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									          ARIZONA CHIROPRACTIC SOCIETY
                 APRIL 2007 NEWS
                      Statewide Non-Profit Chiropractic Association
                Alan M. Immerman, D.C., President and Executive Director

HB 2757 HEALTH INSURANCE; CERTAIN MANDATES EXCLUDED GOES DOWN IN
FLAMES IN SENATE HEALTH COMMITTEE 5-2

          HB 2757 Health Insurance; Certain Mandates Excluded was defeated in the Senate Health
Committee on March 29, 2007 by a vote of 5-2. Committee Chairwoman Republican Senator Carolyn
Allen and Vice-Chairman Republican Senator Tom O’Halleran joined together with the three Democrats on
the panel to sink the bill. If passed, this bill would have allowed insurers to sell individual health insurance
policies that would not have covered chiropractic. These policies would have become commonplace.
Therefore, the defeat of HB 2757 is a huge victory for the profession.

          HB 2757 is a “Majority Program” bill. This means that legislative Republican leadership has
adopted it as one of its key bills which it wants passed this year. Therefore, you can expect repeated efforts
to bring it back to life. ACS will be extremely vigilant, watching for any signs of life and ready to
extinguish them out as quickly as they surface. Stay tuned – you will likely be called upon again to contact
legislators.

           The overall prospects for passage of HB 2757 do not look good. In the Senate there are 30
members of which 13 are Democrats and 17 are Republicans. It takes 16 votes to pass a bill in the Senate. It
is likely that all 13 Democrats will vote no on HB 2757 and that Republican Senators Allen and O’Halleran
and possibly 1-2 other Republicans will vote no. Count the numbers and there is no way the proponents get
to 16 yes votes. Therefore, at this point, it appears unlikely that HB 2757 will pass this year.

         In other legislative news, SB 1504 Chiropractors; Copays has run into a temporary delay because
two days prior to the House Health Committee hearing scheduled on March 28, 2007 a policy advisor from
the Arizona Department of Insurance told the Legislature that the bill had problems with wording. ACS still
does not know why we were not informed of these alleged problems until this late in the legislative process.
In any case, the problems have been corrected and ACS is looking for another bill to use as a “vehicle” to
carry our legislative language. We have the cooperation of key individuals at the Legislature and so expect
to move forward shortly. Stay tuned – you will be asked to lobby legislators on this bill in the near future.

         HB 2115 Professions; Disciplinary Action; Continuing Education has now passed the initial vote
by the full Senate. It is awaiting the final vote by the Senate, then must receive one final vote from the
House, and then will go to the Governor. There is no opposition and so we continue to expect that this bill
will soon become law, thus allowing the Board to order doctors to take CE classes in record keeping and
other subjects rather than harshly disciplining licenses over minor violations. This will be another great
victory for the profession and a direct result of the pressure brought to bear on the Board by ACS over the
past two years.

         HB 2114 AHCCCS; Chiropractic Services: This AAC bill, which would change the definition of
chiropractic from care for subluxations and neuromusculoskeletal conditions to care for only neck and back
pain, appears to be dead for this year.

         This is an extremely important point: None of our legislative victories would have been possible
without the work that you and your staff have done with emails, phone calls, postcards and letters. The
feedback we have received from the Legislature is that your communications have had a major impact. You
should be very proud of yourself and your staff. This is what it takes to get the job done!

MEMBERSHIP COSTS $3.33 PER DAY, LESS THAN ONE FOURTH THE COST OF LUNCH
         Does it make a difference to your office whether or not individual insurance policies cover
chiropractic? Does it make a difference if copays are $20 versus $70 per visit? Does it make a difference to
you if Arizona has the most aggressive Chiropractic Board in the nation? If so, now is the time to join ACS,
simple as that. Call 602-368-9496 and we will sign you up quickly and answer any questions you might
have. Join now to support intelligent and efficient solutions to these problems. Please join today – we need
funding for our lobbyist, attorney, staff, etc. Many thanks to our stalwart members who are truly the
foundation of the profession in Arizona. One day we will publish their names and let everyone know who
has been carrying the load. ACS is extremely proud of its remarkable group of member-heroes.

DAVID BROTMAN, D.C. JOINS ACS BOARD OF DIRECTORS

         ACS is delighted to announce that Dr. David Brotman has now joined the ACS Board of Directors
to help guide the organization. Dr. Brotman served for ten years on the Arizona Board of Chiropractic
Examiners and brings valuable perspective to our Board. The distinguished Board members now include
Drs. Gregg Friedman, Heide Hartmann-Taylor, Karen Jacobson (AZ ICA rep.), Kelly Buth, Michael
Cormier, David Brotman, Shaun Miglore and Alan M. Immerman.

ANNOUNCING THE ALL NEW ACS WEBPAGE: WWW.AZCHIROPRACTORS.ORG

          ACS is very proud to announce the launch of our totally new webpage www.azchiropractors.org.
This is a practical webpage with loads of information which you will be able to use on a daily basis in your
office. Be sure to take a look. It is a work of art in addition to a treasure trove of ideas.

        X-RAY EQUIPMENT * NEW * REFURBISHED: High Frequency X-ray Systems, Digital X-
         ray Systems * Digital Cassettes, 300 MA Systems * Automatic Processors, Chiropractic Tables *
         New * Refurbished, Statewide Sales and Service, Leasing Programs Available * New Practices
         Welcome!!!! 602.439.3100, Tonya or Terry * Custom X-ray Equipment Sales and Service.

        MALPRACTICE INSURANCE CARRIER: Chiropractic Benefit Services is the best
         malpractice program in Arizona. We have the experience and passion to defend and protect you in
         a court of law. We offer the best coverage, and the lowest prices in Arizona. Call CBS at
         800.883.0412.

URGENT CALL FOR ACS SPECIAL FUND CONTRIBUTIONS

          Doctors, it is expensive to run an association and hire lobbyists and attorneys. To pay these
expenses, ACS has created a Special Fund which exclusively funds legislative lobbying efforts and legal
efforts with the Arizona Department of Insurance. ACS has requested $1,000 contributions from every
doctor. Fortunately many doctors have risen to the challenge. However, more contributions are needed
now. Please mail your checks today to ACS or send an email giving ACS authorization to charge your
credit card for a Special Fund contribution. The business and profession you save will by your own.

UNITED HEALTHCARE AND HUMANA ISSUES

          A few quick reminders about United for 2007: Payment for hot and cold packs will be “integrated”
into the primary procedure, i.e., you will not be paid for these services. For unattended electrical
stimulation, you must bill with HCPCS Code G0283 rather than CPT code 97014. Beginning February 1,
2007, United will refuse to honor assignments of benefits and will instead send payments to patients if you
are out-of-network. In some states, United is only paying for physiotherapy if performed by the DC, not a
CA.

         Many doctors have contacted ACS about problems with Humana. Doctors have followed ACS
protocol to resolve problems by filing formal Grievance Letters (contact ACS for complete information
about these powerful tools) but Humana has refused to identify a Grievance Officer or accept the Letters.
Therefore, ACS filed a complaint with the Department of Insurance and an investigation has begun.
        PINCUS AND ASSOCIATES, P.C. – ARE YOU TIRED OF REDUCING YOUR BILL? With
         offices in Tempe and Tucson, there is no longer any reason for you to routinely reduce your bill on
         accident cases. Call Steven Pincus, Esq. At 480.777.2599, or Michelle Lespron, Esq. At
         520.888.2599, to learn how it is to work with attorneys who understand how to beat the insurance
         companies at their own game. You deserve to be paid for all of the work you put in to treating a
         patient!!!

        CHIROPRACTIC VOLUNTEERS FOR MISSIONS needed for the Phoenix chapter of
         Flying Samaritans. Bring your compassionate hearts and healing hands for weekend mission trips
         to Baja, Mexico. It's a great way to give back! Email or call Dr. Patricia Henthorn, D.C. -
         docpatti@cox.net, 480-861-4737.

ANTI-INFLAMMATORY DRUGS: A CLEAR AND PRESENT DANGER

          According to an article in The New England Journal of Medicine (June 16, 1999), there is a “silent
epidemic” of aspirin- and nonsteroidal anti-inflammatory drug (NSAID)-related deaths. Authors of the
article estimate that about 16,500 people die each year due to gastrointestinal problems caused by these
drugs. To put the severity of this estimate in perspective, 16,685 people died in 1997 from AIDS. Dr. M.
Michael Wolfe, of the Boston University School of Medicine, believes that if deaths resulting from
complications of NSAIDs were given their own classification, they “would constitute the 15 th most
common cause of death in the United States.” NSAIDs include aspirin, ibuprofen, and ingredients in Aleve,
Naprox, Voltaren, and Indocin.

         Your patients have a choice: Potentially dangerous NSAIDs or gentle conservative noninvasive
chiropractic adjustments. A word of caution: Be careful when you tell patients about the dangers of
NSAIDs or the medipractic Chiropractic Board may charge you with “instilling fear in the public.”

INSURANCE EQUALITY LAW 20-461 PROHIBITS LIMITATIONS ON MODALITIES

          On August 25, 1992, the Arizona Department of Insurance issued an enforcement letter to respond
to the following question:

“Q: May an insurer impose exclusions or limitations on treatment modalities, such as spinal manipulation,
so long as these exclusions or limitations apply to all types of physicians?

A: No. Such exclusions or limitations are targeted at the services provided under certain types of licenses
(in the case of spinal manipulation, for instance, chiropractors and some osteopaths), in favor of other
forms of treatment such as surgery. The obvious intent of the law is to provide freedom of choice by the
consumer as to the type of practitioner (and thus the type of treatment) he or she deems appropriate for the
medical condition based on personal factors.”

          This means that it should not cost any more for patients to receive out-patient chiropractic care
than it costs to receive out-patient medical care for the typical conditions we treat. The ACS attorney, John
P. Flynn of the prestigious Phoenix law firm Tiffany & Bosco is actively negotiating with the Department
of Insurance regarding these issues at the present time. We will keep you informed of the developments.

CHIROPRACTIC BOARD WILL PROSECUTE YOU FOR RENDERING CARE THAT IS NOT
“MEDICALLY NECESSARY”

         Board minutes which are sent regularly to all ACS members frequently show cases where the
Board has charged doctors for rendering care which was allegedly not medically necessary. You need to be
aware that the Board has gone this far into invading your clinical domain. You can literally have you
license placed in jeopardy if 3 of 5 Board members determine that the care you gave was not medically
necessary. Remember that 2 of the 3 Board members, Drs. Haydon and Baker, have rich histories of
working for insurance companies as IME doctors. In her application to the Governor to be appointed to the
Board, Dr. Haydon even listed one of the top State Farm lawyers in the state as one of her three personal
references! This means you can expect State Farm and Allstate medical necessity standards to be applied
by the Board to your files. For this reason, and many, many more, ACS is absolutely dedicated not only to
complete Board reform, but to total Board member removal and replacement. Both Drs. Haydon and Baker
were nominated to the Board by the AAC and remain members of the AAC.

         The AAC, an ally, defender and spokesman for the Board, recently published letters from the
Chiropractic Board’s Executive Director and the Ombudsman’s Office attempting to excuse the Board’s
dismissal of 1,100 complaints filed against the 3 DCs on the Board for allegedly disposing of private
protected patient medical records in outside trash without first shredding or incinerating which is a
violation of the law. The AAC, as usual, only presented the Board’s side of the story. The Board did not
even ask ACS to publish the letters.

          The Chiropractic Board’s website states that the Board does hear anonymous complaints. ACS is
aware of a number of anonymous complaints which have resulted in severe penalties. Therefore, the Board
members have chosen to treat themselves differently then they treat all other DCs in the state. Without
divulging confidential details, we want to leave you with this final conclusion: The anonymous complaints
are not going away. They are sitting in safe storage. They will emerge from storage one day soon, probably
this year, and become public complaints. There is a logical and simple explanation for the delay. Think of
the complaints as a ticking time bomb that will inevitably go off. The Board members will face the same
justice that they have dispensed to their colleagues with such vengeance over the past years. Once again, it
is inevitable.

          In the March, 2007 issue of the internationally published The Chiropractic Journal, an article and
editorial were published regarding the crisis with the Arizona Chiropractic Board. The article, entitled
“Arizona bars IMEs from Board,” may be read at
http://www.worldchiropracticalliance.org:80/tcj/2007/mar/c.htm and the editorial “Can Board Members
Serve Two Masters?” may be read at http://www.worldchiropracticalliance.org/tcj/2007/mar/rondberg.htm.
Every Arizona DC must read these publications.

SPECIAL TREASURES FOR MEMBERS

1. In March, 2007 ACS sent via email the January and February minutes from the Arizona Board of
Chiropractic Examiners to all ACS members. If you need another copy, just send an email request.
2. ACS has assembled a complete Preston Long rebuttal package including a sample report which
discusses 17 RCTs which support chiropractic care of neck and back problems, official guidelines
endorsing chiropractic from 7 countries, risk of stroke, Dr. Long’s Chiro Board file and deposition history,
and much more. ACS members may email for a copy.
3. Sample Chiro Board Required Daily Notes: The most comprehensive package in the profession No
one can guarantee you that their information will protect you from the Board’s wrath over record keeping.
However, ACS is confident that we have the most valuable and accurate information available. ACS has
researched and found notes that were approved by the Board after a lengthy audit process. Send an email
request and you will see what a typical daily note must be in the eyes of the Chiro Board.
4. Timely Payment of Claims, Adjudications, Adjustments: All of the tools you need for when an
insurer is late in paying your bills.
5. Grievance Letters: a special legal device that can be used to get insurers’ attention and quick action on
claims.
6. Health Care Appeals Process and Request Form: a guide for using the legal Health Care Appeals
Process to overturn medical necessity denials.
7. Medical Records Protocol: this is the protocol which you are required by law to have on file in your
office.
8. Much, much more! ACS provides individualized guidance to members on how to resolve insurance
problems.

SPECIAL THANKS TO MEMBERS OF THE ACS PRESIDENT’S CLUB
       Many thanks to our members who have agreed to contribute double the normal amount of dues of
$100 per month to help ACS fight for chiropractic progress. These doctors are premier members of ACS’s
President’s Club. Please join the President’s Club today! We can do so much more for chiropractic with
additional support!

ARE YOU REGULARLY RECEIVING EMAIL FROM ACS?

         The ACS Members’ Only Email List is the most sought after in the profession. We are frequently
(sometimes daily!) sending on-point alerts regarding a wide variety of subjects. We are sending emails on a
regular basis and want to assure that you are receiving them. If you are not receiving ACS emails please
notify us immediately. If you already get all of ACS information by email and don’t need a fax as well, let
us know. If you are not a member and want to join today, smart move! Call 602-368-9496 to join.

WELL ESTABLISHED EAST MESA AZ PRACTICE FOR SALE, Diversified, Activator, and Rehab.
1 block north of US 60, established 16 years, doctor relocating out of state. Extremely low overhead,
collections at 23,000 per month. $199,000. Great Opportunity. Call 480 375-0068.
PHOENIX OFFICE seeking associate DC with good diagnosing/report writing skills and PT cert. Must
have or be willing to be credentialed by BCBS and other health plans. 3 ½ day work-week. Salary/bonus
negotiable, health insurance reimbursement arrangement, possible partnership buy in. Please call Dr.
Strandlund, D.C. at 602.274.9988.
OFFICE SPACE TO SHARE: Newly renovated North Scottsdale office. Have 2-3 rooms to yourself.
Rehab area, massage, new x-ray unit. Serious inquires only. Call Dr. Jeff Woolston, D.C. 480-556-6797 or
email drsjandlwoolston@yahoo.com
TUCSON -- OFFICE SPACE TO SHARE: Fully equipped and staffed office. Current DC offering
opportunity to DC to move existing or start a new practice with very low overhead! Contact David Nathan,
D.C. 520-408-2225.
TURNKEY OPPORTUNITY IN LK. HAVASU CITY, AZ. 1550sq.ft. office with great frontage and a
comfortable lease in our friendly town of 55K people. Practice established 9 Years. All equipment and staff
incl. for a smooth transition. 39K. Poss. financing with reasonable down. Call Dr. Bittner @ 928-486-4899.
FOR SALE: Small, white, office fridge, $75. Many different framed posters, poster frames, whiteboards,
and wastebaskets, all negotiable. Call Dr. Dave Swan, D.C. at 480-628-1397.
SHARED SPACE AVAILABLE for Independent Contractor (Chandler) / FOR SALE: CBP Traction &
Misc. Chiropractic Equipment. Contact Dr. Jeff C. @ (480) 940-4880
FREE ICD searching on www.chirocode.com Every current ICD-9-CM code is here with its short
description. Search by code or key words. Visit the ChiroCode BookStore for orders (1500 forms, etc)
TWO CHIROPRACTIC ADJUSTING TABLES: $500 each. One Electra (now Elite) manual drop piece
table. One Lloyd bench style adjusting tale with tilting headpiece and arm rests. Adjustable height. Call Dr.
J. at 602-616-7806.

                          ARIZONA CHIROPRACTIC SOCIETY
            ALAN M. IMMERMAN, D.C., PRESIDENT AND EXECUTIVE DIRECTOR
                           15214 N. 10th Place, Phoenix, AZ 85022
                          VOICE 602.368.9496 – FAX 602.368.8954
                EMAIL: aimmerman1@cox.net – Website: www.azchiropractors.org

								
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