sherman students enrolling between 2004 and 2006 compared entrance GPAs with Sherman College quarterly GPAs, cumulative GPAs and national board scores. Strong correlations were found between entrance requirements and Sherman College GPAs and national board scores, supporting the concept that increasing the entrance requirement would lead to an improvement in student performance in the chiropractic program and on national board exams. College officials believe increasing the entrance requirements will result in better-equipped students who are able to thrive within the chiropractic program. In addition, the change should result in increased retention and graduation rates. Vice President for Enrollment Services Robert Irwin, D.C., doesn’t expect the revised policy to cause any changes in enrollment trends, as most Sherman students exceed a 2.6 entering GPA. By giving a year’s notice to students preparing for admission, the college does not expect the change to be a hardship on any qualified candidates. “We want to ensure the best possible fit between Sherman College and its students,” Irwin says. “Aligning admission requirements with the high academic standards already in place at Sherman just makes sense.” Executive Vice President/Provost Myron Brown, D.C., who serves on the task committee of the CCE that is currently considering a major re-write of its educational standards, agrees. He says that because part of Sherman College’s mission is to train leaders for the profession, raising the entering GPA is appropriate. As a member of the task force, Brown hopes the CCE’s new educational standards will focus on outcomes relative to an institution’s mission and leave the process, including entering GPAs, up to the institutions. Sherman College will continue to monitor the effect of entering GPA on educational outcomes and if necessary, will adjust admission policies accordingly.

New York State Metro delegate to the American Chiropractic Association (ACA) H. William Wolfson, DC, of Commack, NY, was named a Fellow of the International College of Chiropractors (ICC) at the ACA House of Delegates meeting on March 23, 2007, in Washington, D.C. Election to the ICC is touted as one of the highest honors of service in the chiropractic profession. Dr. Wolfson was presented a plaque commemorating the honor from Dr. Lewis Bazakos, ACA Chairman of the Board of Governors

Chiropractors Must Focus on Improving Documentation Error Rate (Arlington, Va.) The first phase of the historic Medicare Chiropractic Demonstration Project will come to a close this weekend, ending a two-year program to collect cost and other data related to an expansion of chiropractic services offered in Medicare. It is ACA’s hope that the demonstration project will prove effective in convincing Congress to enact permanent legislation to reimburse doctors of chiropractic within Medicare for common services beyond manual manipulation of the spine to correct a subluxation, such as exams, plain X-rays, therapy services and clinical lab services. The Medicare Chiropractic Demonstration Project will officially end on March 31, 2007. Under the next phase of the demonstration project, no additional chiropractic services will be provided within Medicare; the Centers for Medicare & Medicaid Services (CMS) will concentrate on collecting and evaluating claims data – a process expected to require an additional two years. CMS will furnish Congress with a formal analysis and report on the findings of the pilot project in spring 2009. “On behalf of all ACA leadership, I wish to expresses my sincerest appreciation to all who were involved in the Medicare Chiropractic Demonstration Project, especially the individual doctors of chiropractic who elected to participate over the past two years,” said ACA President Richard G. Brassard, DC. “The demonstration project was an unprecedented opportunity for the chiropractic profession to show Medicare officials that the arbitrary limits on chiropractic services are costly to taxpayers and do a great injustice to patients.” At this time, ACA is reminding all doctors of chiropractic to focus on improving the chiropractic documentation error rate within the existing Medicare program. ACA fears that continued high claims error rates will be used as an argument to thwart future efforts to allow chiropractors to provide additional services, even if results from the Medicare Chiropractic Demonstration Project are favorable. ACA offers a number of valuable Medicare resources on its Web site at www.acatoday.org/medicare. In 2003, the U.S. Congress enacted legislation requiring CMS to conduct a “pilot program” allowing doctors of chiropractic to furnish additional services under Medicare. The pilot project, known as the Medicare Chiropractic Demonstration Project, was enacted into law as a direct result of an ACA lobbying campaign. The first phase of the demonstration project has been underway in select geographic areas – including Maine, New Mexico, 26 counties in Illinois, 17 counties in Virginia, and one county in Iowa – since April 2005. “Upon completion of the Medicare Chiropractic Demonstration Project, the chiropractic profession should have solid and reliable data on which to build our case for a permanent expansion within Medicare. If the data are favorable, it will be the pathway to enacting a law that will win us the Medicare coverage we have sought for years,” Dr. Brassard said. Public policy experts agree that changes to the Medicare program routinely roll over into the private sector, where health care plans often model their benefits after Medicare and adopt changes that the government makes to the program. Consequently, any positive results from the chiropractic demonstration that lead to permanent changes in the Medicare program will not only have encouraging implications for senior beneficiaries, they will also have a significant impact on the U.S. health care system for years to come. “The results of the demonstration project could finally mean the end of 30 years of discrimination against millions of patients who have been denied needed chiropractic care for far too long – not only under Medicare, but also under many private insurance plans that use Medicare as a model,” Dr. Brassard noted. For more information about chiropractic in Medicare, including the Medicare Chiropractic Demonstration Project, contact Jaime Mulligan at [email protected] or visit the ACA Web site at:

The state senate has approved legislation sponsored by Sen. James L. Seward (R-C-I/Milford) that would create a state panel to review proposed health insurance mandated benefits to analyze their costs and impact on the cost of health insurance. Senate bill 3020 was approved by the senate unanimously. "Almost three million New Yorkers do not have health insurance, and for others, its rapidly escalating cost is putting affordable health coverage out of reach," Seward said. "Over the years the legislature has enacted legislation requiring that health insurance cover more than 30 different services, treatments and providers, and they all come with a cost." The legislation establishes the "health care quality and cost containment commission," the purpose of which is to analyze and report on the impact of proposed health insurance mandates. It would be charged with a) investigating the current practices of health plans; b) evaluating potential premium impact as well as avoided costs; c) analysis of current medical thinking to determine the mandate's affect on health care quality. The 2006-07 state budget includes a $300,000 appropriation for the commission, which would be included in the state insurance department. "Studies have shown that coverage of mandated services has increased premiums by 12 percent," Seward said. "And every one percent jump in insurance premiums means that 30,000 New Yorkers lose their health insurance. The commission will review mandates and advise the legislature on their estimated costs so that the legislature can make an informed decision on a particular mandate bill." The measure is sponsored in the assembly by Alexander "Pete" Grannis. "The best health insurance coverage is of no value if no one is able to afford it," Seward said.