If a happy college is a healthy college, let it be said New York Chiropractic College is “clearly in the pink,” and naturally no less! For the sixth straight year New York Chiropractic College not only earned a position on the Chronicle of Higher Education’s “Great Colleges to Work For” list and, and made its coveted “Honor Roll” (for the fifth consecutive time), but also earned top rankings in a very respectable10 out of 12 categories: collaborative governance; compensation and benefits; confidence in leadership, facilities, workspace, and security; job satisfaction; professional/career- development programs; respect and appreciation; supervisor or department chair relationship; teaching environment; and work/life balance.

NYCC President Dr. Frank Nicchi, delighted to have once again earned the publication's distinguished honor said, "At New York Chiropractic College we empower our people to achieve exceptional results and trust they will summon their very best in achieving them. As a result, I firmly believe that they enjoy their work, feel great pride in their accomplishments, and care deeply about the college's success."

This year, of the nation’s 92 colleges distinguishing themselves based on surveys completed by administrators, faculty members, and professional support staff members, only three exceeded NYCC’s laudable 10-category recognition.

To learn more about NYCC, please visit www.nycc.edu.

Frank W. Landseadel, DC July 9, 2014 age 77 of Lancaster, NY. Beloved husband of 56 years to Ellen (nee Canton) Landseadel; dearest father of Frank (Susan) Landseadel, Kathleen (Daniel) Gauthier, Jean Nolan and the late Dr. David Landseadel (Karrie); also survived by loving grandchildren and great-grandchildren; son of the late Frank and Gertrude (nee Gust) Landseadel; brother of Jane Swanson; dear brother-in-law of Mary (Veral) Smedley. Frank was a life long member of NY Chiropractic Assoc., The American Chiropractic Assoc. and the NYS Council of Chiropractic. No prior visitation. Family, friends, patients and all who knew Frank are invited to a Mass of Christian Burial on Monday July 14, 2014 at Annunciation Church 7580 Clinton St, Elma at 10 AM. Interment will be private at the convenience of the family. Memorials may be made to a . Expressions of sympathy may be shared at www.sliwinskifuneralhome.com Arrangements by MELVIN J. SLIWINSKI FUNERAL HOME

Published in the Buffalo News from July 12 to July 13, 2014

- See more at: www.legacy.com/obituaries/buffalonews/obituary.aspx

Charles Krasner, D.C., 94, a lifetime NYSCA member, passed quietly in a Pennsylvania nursing home after a long illness A 1949 graduate of the Chiropractic Institute of New York, where he remained as an instructor/professor for years after. A member over the years of the NYSCA Brooklyn and Queens districts, the latter, where he practiced in Flushing for years, he last was a member of the Suffolk district till retiring to Florida. He was President at the time of licensing. He started and taught the Consultants' program for many years

He is survived by two sons, Davis S. Krasner, D.C, currently practicing in Queens. and Barry Krasner, retired president of the Air Traffic Controllers Union

Arlington, Va.—The American Chiropractic Association (ACA), in a letter to U.S. House and Senate conferees regarding legislation addressing recent health care issues uncovered at the U.S. Department of Veterans Affairs (VA), urges lawmakers to further integrate the essential services provided by doctors of chiropractic (DCs) in the VA health care system.

The letter, addressed to Chairman Jeff Miller (R-Fla.) and Ranking Member Mike Michaud (D-Maine) of the House Committee on Veterans Affairs and Chairman Bernie Sanders (I-Vt.) and Ranking Member Richard Burr (R-N.C.) of the Senate Committee on Veterans Affairs, reminds legislators that chiropractic physicians deliver conservative care for neuromusculoskeletal conditions necessary for America’s veterans.

ACA believes improved access to chiropractic services for the veteran population will result in decreasing its overuse and abuse of prescription pain medications. This can be accomplished by transitioning to a conservative-care-first model, which focuses on using conservative treatments, providing care in out-patient settings and incorporating health promotion and wellness counseling. Veterans should be afforded the opportunity to choose and have access to services provided by chiropractic physicians prior to prescription medication and surgical procedures. The need for change in the VA is urgent. Recent statistics from a Center for Investigative Reporting special report found that prescriptions in the VA for four highly addictive painkillers have surged by 270 percent since the war in Afghanistan began, far outpacing the increase in patients. Additional VA research shows that the fatal overdose rate among veteran patients is nearly double the national average.

“VA currently provides access to a DC at more than 45 major treatment facilities within the U.S. However, the overwhelming majority of eligible veterans continue to be denied access to chiropractic services because VA has failed to take any significant action to provide access at around 100 other VA facilities,” said ACA President Anthony Hamm, DC. “Action is needed to ensure that all the brave men and women who have put their lives on the line for our country have access to as much health care as they need when they get back home, regardless of the provider they wish to see.”

ACA’s letter urges conferees to integrate language from pending legislation in the U.S. House and Senate into the coming House-Senate conference report, as further integration of chiropractic physicians within VA can significantly reduce costs without compromising excellent clinical outcomes or high patient satisfaction.

The full text of the letter can be found on ACA’s website.

The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States advocating for more than 130,000 doctors of chiropractic (DCs), chiropractic assistants (CAs) and chiropractic doctoral students. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients. Visit us at www.acatoday.org.

The NYSCA Fall Convention in September promises to have something for everyone. It will once again be on Long Island, September 19 through September 21.

Our convention committee has put together a diverse and timely program. We have a wide variety of topics with quality speakers. Continuing education credits will of course be available, and it is a great time to be on Long Island. Try to stay some extra time to enjoy some of the attractions. We even have availability for Yankee tickets on Thursday for a discount to NYSCA members.

On Friday we will have some solid basic practice update information for Workers’ Compensation and Auto No-Fault Insurance. Saturday morning features Dr. David Seaman, the nationally well-respected nutrition author and speaker. Dr. Seaman's presentation with give you a perspective from which to observe the affects of diet and nutrition on neurological processes with regards to acute-to-chronic pain.

Dr. Christina Acampora of Aligned Methods will be speaking on Saturday afternoon with the topic “Communication with Medical Doctors”. This will be followed by Dr. Steven Weiniger of BodyZone, presenting on the subject of Strengthening Posture, Balance, & Motion.

Sunday's session will feature Medicare documentation, which as you know is currently being reviewed in the downstate area by NGS. We have the honor of hosting Susan McClelland, the ACA Medicare advisor and one of the foremost experts in Medicare for chiropractic. This program alone will be a great asset to your practice.

I hope you can join us for a weekend of education and fun. If you have any questions or concerns, please feel free to call me.

Sincerely,
Louis Lupinacci, DC
NYSCA President

Some good news on the Medicare front:

We have been informed that effective July 1, 2014 the 2% reduction for codes 98940, 98941 and 98942 will be eliminated. As you will recall, this 2% reduction was put in place as a result of the demonstration project that was determined not to be cost neutral. This will be removed effective July 1.

Respectfully submitted,
Mariangela Penna DC
NY CAC Representative

The NYSCA would like to express our deepest gratitude to the American Chiropractic Association and New York Chiropractic College for their support and advocacy regarding a proposal from the New York State Workers' Compensation Board to limit DCs' workers' compensation reimbursement.

In their recent letter, the ACA urged the Board to reconsider their proposal. Citing numerous cost effectiveness studies related to the services provided by DCs, ACA stated that such a proposal "detracts from the aims of New York's workers' compensation reforms, which include patient-centered, evidence informed and cost-effective care." ACA opposes the establishment of any system which unfairly limits one profession compared to other authorized providers and vows to voice this view strongly whenever and wherever necessary.

As always, the NYSCA and Council, through the Joint Legislative Task Force, continue to work for protecting practice rights and the services provided under New York State Workers’ Compensation. We will also keep you, our membership, informed as updates occur.

Abstract (provisional)

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Background

Low back pain is among the most common and costly chronic health care conditions. Recent research has highlighted the common occurrence of non-specific low back pain in adolescents, with prevalence estimates similar to adults. While multiple clinical trials have examined the effectiveness of commonly used therapies for the management of low back pain in adults, few trials have addressed the condition in adolescents. The purpose of this paper is to describe the methodology of a randomized clinical trial examining the effectiveness of exercise with and without spinal manipulative therapy for chronic or recurrent low back pain in adolescents.

Methods

This study is a randomized controlled trial comparing twelve weeks of exercise therapy combined with spinal manipulation to exercise therapy alone. Beginning in March 2010, a total of 184 participants, ages 12 to 18, with chronic or recurrent low back pain are enrolled across two sites. The primary outcome is self-reported low back pain intensity. Other outcomes include disability, quality of life, improvement, satisfaction, activity level, low back strength, endurance, and motion. Qualitative interviews are conducted to evaluate participants' perceptions of treatment.

Discussion

This is the first randomized clinical trial assessing the effectiveness of combining spinal manipulative therapy with exercise for adolescents with low back pain. The results of this study will provide important evidence on the role of these conservative treatments for the management of low back pain in adolescents.

Abstract (provisional)

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Background

Lumbar spinal stenosis is the most common reason for spinal surgery in older adults. Previous studies have shown that surgery is effective for severe cases of stenosis, but many patients with mild to moderate symptoms are not surgical candidates. These patients and their providers are seeking effective non-surgical treatment methods to manage their symptoms; yet there is a paucity of comparative effectiveness research in this area. This knowledge gap has hindered the development of clinical practice guidelines for non-surgical treatment approaches for lumbar spinal stenosis.

Methods

This study is a prospective randomized controlled clinical trial that will be conducted from November 2013 through October 2016. The sample will consist of 180 older adults (>60 years) who have both an anatomic diagnosis of stenosis confirmed by diagnostic imaging, and signs/symptoms consistent with a clinical diagnosis of lumbar spinal stenosis confirmed by clinical examination. Eligible subjects will be randomized into one of three pragmatic treatment groups: 1) usual medical care; 2) individualized manual therapy and rehabilitative exercise; or 3) community-based group exercise. All subjects will be treated for a 6-week course of care. The primary subjective outcome is the Swiss Spinal Stenosis Questionnaire, a self-reported measure of pain/function. The primary objective outcome is the Self-Paced Walking Test, a measure of walking capacity. The secondary objective outcome will be a measurement of physical activity during activities of daily living, using the SenseWear Armband, a portable device to be worn on the upper arm for one week. The primary analysis will use linear mixed models to compare the main effects of each treatment group on the changes in each outcome measure. Secondary analyses will include a responder analysis by group and an exploratory analysis of potential baseline predictors of treatment outcome.

Discussion

Our study should provide evidence that helps to inform patients and providers about the clinical benefits of three non-surgical approaches to the management of lumbar spinal stenosis symptoms.

Trial registration: ClinicalTrials.gov identifier: NCT01943435

Abstract (provisional)

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Background

Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the interexaminer reliability of a novel method for mapping upright spinal sites to the prone position.

Methods

Experiment 1 was a thought experiment exploring the consequences of depending on the erroneous landmark association of the inferior scapular tip with the T7 spinous process upright and T6 spinous process prone (relatively recent studies suggest these levels are T8 and T9, respectively). This allowed deduction of targeting and charting errors. In experiment 2, 10 examiners (2 experienced, 8 novice) used an index finger to maintain contact with a mid-thoracic spinous process as each of 2 participants slowly moved from the upright to the prone position. Interexaminer reliability was assessed by computing Intraclass Correlation Coefficient, standard error of the mean, root mean squared error, and the absolute value of the mean difference for each examiner from the 10 examiner mean for each of the 2 participants.

Results

The thought experiment suggesting that using the (inaccurate) scapular tip landmark rule would result in a 3 level targeting and charting error when radiological findings are mapped to the prone position. Physical upright exam procedures like motion palpation would result in a 2 level targeting error for intervention, and a 3 level error for charting. The reliability experiment showed examiners accurately maintained contact with the same thoracic spinous process as the participant went from upright to prone, ICC (2,1) = 0.83.

Conclusions

As manual therapists, the authors have emphasized how targeting errors may impact upon manual care of the spine. Practitioners in other fields that need to accurately locate spinal levels, such as acupuncture and anesthesiology, would also be expected to draw important conclusions from these findings.

Abstract (provisional)

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Background

Several studies showed the effect of osteopathic manipulative treatment on neonatal care in reducing length of stay in hospital, gastrointestinal problems, clubfoot complications and improving cranial asymmetry of infants affected by plagiocephaly. Despite several results obtained, there is still a lack of standardized osteopathic evaluation and treatment procedures for newborns recovered in neonatal intensive care unit (NICU). The aim of this paper is to suggest a protocol on osteopathic approach (NE-O model) in treating hospitalized newborns.

Methods

The NE-O model is composed by specific evaluation tests and treatments to tailor osteopathic method according to preterm and term infants' needs, NICU environment, medical and paramedical assistance. This model was developed to maximize the effectiveness and the clinical use of osteopathy into NICU.

Results

The NE-O model was adopted in 2006 to evaluate the efficacy of OMT in neonatology. Results from research showed the effectiveness of this osteopathic model in reducing preterms' length of stay and hospital costs. Additionally the present model was demonstrated to be safe.

Conclusion

The present paper defines the key steps for a rigorous and effective osteopathic approach into NICU setting, providing a scientific and methodological example of integrated medicine and complex intervention.

Are you a Medicare provider who was unable to successfully demonstrate meaningful use for 2013 due to circumstances beyond your control? CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment adjustment for the 2013 reporting year. Payment adjustments for the Medicare EHR Incentive Program will begin on January 1, 2015 for eligible professionals. However, you can avoid the adjustment by completing a hardship exception application and providing supporting documentation that proves demonstrating meaningful use would be a significant hardship for you. CMS will review applications to determine whether or not you are granted a hardship exception. CMS has posted hardship exception applications on the EHR website for:

• Eligible professionals
• Eligible professionals submitting multiple National Provider Identifiers (NPIs)

Applications for the 2015 payment adjustments are due July 1, 2014 for eligible professionals. If approved, the exception is valid for one year.

New Hardship Exception Tipsheets
You can also avoid payment adjustments by successfully demonstrating meaningful use prior to the payment adjustment. Tipsheets are available on the CMS website that outline when eligible professionals must demonstrate meaningful use in order to avoid the payment adjustments.

Want more information about the EHR Incentive Programs?
Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

SERVICE-SPECIFIC PREPAYMENT REVIEWS OF CHIROPRACTIC SERVICES (CPT CODES 98940 AND 98941)

Attention Services for Jurisdiction K Part B Chiropractic Providers in Connecticut and New York

National Government Services will be conducting service-specific prepayment reviews on CPT code 98940 in the Queens, NY area and CPT Code 98941 in CT and the upstate and downstate NY areas.

A prepayment review consists of a medical review of claims prior to payment. Request for records are most frequently electronically generated and referred as ADS letters. Please note that when medical records are requested for chiropractic services, it is necessary to submit all the specific documentation as notated in the ADS, which would include but is not limited to:

• Services up to three (3) months prior to and including the date(s) of service in question
• Advance Beneficiary Notice of Noncoverage

The primary focus of the audits will be to better identify common billing errors, develop educational efforts, and prevent improper payments. Providers will be receiving ADSs asking for documentation to support the service billed. Medical Review encourages providers to respond with the requested documentation in a timely manner to expedite adjudication of these claims.

Providers can assist in this process by:

• Reviewing all contractor publications and LCDs
• Understanding Medicare coverage requirements
• Ensuring office staff and billing vendors are familiar with claim filing requirements
• Performing self-audits of medical records against billed claims using coverage criteria, LCD, and coding guidelines
• Responding to request(s) for records in a timely manner (CMS requires that providers respond to an ADS within 30 days of the request)
• Ensuring documentation is legible and demonstrates that the patient’s condition warrants the services being reported and billed