Unprecedented Opportunity to Assist Regulatory Authorities’ Investigations: Your Assistance is Urgently Needed

The American Chiropractic Association is urging doctors of chiropractic nationwide to take immediate action to provide documentation pertaining to the discriminatory practices of chiropractic networks. The investigation of these matters is becoming of national interest and we want to be ready to supply regulatory authorities with the information they need. Your assistance is needed by June 15, 2007. "Doctors across the country have the information that regulatory authorities need to address the serious problems posed by managed care organizations," announced ACA President Dr. Richard Brassard. "Many doctors have assisted us over the past two years in this long battle, but now more than ever, it is time for all doctors of chiropractic to take a stand to protect our patients and our profession. We have a real opportunity, one that we may not have again, to address the problems of these networks – and we cannot do it without help." ACA has been in communication with several state Departments of Insurance and Attorneys General regarding tactics by managed care networks that, in ACA’s view, limit reasonable and necessary treatment, placing effective patient care at risk. Our preliminary evidence gathered was used to petition these state regulatory agencies to investigate these practices. Recent indications received by ACA lead us to believe that state agencies are prepared to take a closer look in connection with these managed care networks. "The only way that state authorities will act is if they have the ‘ammunition’ to take on the powerful and wealthy managed care companies," added Dr. Brassard. "That ammunition is your patients’ records, which contain hard evidence on how managed care decisions have limited access to medically necessary chiropractic care that is provided for under plan descriptions and/or state law." To do your part and assist ACA and regulatory authorities with this historic investigation, we request that you take the following steps by June 15. (Documentation will continue to be collected after that date, but will be most useful before the deadline.) Read and sign the Business Associate Agreement (found here) creating an arrangement between you and the ACA, so that you do not need to sanitize records for this project or in the future. The purpose will always be for the Insurance Relations Department to investigate issues that impede patients obtaining the care they need. Note that all unsanitized patient records will be kept in a locked room in locked cabinets. Identify patients whose care or benefits have been compromised by coverage decisions made by managed care networks and speak with them to ascertain if they are interested in allowing their medical file to be shared with the ACA and regulatory authorities. A patient information sheet is provided (here) for your convenience. Only the ACA, State Departments of Insurance and State Attorneys General offices will be privy to the information in the patient records. No information regarding patients or their doctors will be shared with managed care companies. Obtain HIPAA Authorization: Explain HIPAA rights to the patient – (a brochure can be found (here) just in case you are unsure if your office documentation is up to date.) Once you are sure the patient clearly understands the reason for this initiative, and they indicate they would like to participate, have them sign the HIPAA Authorization (found here) which has been pre-completed for your convenience. Mail the following to the ACA: copies of your five complete unsanitized patient files with the associated HIPAA Authorization and your signed Business Associate Agreement to the following address: American Chiropractic Association Attention: Insurance Relations/Records 1701 Clarendon Blvd Arlington, VA 22209 If you are having trouble accessing the links above, all the referenced documents can be found on the ACA Web site at www.acatoday.org/datacollection For questions about this initiative, please e-mail [email protected] or call (703)276-8800 and ask to speak with someone in the Insurance Relations Department. Your assistance with this unprecedented data collection is appreciated. Together we can bring managed care abuses to light and with one voice share this information with those who have the power to bring change.

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