ISCA Sept/Oct Newsletter 2008

September/OctOber 2008 IScA repOrt

The time for another “pep talk” for those that seem disinterested in the state of affairs within our Profession. With this being an election year, all of the politicians are being courted by the lobbyists and special interest groups including the ISCA. It’s your time to speak to the Legislators and voice your concerns. The only way you can effectively accomplish this is to attend some of the functions that are

hosted by Legislators in your district or at some of the functions that Pat McGuffey attends. As the saying goes, if you don’t vote, you have no right to complain. The ISCA is being open and wishes to provide activities and functions that will benefit the majority of our members. If you have other ideas or suggestions, bring them forward to the ISCA office or myself. The Board of Directors initiated a strategic planning session in June. It sounds simple, just give a few ideas, jot them down and you’re done. Lane and Pat met with a Professional group that has helped other Associations to help guide us through this process as it is not easy and is very time consuming. Those of you that would like things to change or may be dissatisfied with some aspects of the Association need to become involved in planning or volunteer to be on a committee. That is where changes can be made.

I am encouraging everyone to participate in all of the ISCA functions. This helps all members to work and socialize together. We can’t count on anyone to do our work except ourselves. We have the annual golf outing on September 23, at Purgatory Golf Club. Not everyone enjoys the game of golf but that doesn’t mean you can’t support it by helping work the event, solicit players, assist with door prizes and just showing up for a visit at lunch. If something is important to you and your office, you plan for it. The ISCA is important to us so plan for

these events just like a vacation and maybe bring the family.

The summer has been fairly busy with various committee meetings on speakers and the insurance industry. I have been informed of the various interim summer committees that the Legislators are holding so the Legislative committee can plan some strategy for the January session. Other than that, summer has gone by very quickly yet uneventful of which I am very thankful.

This year is going to be different at the Fall Conference in several ways. The annual meeting will be held during the luncheon as time constraints for the lectures has been a problem. Also, the luncheon is usually “Awards” day to members that have served the ISCA in special ways. In the past, the prestigious “DC of the Year” award was picked solely by the President. This is going to change as I feel this award is the ISCA membership’s opinion of the deserving member. The guidelines for deadline, nominating and voting for a candidate are on page 11 in this newsletter. The Board of Directors has approved of this recommendation.

This may be my last message to you as President as the elections will be October 31, I believe or the next Fall Conference and the next newsletter should be out the first part of November. I would like to thank the entire Board of Directors for your supporting me this past couple of years. It was your confidence and discussions that really helped me as we made some dramatic changes for the ISCA. The experience of being a District Rep and then on the Executive Committee was wonderful. Everyone should serve at least one term. However, the experience of being President of the ISCA is one that I will never forget. This experience has changed me in many ways and it is hard to explain. I thank all of you for this experience. I just hope that I have served you well enough. Time will tell. God Bless!!

InsIde ThIs Issue

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PresIdenT's Message Dr. Duane Binder, D.C.

IScA Report September/OctOber 2008

PRESIDENT'S MESSAGE..................................................................................1ISCA BoArD of DIreCTorS & STAff INfo...................................................2ExECuTIvE DIRECTOR'S MESSAGE................................................................3CoCSA uNveIlS BACkpACk 2008 SAfeTy kIT......................................4New oShA weB pAGe.................................................................................4welCome New ISCA memBerS.................................................................5Dr. TeNNANT'S ACA upDATe......................................................................5SuPREME COuRT OPINION ON NONCOMPEPTITION AGREEMENTS....6uNITeD heAlTh CAre fINeD AlmoST $800,0000.....................................6STOP THE PATIENT REvOLvING DOOR.....................................................7

hIrING A mASSAGe TherApIST.....................................................................8LIMITED CHIRO RADIOGRAPHY LICENSE.......................................................9HEALTH RECORDS: INDIANA CODE 16-39....................................................12DCS muST BeGIN uSING New ABN for No lATer ThAN SepT. 1.........13ISCA DC of The yeAr GuIDelINeS..........................................................14your voTe mATTerS.....................................................................................14ChIroprACTIC ColleGe upDATeS..............................................................15meDICAre provIDerS muST uSe oNly NpI #'S oN ClAImS....................15ISCA FALL CONFERENCE...........................................................................16-17ISCA ClASSIfIeDS......................................................................................18-19

September/OctOber 2008IScA repOrt

PresidentDuane Binder, D.C.Clinton, IN [email protected]

First Vice-PresidentPeter Furno, D.C.Zionsville, [email protected]

Second Vice-PresidentRay Nanko, D.C.Muncie, [email protected]

SecretaryMarian Klaes-Lanham, D.C. Seymour, [email protected]

TreasurerChris Bryan, D.C.South Bend, [email protected]

Immediate Past PresidentAnthony Wolf, D.C.Indianapolis, IN [email protected]

Past President RepresentativeMick Gallagher, D.C. Indianapolis, IN 317.571.1480 [email protected]

DIRecToRS aT LaRge

Ted Friedline, D.C. Salem, [email protected]

G. Matt Howard III, D.C.Muncie, IN [email protected]

Michael, Phelps, D.C.Martinsville, [email protected]

DISTRIcT DIRecToRS

District oneRon Daulton, Sr., D.C.Hammond, [email protected]

District TwoGerard Hofferth, D.C.South Bend, IN574.256.1008

District ThreeJames Cox II, D.C.Fort Wayne, [email protected]

District FourG. Lyman Shaw, D.C.Brownsburg, [email protected]

District FiveDerek Dyer, D.C.Huntington, In [email protected]

District SixRobert Tennant, D.C.Shirley, IN [email protected]

District SevenDiane Vuotto, D.C.Indianapolis, IN [email protected]

District eightMichael Toney, D.C.Terre Haute, [email protected]

District NineNate Unterseher, D.C.Seymour, [email protected]

aLTeRNaTe DIRecToRS aT LaRge

Terry Tolle, D.C.Greensburg, IN [email protected]

John Volbers, D.C.Indianapolis, [email protected]

C.C. Paprocki, D.C.Greenwood, IN317.535.7507

aLTeRNaTe DISTRIcT DIRecToRS

District oneLewis Myers, D.C.Valparaiso, IN219.464.4444

District TwoVacant

District ThreeVacant

District FourGarry Fuller, D.C.Brownsburg, [email protected]

District FiveVacant

District SixStephen Frank, D.C.Anderson, [email protected]

District SevenSheila Wilson, D.C.Indianapolis, [email protected]

District eightShaun Tymchak, D.C.Newburgh, [email protected]

District NineJohn Krawchinson D.C.Seymour, IN812.524.2273

AlternAtes:the IsCA by-laws allow for the Directors at large and the District Directors to have Alternate Directors. the Alternate At large Directors may reside anywhere in the state. the Alternate District Directors must reside within their district. there are 9 districts and their boundaries are the same as per the national census. this is done to keep the Districts in line on a proportional basis.When the Directors are not present, the Alternate Directors have the full voting powers as the Directors and may take their place at any meetings. this system was initiated to involve more people in the association’s decision-making process and to serve as a training ground for future board members. the Alternate Directors at large are nominated by the Directors at large and then must be approved by the Board of Directors. the District Director Alternates are recommended by the District Directors and approved by the board.

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Patricia McguffeyExecutive [email protected]

Lane VelayoAssociation [email protected]

Tom Johnson, cPaChief Finanical [email protected]

Debra Scott, IoMVice President of [email protected]

Stephanie HigginsDirector of [email protected]

Stacy QuasebarthDirector of [email protected]

connie VickeryGovernmental [email protected]

John LivengoodGovernmental [email protected]

Patrick RussellExecutive [email protected]

Krista [email protected]

200 S. Meridian St., Suite 350Indianapolis, IN 46225info@indianastatechiros.orgwww.indianastatechiros.org317.673.4245 phone 317.673.4210 fax

IndIana sTaTe chIroPracTIc assocIaTIon sTaff & Info

IndIana sTaTe chIroPracTIc assocIaTIon Board of dIrecTors

September/OctOber 2008 IScA repOrt 3

The Legislature adjourned for the 2008 legislative session in march but my work with the legislative process began again shortly thereafter!

In addition to the many legislators’ campaign fundraisers and outings that I attend on behalf of ISCA, LMv also monitors relevant Legislative Interim Study Committees on ISCA’s behalf. Legislative Interim Study Committees are currently meeting to study issues mandated

by Legislative Council. The Committees and Commissions will recommend legislation for the 2009 legislative Session.

The Select Joint Commission on Medicaid Oversight is one of the Commissions that has met twice. At the first meeting the Commission obtained updates from eDS and the IBm/ACS modernization plan for enrolling individuals for public assistance, and FSSA Secretary, Mitch Roob’s report that attempted to address legislators’ concerns. Several individuals that receive public assistance testified regarding their problems with the roll-out of the Modernization Plan. Legislators also expressed their concerns over the fact that their constituents have complained to them about the long phone waits and other difficulties when they attempt to sign up for public assistance programs. Two law suits have been filed suing the state to stop the roll out of the modernization plan.

At the second meeting of the Commission, Legislators heard numerous concerns regarding Medicaid managed care and the problems for Medicaid providers created by low Medicaid reimbursement rates.

The mandated Benefit Task force that is required by the legislature to study the potential cost of the Assignment of Benefits (AoB) legislation has met three times and is in the process of preparing a report to be reviewed by the Health Finance Commission and Legislative Council.

I attended the meetings and provided studies and other documents to support ISCA’s position on AoB. ISCA spearheaded the legislation in the 2008 General Assembly Session that would allow health

providers that are out of insurance company’s networks to receive the assignment of benefits (payments) directly from the patient. once again without the legislation, Chiropractors will have difficulty receiving payment for services rendered and the patient is in an unfair and vulnerable position. The information I provided to the Task force demonstrated the importance of AoB and the fact that it does not increase healthcare costs or denigrate healthcare networks. However, insurance representatives continue to vehemently oppose this issue based on their rhetoric that it will increase healthcare premiums, etc. The Task Force is comprised primarily of representatives from the insurance industry so I do not expect the Task Force to provide a fair and unbiased report to Health Finance and Legislative Council. We are still waiting for the Task force to present their findings.

In addition, ISCA hosted a meeting with advocates and other provider groups to educate them on AoB and to attempt to create a broad coalition of support. ISCA also intends to work with our members to organize a strong grassroots effort to have you obtain patients’ signatures on petitions and enlist their assistance to write letters to legislators asking for their support of AoB. we are also going to try to educate those that opposed AoB last year without truly understanding what the legislation would do. You will be hearing from us soon to enlist your support.

each day your ISCA office answers numerous questions about advertising, cost for copying medical records, Medicaid, Medicare and numerous insurance questions to name a few. Many of these answers are posted on our web site at www.indianastatechiors.org. please visit your web site where you can find information, register for conferences and update your profile, etc.

ISCA’s Legislative Committee has been actively meeting to discuss ISCA’s legislative issues and determining priorities for the 2009 legislative session. Please let us know if there are issues that you wish for the Committee to review.

I look forward to seeing all of you at our September 23 golf outing and at our fall conference October 31 to November 2. Please remember that we need your attendance and support to make our ISCA strong and viable.

Please feel free to contact me if I may be of assistance at 317-673-4215 or e-mail me [email protected].

execuTIve dIrecTor's MessagePatricia McGuffey

Isca’s noMInaTIng coMMITTee WILL Be MeeTIng To seLecT Board MeMBers and dIsTrIcT dIrecTorsAnyone that is interested in getting more involved with the ISCA by either participating on a committee or as a part of the Board please contact me or anyone on the nominating committee. (317)-673-4245 or [email protected].

Dr. Anthony wolf, Dr. Bob Clements, Dr. Gary Billingsley, Dr. peter furno, Dr. michael Gallagher, Dr. matt howard, Dr. Bob Tennant, Dr. Gerard Hofferth, Dr. Mike Toney, Dr. Gary Shaw.

September/OctOber 2008IScA repOrt4

Your Partner in Imaging

At Center for Diagnostic Imaging (CDI), our team of subspecialized radiologistsare national experts in musculoskeletal imaging and pain managementprocedures, ordered for diagnosis and/or therapeutic treatment of pain inall areas of the spine as well as joints.

Consultations are available with all of our radiologists, who can help guideyou in determining which imaging exam or pain management procedurewill work best with your ongoing patient care cycle.

Call us to schedule a patient.tel 800.537.0005

Fishers • East • North • South • Southeast • DowntownPatients: www.CDIradiology.com |Medical Professionals: www.insideCDI.com

CDI’s Services:• High-field, short MRI

• Weight-bearing MRI

• Multi-slice CT

• X-ray

• Nuclear Medicine

• Ultrasound

• Pain Management

Procedures

(Note: Chiropractors

cannot refer Medicare

patients for injections.)

Chiro Ad_8.4.08:Layout 1 8/4/2008 4:20 PM Page 1

cocsa unveILs BackPack 2008 safeTy kITpromoTe BACkpACk SAfeTy whIle SupporTING ChIroprACTIC AND BuIlDING your prACTICe help prevent backpack injury in your community and grow your business with the Backpack Safety kit from the Congress of Chiropractic State Associations (CoCSA). This kit provides you with a step-by-step way to give professional presentations to classrooms, organizations, and seminars about the growing issue of backpack injury.

Your presentation will spread awareness of backpack injury and will equate you and your clinic with the solution, helping you increase referrals, develop new patients, and build your practice. All proceeds from the purchase of your kit will be used by COCSA to support, lobby, and promote chiropractic in your community and nationally.

In addition to an entertaining 10 minute DvD for elementary School Students, the Backpack Safety kit includes a CD packed with three presentations – for different audiences – in both PowerPoint and PDF format for creating overhead transparencies. Also on the CD are customizable marketing tools, such as samples of parent and School official Introductory letters, event press releases, and scripts for introducing schools to Backpack Injury health concerns.

Add-on options to the Safety kit are Airpacks Backpacks – supplied by CoCSA partner Core products – for demonstrating a CoCSA-endorsed, ergonomically designed solution to backpack injury. Some AirPacks options provide a variety of backpacks to offer immediate sales in a range of sizes and colors.

To order your CoCSA Backpack Safety kit, go to: www.coreproducts.com/cocsa/safetykit/default.asp.

neW osha WeB Page

The occupational Safety & health Administration unveiled a new web page showcasing free occupational safety and health information related to flood and tornado cleanup and recovery crews. The web page, located at www.osha.gov/oshDoc/flood-tornado-recovery.html, provides information about way to recognize and avoid injury from cleanup and recovery hazards, and offers more than 40 fact sheets and easy-reference QuickCards in English and Spanish, along with links to other workplace safety and health related webpages.


WeLcoMe neW Isca MeMBers!

The ISCA would like to recognize our newest members:

sTudenTsShelly Coughlin

kyle BowlingSarah RaganAaron PoppDave Evans

1sT year In PracTIceSarah Paun – Paun Family Chiropractic

Lauren Montieth – Optimal Wellness Center of IndianapolisJustin Mohr – Mohr Chiropractic Center, P.C.

Aaron Mobley – Lucinda Jordan DCPCPaul Gehin – ProHealth Chiropractic

Hillary Hushower – Rangeline Chiropractic

3rd year In PracTIcePeter Adam – Adam Chiropractic Center

ouT of sTaTe/ouT of ProfessIonDave Ervin – Health Source

In MosT cases, dcs sTILL MusT fILe MaInTenance care WITh MedIcareACA Update by: Dr. Robert Tennant

Since the release of Medicare’s new Advance Beneficiary Notice of Noncoverage (ABN) form, a number of organizations and periodicals have reported that doctors of chiropractic are no longer required to bill maintenance care. After consulting the Centers for Medicare and medicaid Services (CmS), ACA has learned that this is not true.

According to CMS, in most instances maintenance care must still be billed. Most of the confusion on this matter lies with the new “Option 2” box, which allows patients to indicate that they wish to receive the services but do not want the provider to bill Medicare. Only in this instance may doctors not submit a Medicare claim for maintenance care.

In addition to this new option, other changes to the ABN include a requirement to enter an estimated cost and to verbally review the form with patients prior to signing and answer any questions.

All medicare providers will be required to use the new ABN form starting Sept. 1, 2008.


IndIana faLse cLaIMs acT and The defIcIT reducTIon acT of 2005Submitted By: Dr. David E. Jose, Esq., krieg Devault llpphone: 317.238.6211 email: [email protected] Website: www.kdlegal.com

One of my partners, Randy Fearnow, handles a variety of fraud investigation matters for health care providers, and he has informed me of an important recent development. The federal Deficit reduction Act of 2005 (“DrA”) included a number of provisions addressing health

care fraud and abuse. Among those was the requirement that all companies or individuals providing $5 million or more annually in services reimbursable by medicare/medicaid or other government reimbursement programs provide notification to all employees and vendors concerning applicable state and federal fraud and abuse laws. providers meeting the $5 million threshold were required specifically to educate employees and vendors concerning applicable state false Claims Acts. (In a subsequent newsletter, I will describe the requirements for compliance with the DRA and the providers covered by it.)

In conjunction with the DrA, the states were provided a financial incentive to enact laws establishing liability to the state for individuals and entities that submit false or fraudulent claims to the state Medicaid programs.

Indiana had a False Claims Act at the time the DRA education provisions became mandatory on January 1, 2007. The Indiana General Assembly, in fact, amended the Indiana False Claims Act prior to January 1, 2007 to help ensure that Indiana’s law would qualify Indiana for the financial incentives available in the DrA. That amendment made it easier for the state to prove the element

of knowledge under the statute, which also made it consistent with the federal False Claims Act.

on July 24, 2008, the Indiana medicaid fraud Control unit (“mfCu”) was notified formally by the Inspector General of the Department of Health and Human Services that the Indiana statute complies with the DRA. This means that the State of Indiana is now entitled to an increase of ten percent (10%) of its share of any amounts it recovers under Indiana’s False Claims Act. Thus, since Indiana contributes approximately thirty-seven percent (37%) of the costs of medicaid, it will now be entitled to forty-seven percent (47%) of any fraud recoveries under the Indiana False Claims Act.

Thus, the Indiana mfCu has an increased financial incentive to pursue various Medicaid audits under the State False Claims Act, particularly with the released “knowledge” requirement. This added incentive is particularly important considering the Indiana MFCu’s interest in going after employers of excluded providers under the Indiana false Claims Act. (This is a topic covered in a recent newsletter.) randy fearnow and our firm are handling a number of cases in which the MFCu has threatened litigation against employers of excluded individuals under a broad interpretation of the governing laws. The increased economic incentive from the federal government may well be the inducement the Indiana MFCu needs to test to expansive theories. If you have any questions about the DRA or the MFCu enforcement initiatives, please contact me at 317.238.6211 or [email protected], or randy fearnow at 317.238.6279 or [email protected].

oIg refInes Procedure for ProvIders To seLf-dIscLose PoTenTIaL fraud

To facilitate the process by which providers may voluntarily report fraudulent conduct affecting Medicare and other federal healthcare programs, the hhS office of the Inspector General (oIG) has streamlined its Self-Disclosure protocol (SDp).

Specifically, providers who disclose in good faith any self-discovered evidence of potential fraud will not be required to enter into Corporate Integrity or Certification of Compliance Agreements with OIG. “We believe [this new protocol] recognizes the provider’s commitment to integrity and also advances our goal of expediting the resolution of self-disclosures,” said Inspector General Daniel R. Levinson in an April 15 letter to healthcare providers.

In addition, OIG had previously committed to settling liability with SDP-participating providers for an amount near the lower end of the damages continuum. “To date, OIG has returned approximately $120 million to the medicare Trust fund through SDP and participating providers have avoided the costs and disruptions associated with a government-direct investigation,” adds Levinson

unITed heaLThcare fIned aLMosT $800,000.

The North Carolina Department of Insurance has settled with united Healthcare of North Carolina as a result of an investigation into the insurer’s practices. The investigation found that united HealthCare had violated state regulations pertaining to claims processing and payment. As a result of the settlement, united HealthCare is required to pay the Department $786,655.87. Additionally, united healthCare will be required to reprocess claims that were inappropriately processed and to follow a “Process Improvement Plan” in the future.

Since Departments of Insurance have the regulatory authority to fine insurers and to require process improvements from them, it is imperative that providers and patients report insurer concerns to local Departments of Insurance. For information to assist in writing appeal letters and for information to help DCs contact Departments of Insurance regarding state regulation violations, please visit www.acatoday.org/appeals.


Does this scenario seem familiar? Sally comes to your office experiencing back pain. She learned about you from a friend and heard you did a great job. After her initial consultation and diagnosis, she agrees to schedule visits for the next few months for treatment.

During Sally’s visits you tell her about the benefits of chiropractic healing and instruct her on proper spine care. Like many of your patients, during her first few visits Sally asks many questions and expresses concerns. She soaks up everything you have to share because she is in pain.

After a few weeks of treatment, Sally’s back pain is gone and she’s feeling noticeably better. She tells you she feels like her old self again, and begins to miss an appointment or two here and there. Like many patients you’ve seen over the years, she eventually quits coming after a few months – feeling better, but not cured.

unfortunately, this scenario replays itself in chiropractic offices across the country. Chiropractors spend countless hours and much energy generating new clients to replace the ones who don’t stay. They put virtually all of their time, energy, and money into obtaining new patients and none at all into patient retention.

Ask yourself these questions:• Once patients stop visiting on a regular basis, what do you do to prevent them from becoming inactive and totally falling off the radar?• Do you have systems in place to keep your name in front of patients on a consistent basis?• Do you educate your patients every time they come in on aspects of caring for their health – outside of the pain you are treating them for?

All businesses have customers that leave. Large companies call these transient customers “churn.” Smart managers; however spend time and energy reducing their churn because they know it costs approximately eight times more to gain a new client than it does to keep a current one.

Although you will never be able to completely stop patients from leaving, you can put into place processes to reduce their abdication.

Evaluate you current retention procedures. What do you do to ensure patients won’t forget about you until their back hurts again? If someone comes in for treatment for a specific pain, such as lower-back pain, it’s your job to do your best to stop the pain. That is what patients expect from you. But it is also your job to convince your patients that stopping the pain is only part of the treatment if they are to live pain-free for a long time.Offer extras. Many practice offer free educational classes on nutrition and exercise as an added benefit at no charge. offer the classes. If patients do not come, ask why not. Show how the classes will help them stay healthy.keep information flowing outside your office. Send patients home with information on classes you are teaching (or whatever other extras you offer) and the reasons why attending them is important. Give them information to look over when they are more relaxed and at ease. Something as simple as a flyer on colorful paper works fine.Teach while you adjust. Patients cannot tell other people about how you are helping them if they don’t understand it themselves. To sustain your practice and develop lifetime clients, you must teach clients about other aspects of their health (besides the pain they are experiencing) that benefit from your care, and have them recognize the importance of that.Thank patients individually. A personal thank you lets them know they are valued. Continue to thank patients even after that become “regulars.” Gratitude goes a long way toward building sustaining relationships.Pay attention to missed appointments. Act on them right away. Have a prepared “tips sheet” or article to give or mail to patients who fail to come in when scheduled. Teach them about the consequences of missing appointments without reprimanding them.Take action immediately. When patients miss appointments, take the time to call them yourself and see what is going on. Maybe there is a reason you should know and can address, such as a rude staff member or difficulty in parking. for the health of your practice, it’s important to be proactive about issues or potential problems rather than reacting when it may be too late.Produce a monthly e-newsletter. Focus on health tips and advice. Producing an online newsletter is inexpensive and can be a great way to keep existing patients happy and reactivate old ones.

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In MeMory of roB sherMan

robert p. Sherman, age 58, of Blacklick, oh passed away peacefully at home surrounded by his wife and daughter, on friday, July 11, 2008. he was born to the late Sol and Cissie Sherman on march 17, 1950 in Cincinnati, oh. he is survived by his wife, Susan Sherman and daughter Eryn Sherman. Rob had served the chiropractic profession for most of his life. Rob served the profession in Ohio as counsel to the state chiropractic examining board, as executive director of the OSCA, OSCA legal counsel and on a national level as the executive director of the COCSA. In everything that he did for our profession, Rob Sherman made a difference. He was one man, but he was a man with many gifts, and he used those gifts to make our profession better. He helped to set the foundation for where the OSCA and COCSA are today. Please keep Rob's family in your thoughts and prayers.

sToP The PaTIenT-revoLvIng doorBy kelly robbins


whenever you consider bringing on any new staff you need to first establish a need for that position. Though there is no real recipe for when to hire a massage therapist, a good rule of thumb is when you are consistently seeing over 100 patient visits a week. If you are not at that level then set a goal that when you are over 100 patient visits for 4 weeks straight, then you will bring on a massage therapist.

Consider surveying your patients to see how many patients would be interested in utilizing massage therapy in your office and find out how much they would be willing to pay out of pocket for these services. when your staff verifies insurance coverage they should ask insurance companies if massage therapy is covered in your office. Another question to consider is if you have the necessary space to provide massage therapy and if you do have the space is there another service you could provide in that same space that would generate more income or provide a better service for your patients. If you have a clinic that has no problems producing new patients and you have the space then you might consider hiring an associate doctor rather than a massage therapist because of the income potential that an associate can offer. Or you might consider utilizing rehab services or a decompression table in that space.

Once you have established a need or an opportunity for massage therapy then you should begin breaking down the cost of having a massage therapist on staff. How much will your overhead increase, how much will you have to pay them, and how much can you make from them. I recommend not paying more than 1/3 of what you can make an hour from massage therapy. If you have projected that you are going to make $60 an hour from massage therapy then you should not be willing to pay more than $20 per hour to the therapist. If you are billing insurance then it may be difficult to establish how much you can make from massage based on the fairly low insurance reimbursement the nation is experiencing.

when figuring your cost keep in mind that if you hired a massage therapist for $10 an hour it will actually cost you $11.02 per hour when you factor in taxes you are responsible for. You also want to make sure that if you are paying an hourly wage for massage that every hour they are in the office massage is being done.

how to hire a massage therapist?How to hire massage therapists has been a controversial topic in the chiropractic profession for many years. After establishing the need for a qualified massage therapist, the first question a facility needs to ponder is “will the massage therapist be an employee or an independent contractor?” If you bring them in as an employee then the facility will be responsible for paying employment taxes on the employee. If you bring them in as an independent contractor you are not responsible for those employment taxes, except for furnishing them a 1099 at the end of the year.

What does the Irs have to say?The first resource we need to consult is the Internal revenue Service (IrS). here is how the IrS defines an independent contractor:“Who is an Independent Contractor? A general rule is that you, the payor, have the right to control or direct only the result of the

work done by an independent contractor, and not the means and methods of accomplishing the result.”

To determine whether a worker is an independent contractor or an employee under common law, you must examine the relationship between the worker and the business. All evidence of control and independence in this relationship should be considered. The facts that provide this evidence fall into three categories – Behavior Control, Financial Control, and the Type of Relationship itself.

Behavior Control covers facts that show whether the business has a right to direct or control how the work is done through instructions, training, or other means.

Financial Control covers facts that show whether the business has a right to direct or control the financial and business aspects of the worker’s job. This includes:

The extent to which the worker has unreimbursed business expenses,The extent of the worker’s investment in the facilities used in performing services,The extent to which the worker makes his or her services available to the relevant market,How the business pays the workers, andThe extent to which the worker can realize a profit or incur a loss.

Type of Relationship covers facts that show how the parties perceive their relationship. This includes:

Written contracts describing the relationship the parties intended to create,The extent to which the worker is available to perform services for other, similar businesses,Whether the business provides the worker with employee-type benefits, such as insurance, a pension plan, vacation pay, or sick pay,The permanency of the relationship, andThe extend to which services performed by the worker are a key aspect of the regular business of the company.

For more information on “Independent Contractor verses Employee” go to www.irs.gov.

What does the insurance industry say?The next issue is regarding the ability to bill services provided by an employee or an independent contractor. In Indiana when your employee provides a service that is within your scope and you direct and instruct them to provide the service it can be billed under your license because you are taking full responsibility for that service and you have directed that service. They are an employee of the clinic so the doctor and staff operate as one. The issue with an independent contractor is that as an independent contractor they are a separate entity, a separate business, than the clinic. If you use an independent contractor you should contact your insurance networks to determine if you can bill for their services under your license as an independent contractor.

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hIrIng a Massage TheraPIsTBy Sam martin, Chiro Complete (www.chirocomplete.com)


In 2006, The sTaTe Board of heaLTh esTaBLIshed neW ruLes for LIMITed chIroPracTor radIograPhy LIcense

Rule 13. Limited Chiropractic Radiography License410 IAC 5.2-13-1 license requirementsAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35

Sec. 1. (a) To be eligible for a limited chiropractic radiography license a person shall have:(1) completed a limited chiropractic radiography program approved by the department;(2) passed an exam approved by the department;(3) been certified as proficient in performing the procedures included in the limited chiropractic radiography curriculum by a licensed practitioner or a licensed radiologic technologist employed as an educator in a radiologic technology program approved by the department; and(4) completed the requirements in 410 IAC 5.2-4.(b) persons issued a limited chiropractic radiography certificate by the department prior to the effective date of this rule are deemed to be in compliance with subsection (a) and will continue to be issued a renewal upon compliance with the application requirements under 410 IAC 5.2-4. (Indiana State Department of health; 410 IAC 5.2-13-1; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA; errata filed Jan 17, 2007, 11:14 a.m.: 20070131-Ir-410050190ACA)410 IAC 5.2-13-2 Scope of practiceAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35Sec. 2. A limited chiropractic radiography license authorizes an individual to perform spine and extremity radiographic procedures ordered by a practitioner. (Indiana State Department of health; 410 IAC 5.2-13-2; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

rule 4. licensing and permitting procedures410 IAC 5.2-4-1 Application and approvalAuthority: IC 16-41-35-26; IC 16-41-35-28;, IC 16-41-35-29Affected: IC 16-41-35

Sec. 1. (a) To obtain a license or permit, the applicant shall:(1) submit an application for a license or permit on a form and in a manner approved by the department;(2) submit documents required by the application for a license or permit;(3) furnish evidence satisfactory to the department that the qualifying requirements have been met as required by IC 16-41-35- 29 and this article; and(4) submit the appropriate fee.(b) upon receipt of a completed application for a license or permit, the department will review the application and accompanying documentation to determine that the applicant has met the requirements of this article.(c) upon determination by the department that the applicant

While preparing to write this article I surveyed multiple insurance companies to get their ruling on this topic. A Blue Cross/Blue Shield Representative told me that a provider could not use an independent contractor to provide services and bill under their licenses. An Aetna Representative told me a provider could use an independent contractor to provide the services because by billing for the services the provider is basically stating they supervised those services and are taking full responsibility for those services. So it is important for you the provider to do your due diligence and contact those insurance companies you bill for their ruling.

What does your malpractice insurance say?A third issue is that of malpractice insurance. You should contact your malpractice insurance whenever you hire a massage therapist to make sure you are covered for the services they provide. In Indiana most insurance companies will cover your massage therapist under your current policy if they are an employee but may not cover your massage therapist if they are an independent contractor. A representative from NCMIC relayed to me that if you have an employee in Indiana as a massage therapist providing massage therapy then they will cover those services since a massage therapy license is not required in our state. But she also stated that if you are incorporated you will need to contact them and list them as a provider for the corporation. She also stated that they would not cover the services provided by a massage therapist as an independent contractor in a chiropractic office.

Summary!It should seem obvious that hiring a massage therapist as employee is the simplest way to bring on a therapist because of the following:

Less confusion when dealing with IRS policies.Less confusion when billing insurance companies.Less confusion when dealing with malpractice coverage.More control over when, where and how massage will be done.

Should you bring a massage therapist on as an independent contractor here are a few things you should do to give you the peace of mind all of your “ducks are in a row:”

Call the IrS and get a clarification from them on how the therapists should be classified or fill out a SS-8 form (Determination of worker Status for purposes of federal employment Taxes and Income Tax withholding) and let the IrS make the determination for you. I would call first because you can expect several weeks after submitting this form before you get a response from the IRS.Contact your malpractice insurance carrier to see what you need to do to make sure the services provided by your massage therapist will be covered under your malpractice insurance.Contact the insurance companies that you bill the most and find out from them if you can bill for these services. we want to make sure we don’t get reimbursed from insurance companies to later go through an audit and have to pay back money to them because the massage therapist was not an employee at the time the services were performed.

This article has basically touched the surface of the “massage therapist dilemma.” Should you have additional questions regarding massage therapy please contact Sam Martin of Chiro Complete at [email protected] or call (812) 275-2787.

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has failed to comply with this article, the department may request additional information concerning the application, conduct a further investigation to determine whether a license or permit should be issued, or deny the application.(d) upon determination by the department that the applicant has complied with the licensing requirements under this article, the department will approve the application and issue the appropriate license or permit. (Indiana State Department of health; 410IAC 5.2-4-1; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

410 IAC 5.2-4-2 expiration and renewal of licenseAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35

Sec. 2. (a) radiology licenses expire on the last day of the month two (2) years after issuance.(b) If a person becomes licensed in multiple areas, the expiration date of the second and subsequent license will be the same as the original license.(c) If not renewing on-line, at least thirty (30) days prior to the expiration of a person's license or permit, the applicant shall:(1) submit an application for renewal of a radiology license or permit on a form and in a manner approved by the department;(2) submit documents required by the application for renewal;(3) furnish evidence satisfactory to the department that the qualifying requirements have been met as required by IC 16-41-35-29 and this article; and(4) submit the appropriate fee.If renewing through the on-line renewal system, the renewal should be completed on-line at least forty-eight (48) hours prior to the expiration of the license to ensure that the renewal is posted prior to the time of expiration.(d) An individual with an expired license or permit shall not perform radiography, fluoroscopy, radiation therapy, or nuclearmedicine procedures.(e) An application shall be deemed abandoned if, after six (6) months from the date of filing, the requirements for a license or permit have not been completed and submitted to the department. (Indiana State Department of health; 410 IAC 5.2-4-2; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA; errata filed Jan 17, 2007, 11:14 a.m.: 20070131-Ir-410050190ACA)

410 IAC 5.2-4-3 Denial and disciplinary actionsAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 4-21.5-3-6; IC 16-18-2-199; IC 16-41-35; IC 16-42-19-3

Sec. 3. (a) A radiology license or permit may be denied or disciplinary action may be taken by the department if the department determines that the person:(1) engaged in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public;(2) engaged in or knowingly cooperated in fraud, forgery, or material deception in order to obtain a radiology license or

permit;(3) knowingly allowed one's name or radiology license or permit issued under this article to be used by another individual to provide radiology services;(4) has been convicted for a crime that has a direct bearing on the person's ability to perform their responsibilities competently and in compliance with this article;(5) diverted a legend drug (as defined in IC 16-18-2-199) or any other drug or device issued under a drug order (as defined in IC 16-42-19-3) to oneself or another individual;(6) develops such physical or mental disability or other condition that continued practice or performance of his or her duties may be dangerous to patients or the public;(7) operated a radiation machine or used radioactive materials while under the influence of alcohol or drugs such that it endangers the public by impairing the person's ability to work safely and competently;(8) abused, verbally abused, or neglected a patient, or misappropriated property of a patient;(9) exercised influence on a patient in such a manner as to exploit the patient for financial gain of the licensee or a third party, which shall include, but not be limited to, the promoting or selling of goods or services;(10) engaged in lewd or immoral conduct in connection with the delivery of services to a patient;(11) engaged in inappropriate contact with a patient or sexually harassed a patient;(12) failed to comply with this article, any rule of the department, or federal regulation;(13) willfully or repeatedly violated an order issued in a disciplinary proceeding;(14) is incompetent;(15) inaccurately recorded, falsified, or altered patient records;(16) provided false or incorrect information to an employer regarding the status of his or her license; (17) abandoned a patient;(18) knowingly operated a radiation machine that did not meet all applicable requirements set forth in 410 IAC 5; or(19) knowingly administered radioactive materials in a manner that did not meet all applicable requirements set forth in 410 IAC 5.(b) on a determination by the department that a breach of this article has occurred, the department may issue an order underIC 4-21.5-3-6 for one (1) or more of the following disciplinary actions:(1) Issue an order for immediate correction of the breach.(2) Issue an order to require training or education.(3) Issue a written reprimand.(4) place the person on probation.(5) Suspend the person's license or permit for up to one (1) year.(6) revoke the person's license or permit.(c) In determining appropriate disciplinary actions, the department shall consider the following:(1) whether the breach occurred in part for reasons outside of the person's control.(2) whether the person has taken the appropriate steps to reasonably ensure that the breach will not recur.

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(3) The person's history of breaches of this article.(4) The effect of the breach on the patient.(5) The extent that breach was willful, intentional, or repeated.(d) upon a revocation of a license or permit, the person shall relinquish his or her license or permit to the department and the license or permit is deemed to be expired. (Indiana State Department of health; 410 IAC 5.2-4-3; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA; errata filed Jan 17, 2007, 11:14 a.m.: 20070131-Ir-410050190ACA)

410 IAC 5.2-4-4 request for removal of revocation of license or permitAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35

Sec. 4. (a) A person who fails to comply with a revocation or suspension is not eligible for a license.(b) when a person's radiology license or permit has been revoked, the department may, no sooner than two (2) years after the date of revocation, entertain an application for removal of the revocation and issuance of a license or permit. The department shall not remove the revocation or issue a license or permit to a person unless the department has determined that the person is able to practice as a radiologic technologist, radiation therapist, nuclear medicine technologist, or in a limited radiography category in a manner that will not endanger patients or the public. (Indiana State Department of health; 410 IAC 5.2-4-4; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

410 IAC 5.2-4-5 Appeal proceduresAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 4-21.5; IC 16-41-35

Sec. 5. (a) A person aggrieved by an order issued under this article may request a review under IC 4-21.5. If a request for a hearing is not filed within the fifteen (15) day period, the determination contained in the order is final.(b) hearings under this article shall be conducted in accordance with IC 4-21.5.(c) hearings under this article shall be conducted by an administrative law judge who is admitted to the practice of law in Indiana and is not a member of the executive board or an employee of the state.(d) The person shall have the right to be present in person, be represented by counsel, present evidence, and be heard in opposition to the order issued by the department. (Indiana State Department of health; 410 IAC 5.2-4-5; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

410 IAC 5.2-4-6 Name or address change and issuance of duplicate license or permitAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35

Sec. 6. (a) A person issued a license or permit under this article shall notify the department of a change of name or address

within thirty (30) calendar days of such change. Name changes must be received by the department along with a copy of a marriage certificate, a court decree evidencing such change, or a Social Security card reflecting the new name.(b) If a person desires a replacement license or permit reflecting the name change, the replacement license may be issued on request to the department and payment of a replacement fee.(c) replacements for lost, damaged, or stolen licenses or permits may be issued on request to the department and payment of a replacement fee.(d) The failure of a person to receive notification of license renewal because the person did not notify the department of a change of name or address shall not constitute an error on the part of the department nor shall it exonerate or otherwise excuse the individual from renewing such license. (Indiana State Department of health; 410 IAC 5.2-4-6; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

410 IAC 5.2-4-7 retired statusAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35

Sec. 7. A person who was formerly issued a license under this article and is retired from active practice in the licensed area may apply for renewal of his or her license under a retired status. A person with a retired status shall not operate a radiation machine or perform procedures requiring the administration of radioactive materials. A person in retired status who wishes to be removed from retired status and reinstated to active status must comply with all requirements in this article and be issued a license under this article. (Indiana State Department of health; 410 IAC 5.2-4-7; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

410 IAC 5.2-4-8 feesAuthority: IC 16-41-35-26; IC 16-41-35-28; IC 16-41-35-29Affected: IC 16-41-35Sec. 8. (a) The fee for a license issued under this article is sixty dollars ($60).(b) The renewal fee for licenses issued under this article is sixty dollars ($60).(c) There is no fee for a student radiology permit or provisional radiology permit.(d) A twenty dollar ($20) fee will be charged for a retired status license.(e) A twenty dollar ($20) fee will be charged for a duplicate license or permit.(f) A twenty dollar ($20) fee will be charged for issuing a license or permit for a name change.(g) A late fee of sixty dollars ($60) shall be imposed if the renewal application is received after the expiration of the previous license.(h) persons licensed in more than one (1) area licensed under this article are only required to pay one (1) sixty dollar ($60)fee for all licenses issued under this article. (Indiana State Department of health; 410 IAC 5.2-4-8; filed Nov 27, 2006, 1:48 p.m.: 20061227-Ir-410050190frA)

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Indiana code 16-39ARTICLE 39. HEALTH RECORDS

IC-16-39-1 Chapter 1. Release of Health Records to Patient and Authorized PersonsIc 16-39-1-1 right of access; written requests; effective durationSec. 1. (a) This section applies to all health records except mental health records, which are governed by IC 16-39-2, IC 16-39-2, and IC 16-39-4.(b) This article applies to all health records, except:

(1) records regarding alcohol and other drug abuse patient records, which are governed by 42 Cfr, part 2(c) on written request and reasonable notice, a provider shall supply to a patient the health records possessed by the provider concerning the patient. Subject to 15 u.S.C. 7601 et seq and 16 Cfr part 315, information regarding contact lenses must be given using the following guidelines:

(1) After the release of a patient from an initial fitting and follow –up period of not more than six (6) months, the contact lens prescription must be released to the patient at the patient’s request.(2) A prescription released under subdivision (1) must contain all information required to properly duplicate the contact lenses. (3) A contact lens prescription must include the following:

(A) An expiration date of one (1) year.(B) The number of refills permitted.

(4) Instructions for use must be consistent with:(A) recommendations of the contact lens manufacturer;(B) clinical practice guidelines; and(C) the professional judgment of the prescribing optometrist or physician licensed under IC 25-22.5.After the release of a contact lens prescription under this subsection, liability for future fittings or dispensing of contact lenses under the original prescription lies with the dispensing company or practitioner.

(d) on a patient’s written request and reasonable notice, a provider shall furnish to the patient or patient’s designee the following:(1) A copy of the patient’s health record used in assessing the patient’s health condition.(2) At the option of the patient, the pertinent part of the patient’s health record relating to a specific condition, as requested by the patient.(e) A request made under this section is valid for sixty (60) days after the date the request is made.

Ic 16-39-1-2 : x-raysSec. 2. upon a patient’s written request and reasonable notice, a provider shall, at the provider’s actual costs, provide to the patient or the patient’s designee:(1) access to; or(2) a copy of; the patient’s x-ray film possessed by the provider.

Ic 16-39-1-3 Persons entitled to request recordsSec. 3. (a) health records may be requested by a competent patient if the patient is:(1) emancipated and less than eighteen (18) years of age; or(2) at least eighteen (18) years of age.(b) If a patient is incompetent, the request for health records may

be made by the parent, guardian, or custodian of the patient.(c) health records of a deceased patient may be requested by a coroner under IC 36-2-14-21 or by the personal representative of the patient’s estate. If the deceased does not have a personal representative, the spouse of the deceased may make a request. If there is no spouse:(1) a child of the deceased patient; or(2) the parent, guardian, or custodian of the child if the child is incompetent; May make a request.

Ic 16-39-1-4 Patient’s written consent for release of records; contentsSec. 4. except as provided in IC 16-39-5, a patient’s written consent for release of the patient’s health record must include the following:(1) The name and address of the patient.(2) The name of the person requested to release the patient’s record.(3) The name of the person or provider to whom the patient’s health record is to be released.(4) The purpose of the release.(5) A description of the information to be released from the health record.(6) The signature of the patient, or the signature of the patient’s legal representative if the patient is incompetent.(7) The date on which the consent is signed.(8) A statement that the consent is subject to revocation at any time, except to the extent that action has been taken in reliance on the consent.(9) The date, event, or condition on which the consent will expire if not previously revoked.

Ic 16-39-1-5 : Withholding requested informationSec. 5. If a provider who is a health care professional reasonably determines that the information requested under section 1 of this chapter is:(1) detrimental to the physical or mental health of the patient; or (2) likely to cause the patient to harm the patient or another; the provider may withhold the information from the patient.

Ic 16-39-1-6 Inpatient requests Sec. 6. This chapter does not authorize a patient to obtain a copy of the patient’s health records while the patient is an inpatient of a hospital, health facility, or facility licensed under IC 12-24 or IC 12-29. However, if the inpatient is:(1) unemancipated and less than eighteen (18) years of age, a parent, guardian, or next of kin (if the patient does not have a parent or guardian) is entitled to obtain a copy of the health records of the inpatient:(2) incompetent to request the patient’s own health records, a spouse, parent, guardian, or next of kin (if the patient does not have a parent, spouse or guardian) is entitled to obtain a copy of the health records of the inpatient; or(3) competent, a spouse, parent or next of kin (if the patient does not have a parent or spouse) is entitled to obtain a copy of the health records of the inpatient if the inpatient requests that the records be released.

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Ic 16-39-1-7 child’s health records; access to custodial and noncustodial parentsSec. 7. (a) except as provided in subsection (b), a custodial parent and a noncustodial parent of a child have equal access to the parents’ child’s health records.(b) A provider may not allow a noncustodial parent access to the child’s health records if:(1) a court has issued an order that limits the noncustodial parent’s access to the child’s health records; and(2) the provider has received a copy of the court order or has actual knowledge of the court order.(c) If a provider incurs additional expense by allowing a parent equal access to health records under this section, the provider may require the parent requesting the equal access to pay a fee to cover the cost of the additional expense.

Ic 16-39-1-8 copying feesSec. 8. except as provided in section 2 of this chapter, IC 16-39-9 governs the fee that may be charged for making and providing copies of records under this chapter.

Ic 16-39-1-9 alcohol and drug abuse recordsSec. 9. Alcohol and drug abuse records described in 42 u.S.C. 290dd-3 and 42 u.S.C. 290ee-3 may not be disclosed unless authorized in accordance with 42 u.S.C. 290dd-3 and 42 u.S.C. 290ee-3.Indiana Code 16-39 ARTICLE 39. HEALTH RECORDS

Ic 16-39-7: chapter 7. Maintenance of health records, x-rays, and other Tests

Ic 16-39-7-1: Maintenance of health records by providers; violationsSec. 1. (a) As used in this section, "provider" means the following: (1) A physician. (2) A dentist. (3) A registered nurse. (4) A licensed practical nurse. (5) An optometrist. (6) A podiatrist. (7) A chiropractor. (8) A physical therapist. (9) A psychologist. (10) An audiologist. (11) A speech-language pathologist. (12) A home health agency licensed under IC 16-27. (13) A hospital or facility licensed under IC 16-21-2 or IC 12-25 or described in IC 12-24 or IC 12-29.(b) A provider shall maintain the original health records or microfilms of the records for at least seven (7) years.(c) A provider who violates subsection (b) commits an offense for which a board may impose disciplinary sanctions against the provider under the law that governs the provider's licensure, registration, or certification under this title or IC 25.As added by P.L.2-1993, SEC.22.

Ic 16-39-7-2: Maintenance of x-rays by providers; mammograms; violations; civil liabilitySec. 2. (a) This section does not apply to original mammograms, which are governed by section 3 of this chapter.(b) As used in this section, "x-ray film" includes a microfilm copy of the x-ray film.

(c) A provider shall maintain a patient's x-ray film for at least five (5) years.(d) At the time an x-ray film is taken, the provider shall do one (1) of the following:(1) Inform the patient in writing of the following:(A) The patient's x-ray film will be kept on file by the provider for at least five (5) years.(B) If the patient would like a copy of the x-ray film during that period, the provider will provide the patient with a copy of the x-ray film at the actual cost to the provider, as provided in IC 16-39-1-2.(2) have posted conspicuously in the x-ray examination area a sign informing patients of the following: --------------------------------------------------------------------------------(A) All x-ray films will be kept on file by a provider for at least five (5) years.(B) on request during that time, the provider will provide the patient a copy of the patient's x-ray film at the actual cost to the provider.(e) A provider is immune from civil liability for destroying or otherwise failing to maintain an x-ray film in violation of this section if the destruction or failure to maintain the x-ray film is inadvertent and not done in bad faith. However, this subsection does not prevent the imposition of disciplinary sanctions against the provider, as described in subsection (f). (f) A provider who violates this section commits an offense for which a board may impose disciplinary sanctions against the provider under the statute that governs the provider's licensure, registration, or certification under this title or IC 25.As added by p.l.2-1993, SeC.22. Amended by p.l.86-2001, SeC.1.

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cMs InTroduces neW aBn forMaLL dcs MusT BegIn usIng forM no LaTer Than sePTeMBer 1The Centers for medicare & medicaid Services (CmS) has begun implementation of the use of a revised Advance Beneficiary Notice of Noncoverage (ABN) (CmS-r-131). This form replaces the General use ABN (CmS-r-131-G).

Some key features of the new form are that:

It has a new official title, the “Advance Beneficiary Notice of Noncoverage (ABN)”, in order to more clearly convey the purpose of the notice.It replaces both the existing ABN-G and ABN-lIt may also be used for voluntary notifications, in place of the Notice of exclusion from medicare Benefits (NemB)It has a mandatory field for cost estimates of the items/services at issueIt includes a new beneficiary option, under which an individual may choose to receive an item/service, and pay for it out-of-pocket, rather than have a claim submitted to Medicare.

All providers must begin using the new ABN (CmS-r-131) no later than September 1st, 2008.

Questions about the new ABN may be sent to [email protected]

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your voTe MaTTersPresidential Candidates face off on issues affecting healthcare and chiropractic.

John MccaIn www.JohnMcCain.comMcCain, the Republican candidate for the presidency, claims that “bringing [healthcare] costs under control” is the “only way” to make insurance easily accessible for all Americans.

Believes American can and must provide healthcare to every citizen.encourages the expansion of health Savings Accounts (hSAs) for familiesPlans to have $3.6 trillion worth of tax breaks be redirected from businesses to consumers, as consumers would be able to ‘shop’ for customized health insurance under his healthcare plan.

The American Chiropractic Association issued this statement about mcCain’s plan: "Traditionally, the ACA, many consumer and patient groups, as well as the majority of lawmakers on Capitol Hill, oppose this type of policy because insurers would tend to migrate to states that have little or no provider or benefit protection mandates so they could drop coverage for conditions such as chiropractic, diabetes, or mental illness in order to make their policies cost less.”

The Candidate Speaks: "We need to create a ‘next generation’ of chronic disease prevention, early intervention, and new treatment models and public health infrastructure. We need to use technology to share information on ‘best practices’ in healthcare so every physician is up to date. We need to adopt new treatment programs and financial incentives to adopt ‘health habits’ for those with the most common conditions such as diabetes and obesity that will improve their quality of life and reduce the costs of their treatment"- John mcCain, in a speech given April 29, 2008 at the lee moffitt Cancer Center & research Institute in Tampa, fl

Barack oBaMa www.Barackobama.comDemocratic presidential nominee Barack obama is proposing a universal healthcare plan, including mandatory coverage for children.

Believes in quality, affordable and portable healthcare coverage for all Americans.Supports expanding the range of chiropractic services covered by Medicare, along with reimbursement reform that will reward those who deliver high quality care and whose patients achieve good health outcomes.Supports careful examination into why neither the Dept. of veteran Affairs nor the Dept. of Defense have achieved full integration of chiropractors into their health systems despite direction from Congress.Supports commissioning chiropractors as officers in the uniformed Corps of the u.S. Public Health Service.Plans to offer a universal healthcare plan that provides comprehensive coverage, including many, if not all, chiropractic services.

The Candidate Speaks:"As we shift our healthcare delivery system towards a culture of wellness and disease prevention, I believe that chiropractors must play an integral role in expanding access to preventive care and strengthening our public health system."-Barack obama, in a letter to the ACA

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The nominee must be a licensed Indiana DC and a member of the ISCA for at least one year.

The nominee must have worked for the benefit of the Chiropractic profession through their devotion of time, resources and personal commitment. The DC should have strong moral character and ethics in their professional and personal life. That person leads by example to characterize a good role model for future generations. Nominations may made by any member in good standing of the ISCA and must be submitted no later than 30 days prior to the beginning of fall Conference.

Nominees will be published or listed in the newsletter and on the website.

voting for the DC of the year will be by the ISCA Board of Directors from the nominations received. voting may be from the day that nominations close until 2 weeks prior to the beginning of Fall Conference. voting may be in person directly to the Executive Director, fax or email directly to the Executive Director. There will be a total of 19 votes. votes will be tallied by the Executive Director and be kept confidential even after voting is over

Announcement of DC of the Year will be presented at the Saturday luncheon during Fall Conference

ISCA DC of the Year Nomination forms are available on the ISCA website

www.indianastatechiros.org.

FOR MORE INFORMATION CONTACT: Lane velayo

Indiana State Chiropractic AssociationAssociation Manager

[email protected] 317.673.4245

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don'T forgeT: MedIcare ProvIders MusT use onLy nPI nuMBers on cLaIMs

effective may 23, 2008, all medicare providers are required to use oNly their NpI number when filing medicare claims. The reporting of Medicare legacy numbers will result in claim denial.

If your CmS-1500 claims are rejected, visit the National plan and provider enumerator System (NppeS) web site to make sure all the information for your NpI is accurate. If claims continue to be rejected, have a copy of your NppeS record in hand (available on the NppeS web site) and contact your medicare contractor.

for more information, see the NpI portion of the ACA web site http://www.acatoday.org/ or visit the CmS web site http://www.cms.hhs.gov/.

appeals court rules in favor of Palmer alumniThe Iowa Court of Appeals has affirmed a decision that requires palmer College of Chiropractic to release $1.8 million to its former alumni association. In its decision the court wrote, “We concur in the judgment that there can be a distinction between being critical of Palmer’s board and its current direction and being critical of and working to undermine the school itself. It does not appear that the Alumni Association did the latter.” Relations between the alumni association and board began to sour in late 2004 during discussion over whether the alumni should have a voting seat on the college’s board of trustees.

Logan dedicates standard Process student centerLogan College of Chiropractic completed a six-month development project with the dedication of the $3.6 million Standard Process Student Center at a ribbon-cutting event June 19.

The 6,500 square-foot facility is named after Standard process Inc., which donated $500,000 to logan to name the new student center.

The center was constructed in the space previously occupied by the school’s gymnasium.

The new student center includes both recreation and relaxation areas and new Student Services office which serves as a buffer between the different areas.

Source: Logan College of Chiropractic, www.logan.edu

Palmer college accepts apologyAn agreement was reached June 26 with the seven members of the former Palmer Alumni association allowing Palmer College of Chiropractic to dismiss its defamation of character lawsuit against those individuals.

This defamation of character lawsuit was based on statements and character attacks made in 2004 against member of the palmer Board of Trustees, the college, and the administration.The alumni – Drs. John willis, David reopelle, Ted Conger, kirk lee, marc leuenberg, frank Bemis, and Scott harris – issued

a collective public apology to the board, the college, and the administration. The board accepted the apology and retraction, and the lawsuit was dismissed.

SCU Affiliates with massage program & begins offering services at cal stateSouthern California university of Health Services has become affiliated with western Institute of Neuromuscular Therapy (wIN Therapy), provider of a nationally recognized massage-therapy program.

This partnership expands the educational offerings of SCI in the field of complementary and alternative medicine by featuring wIN Therapy’s 1,000 – hour certificate program that encompasses in-depth courses in relation therapy as well as clinical treatment.

In addition to affiliating with wIN Therapy, SCu will now provide chiropractic and acupuncture/oriental medicine (Aom) services at California State university, fullerton (fullerton).

The Student Health Center has been receiving acupuncture services from SCu since oct. 2007; chiropractic has just been added.

Source: Southern California University of Health Sciences, www.scuhs.edu

Life announces building programlife university has been approved for $80 million in tax-exempt revenue bonds to acquire, construct, renovate, and equip a variety of facilities on it Marrietta, GA., campus.

The new project, the first phase of a long-term plan, includes student housing for 300, a parking deck of 600 spaces, a “gymatorium” for graduations and assemblies, a daycare center, and a new café, as well as covered sidewalks and extensive landscaping.

Source: Life University, www.LIFE.edu

chIroPracTIc coLLege uPdaTes


don'T MIss The Isca faLL conferencePlease join us for an outstanding line up of speakers and topics for our Fall Conference.

We welcome Dr. Warren Hammer as our key speaker on Friday evening and on Saturday. Dr. Hammer is the author of Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd Edition, in addition to many published articles and is a nationally and internationally renowned lecturer.

warren hammer DC, mS, DABCo will be spending 12 hours discussing the soft tissue approach to the functional evaluation and treatment of common spinal and extremity problems. He will also be adding spinal evaluation and treatment regarding sciatica by determining which spinal segment to treat based on a spinal functional examination. (Bring portable tables if you have them).

The Indiana Spine Group will be presenting the following lectures on Saturday in addition to a Sunday session of case studies in which attendees can bring in their own cases for discussion.

case sTudIesMinimally Invasive Diagnostic and Therapeutic Techniques (Jonathan Gentile, mD and John Arbuckle, mD)Imaging pearls (Thomas reilly, mD, and paul kraemer, mD) The Surgical patient (Thomas reilly, mD, and paul kraemer, mD)

In addition to this power packed line-up, we are offering risk management hours (friday and Sunday).

•

••

afTer hours recePTIonThe ISCA After hours reception is back! After the Saturday sessions, join your fellow Chiropractors at the ISCA After Hours Reception. There will be prize drawings and we’ll be recognizing new Indiana’s newest DCs. This is a great event to network and relax after a long day of sessions!

PLaTInuM/goLd cIrcLe MeMBersPlatinum and Gold Circle Members of ISCA will enjoy a complimentary dinner at Ruth’s Chris Steakhouse North as part of their member Benefits. Become a platinum or Gold Circle Member and join other Platinum and Gold Circle Members and their spouses for an evening dinner at one of Indianapolis’ finest restaurants.

ISCA Members: upgrade to Platinum or Gold Circle status for 2009 now and join the other platinum/Gold Circle members at this great dinner following Saturday’s Sessions and After hours reception. Contact the ISCA office at 317.673.4245 for details on how you can upgrade your status for 2009 and enjoy your member benefits today!

hoTeL InforMaTIon: SHERATON INDIANAPOLIS - 8787 keystone at the Crossing room rate: $109 / room block ends 10/01/08.reservations: 888.627.7814. reference “ISCA fall Conf.” or “Indiana State Chiropractic Association” when calling.

JoIn us for The Isca annuaL MeeTIng aT The saTurday LuncheonSaturday November 1St, 12:00 to 1:30 p.m.This is your time (for members) to elect a new Board of Directors for ISCA. During this time we will also recognize those who have helped ISCA and the Chiropractic profession over the course of the year, recognize new members of the Association and discuss what is going on with the Association.

16

2008 FAll cOnFerenceOctOber 31 - NOvember 2

SheratON hOtel 8787 KeyStONe crOSSiNg - i

Sign up for 12 hourS get 4 hourS free!*(Sunday or friday 4 hr SeSSion)

regIsTraTIon forM on nexT Page!

regiSter online at www.indianaStatechiroS.org!


PaymeNt iNfOrmatiON amex visa mastercard check (make Payable to iSca)cardholder:______________________________________________ card #:__________________________________________________exp.______________ 3 digit security #:_________________ Signature:__________________________________________________

Questions? call 1.317.673.4245, or e-mail [email protected] / refunds at 90% until October 17. No refunds after October 17.

return to: iSca 200 S. meridian St, Suite 350 indianapolis, iN 46225 or by Fax: 317.673.4210IScA FAll cOnFerence regIStrAtIOn FOrm

regIStrAnt nAme amount

____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

tOtAl $__________

$

$

$

regIStrAtIOn type(example: 1, 2, 3)

cOntAct nAme clInIc nAme

AddreSS cIty StAte ZIp

e-mAIl phOne ( ) FAx ( )

pAckAgeS(example: a, D, g)

1. Platinum.......... complimentary2. gold & Silver..............................3. member (in good standing)....4. member (in arrears).................5. Non-member.............................

-------$145$165$210$230

-------$195$215$260$280

after Oct. 17

package c4 hour Session

-------$230$270$310$330

-------$280$320$360$380

after Oct. 17

package b8 hour Session

--------$350$400$515$535

-------$400$450$565$585

after Oct. 17

pAckAge A12 hour SessionregIStrAtIOn type

adv. adv. adv.

*Members shall only be eligible for all membership benefits, including Fall Conference registration prices, if they are in “good standing.” The ISCA’s By Laws state the following, “a member shall not be in ‘good standing’ when his or her dues are more than two (2) quarters in arrears. ‘Good standing’ will be determined at the time of registration is received in the ISCA office or by the assistant secretary.”

platinum members of the IScA may attend the Fall conference free of charge but registration is still required.

Please indicate if you will attend the luncheon, to assure we provide sufficient meals for all attendees. additional lunches may be purchased for guests at $30.00 each. attendance to lectures is by badge only, including spouses.

i will attend the Saturday luncheon & annual meeting yeS____ NO____ i will attend the iSca after hours reception yeS____ NO____

pleASe check the cOurSeS yOu plAn On AttendIng

dr. WArren hAmmerfri. 4 hr session (5 Pm - 9:30 Pm)

lAWS AFFectIng yOur prActIce*Nerz Walterman fri. 4 hr Session (5 Pm - 9:30 Pm)

IndIAnA SpIne grOup Sat. 4 hr Session (8 am - 12:00 Pm)

dr. WArren hAmmerSat. 4 hr session (8 am - 12:00 Pm)

dr. WArren hAmmerSat. 4 hr session (1:30- 6 Pm)

lAWS AFFectIng yOur prActIce*Nerz WaltermanSun. 4 hr Session (8 am - 12:00 Pm)

IndIAnA SpIne grOup Sun. 4 hr Session (8 am - 12:00 Pm)

*Same course

pAckAge d: ca $89pAckAge e: guest*/Student $75pAckAge F: lunch ticket $30(included with 8 &12 hour session)

pAckAge g: additional after hours reception ticket $30(included with all packages)

*non Dc guest


PracTIces for saLe

mD/DC/pT practices for sell. GI 1.4m in '07. 2.5 years established. Northwest Indiana. Further details upon request by email, [email protected]. Posted 8/5/08 (M)

Practices for Sale in Wayne and White counties and East Central, IN. Call The Paragon Group at (800) 582-1812 or visit our website http://www.eparagongroup.com. Posted 7/09/08

Progressive college community close to Fort wayne, Indiana. Busy highway. long-established beautiful chiropractic office with space to expand, sublet, and/or live in. Creative financing for doctor ready to own practice. phone 260-402-7657 or email: [email protected]

Central Indiana Chiropractic practice for sale. well established (29+ years) in a large, free standing building that boasts low overhead, ample parking space, visible signage, and high patient traffic. This practice has consistent collections in over $240,000 per year with a minimum of 400 to 500 a month. General diversified practice, fully equipped. excellent opportunity. Practice has great growth potential. Serious inquiries only, please. Contact Seller at 765-398-2179. Posted 4/29/08

office suite for lease in historic downtown Noblesville. Great opportunity for a chiropractor to have an office ready to go. Call 317-774-1010.Posted 3/20/08

Retiring in progressive south central Indiana town. Turnkey opportunity in fully equipped fully staffed newly remodeled office. Serious inquiries only, please. Confidentiality agreement must be signed before any information is shared, but priced for quick sale. Send email to [email protected] 3/5/08

practice for sale in lawrenceburg, Indiana. 10 year old well-established practice in a rapidly growing area. $250,000 gross in 2007 on 3 days per week. General diversified practice, fully equipped, modalities, low-tech rehab, x-ray. Excellent oppurtinity. Practice has great growth potential. Motivated seller. Contact Dr. Mike at 513-266-6261. Posted 2/8/08

Associate to Owner Opportunity in 1 year Indianapolis, IN Energetic, Enthusiastic Chiropractor wanted for fabulous associateship to owner opportunity in Indianapolis. Work to learn the practice in 2008 and own the practice in 2009. This Indianapolis office which has been established for 40+ years. This practice has over 8500 patient files and

has collections consistently over $250,000 with $150,000 cash flow to the doctor. Great patients. Great practice. Great opportunity to learn earn and own an established practice. only financially secure persons need respond to [email protected] 2/6/08

assocIaTes avaILaBLe Recent Palmer Graduate. Looking to relocate in Indianapolis. Techniques: Gonstead, Diversified, Activator, Thompson, Cox and ART. Additional training in PT. Diligent, competent and dynamic Chiropractor looking for an opportunity to learn from an experienced Chiropractor. Call 317-508-7127 or email [email protected]. Posted 8/5/08 (M)

palmer graduate. 25 years experience, excellent adjusting and people skills. Multiple techniques including Activator and Cox. $300 a day base fee, references available. Call Dr. Grotzinger 317.585.4808.Posted 07/24/08

recent male graduate. proficient in many techniques, including Cox and mckenzie. I am punctual, hard working and willing to learn. Looking for a fulltime associate position in the Indianapolis metro area. For more information please contact Chris via email at [email protected]. Posted 5/13/08 (M)

I am a Indiana licensed D.C. looking to associate in the NW Indiana area. I can be reached at (219)759-5586 or email me at [email protected] (m)

assocIaTes WanTed

Excellent opportunity at an established chiropractic office of 20 years in small town in southern Indiana. Work independently but benefit from successful 3 affiliated clinic's shared expertise. email resume to [email protected]. posted 8/15/08 (m)

Busy mD/DC/pT practice need Associate Chiropractor. option to buy after one year. 50k + incentive for first year. further details upon request by email. [email protected] posted 6/17/08

Associate wanted Active Chiropractic & Rehabilitation Clinic Evansville, Indiana www.evansvillechiro.com Must be open to rehabilitation and Active Release Therapy and a licensed DC in Indiana with excellent patient communication, service and technical skills. Send confidential resume to [email protected]. Posted 5/19/08

Doctor needed for new office in Nw area. Don't miss this opportunity! must be willing to make great money and work as your own boss. Start immediately. fax resume to (219)987-3366 or e-mail it to [email protected] 5/14/08

New state of the art clinic in Fishers, IN. Dr. would like to relocate out of state. Either share space or take over entire clinic. Great opportunity to have an office ready to go! equipment includes Cervical/lumbar Decompression, Digital X-ray, Cold Laser Therapy, Hill Flexion Distraction Tables, open Bay physiotherapy. Staff includes a massage Therapist. Currently 2,000 sf with potential of 5,000 sf along with % of property ownership. Call (317) 607-0464 if interested in learning more.Having Trouble Getting Started? No Need to Sign your life Away! New state of the art clinic located in beautiful Fishers, Indiana. visit www.fishersfind.com to learn more about fantastic demographics. Share space or take over entire clinic. Great opportunity - turn key office ready to go! equipment includes Cervical/lumbar Decompression, Digital x-ray, Cold Laser Therapy, Hill Flexion Distraction Tables, Open Bay physiotherapy. you name it! Staff includes a massage Therapist. provider insurance benefits pay well. Set your own hours and share the walk-ins! Start your practice for only $3,950. Call (317) 607-0464 or email [email protected] if interested in learning more. Posted 5/7/08

Chiropractic Associate Needed Rapidly expanding Practice in Crown Point, Indiana, is looking for full time position to be filled. enthusiastic, ambitious doctor is a must. must be proficient in Cox Technique, palmer Diversified Technique and Thompson Technique. Salary and profit share of clinic are offered. Send Resume to Dr. Danielle kauffman 7620 e. 109th Ave, Crown point, IN 46307 or e-mail to [email protected] 4/30/08

Busy Chiropractic office looking for tandem chiropractor. Must use Thompson, Activator, Cox flexion/Distraction. pay starts at $1000/wk. Bonus pay with practice growth. Trimboli Chiropractic is in Indiana 35 minutes from Downtown Chicago. Contact us at: [email protected], by phone (219)836-8890 or by fax (219) 836-2344.posted 4/30/08

Central Indiana Practice seeks hard working, well skilled, caring, dedicated Chiropractor proficient in various techniques. Serious candidates only. Contact 765-398-2179 for further details. posted 4/29/08

Busy Southern Indiana practice looking for an intelligent, ethical chiropractor with excellent

IndIana sTaTe chIroPracTIc assocIaTIon cLassIfIeds

18


adjusting skills-diversified/Gonstead. experience is a plus. 28-30 hrs/week. please fax your resume to 812-275-8044 or email to [email protected] 4/15/08

Rapidly expanding Practice in Crown Point, Indiana, is looking for full time position to be filled. enthusiastic, ambitious doctor is a must. must be proficient in Cox Technique, palmer Diversified Technique and Thompson Technique. Salary and profit share of clinic are offered. Send resume to Dr. Danielle kauffman 7620 e. 109th Ave, Crown point, IN 46307 or email [email protected]. Posted 4/7/08

vacaTIon docTors

well Skilled, personable, efficient in patient care. proficient in various techniques, inc. proadjuster. licensed from 1994. exp:Bus.owner/Associate/vac fill-in. Available for temp.or permanent work. for more information please contact 765-683-0845 or [email protected] kathleen Sanderford, D.C. Posted 7/17/08

equIPMenT for saLe

Transworld 300ma 125 kvp chiropractic Xray system complete with floor to wall tubestand with electric locks, 14x17 wallstand with grid,certified collimator and 1.0 - 2.0 140,000 hu tube. Comes complete with operator barrier, cassettes; darkroom accessories and Fischer automatic 90 second cold water film processor. $4,000 obo. Call for details (812) 345-2375. posted 8/6/08 (m)

2 Zenith Hi-Lo tables, older models with longer cast iron bases. Good condition without drops. $1500 for both. Contact 317-474-5574. posted 8/1/08 (Nm)

Synergy rehab/ Decompression Table for sale. Complete spinal rehab system for sale. Provide Active rehab with little space needed. All videos, documentation forms and software included. Never used. Asking $850. optima Spinal Decompression table for sale or lease. One of the best tables at half the price. Other equipment available. Call or e-mail [email protected] or 765-437-4083. posted 7/28/08 (Nm)

Zenith hi-lo adj maybe 80's model $500. Gonstead pelvic bench plaid (80's) $200. mettler ultrasound Sonicator $75. Sentry Systems muscle Stim hi volt $350. Nemectron endosan muscle Stim $400 equipment needs calibrated. Spine model $125, metal/wood spine $175 x-ray: dark room light $75, gloves $125, wood film holder $75, lead apron $125, shields $10, x-ray cassettes: 4 14x17 $125 ea, 5 8x10 $75

ea., 1 10x12 $85, full Spine $125, Supports: 4 lumbar $12ea, 8 Cervical Supports $10ea, C sp collars $10ea, patient Gowns $4 each. Call kathleen Sanderford, D.C. 765-683-0845 or email [email protected] in Anderson, Indiana 40 mi. north of Indy. posted 7/17/08 (Nm)

Q1000 multi frequency resonating laser (includes 808 enhancer probe and carrying case). used sporadically for 14 months. $3,195.00. 12 True laser Diodes, 8 leDs, 7 wavelengths of Laser Energy, 7 Treatment Modes available (with 63 frequencies) Creates penetrating Soliton waves. Treatment Area -Tennis Ball Size. Also comes with 808 enhancer 500mw "infrared laser in a small hand held probe delivers 54joules of Ir energy /3min cycle. Bob Graham, D.C. 616/530-7474 or [email protected]. posted 07/11/08 (Nm)

Large exterior chiropractic sign, fully illuminated. Currently says chiropractic neurology center but can be adapted to suite. please call if (317) 848-6000 or email [email protected] interested. You could save money on signage. posted 7/09/08 (m)

Save 50% on a 3 month old "ergowave" intersegmental traction table. Barely used (really). 1st one to call with $900 cash takes it home. Call Dr. lyons at 260-409-5871 (ft. wayne) posted 7/2/08 (m)

Transworld 325 mp X-ray machine, great condition. Protec Optimax processor, like new. film box, dark room light, 7 film cassettes. Total price: $5,000. Contact Sheila at 317-258-8670. Posted 6/18/09

waiting room furniture for Sale: 6 piece set: 4 chairs with arms, 1 love seat, 1 couch; maple wood and grey cloth upholstery. 5 years old, excellent condition. Total price: $500. Contact Sheila at 317-258-8670 Posted 6/19/08

hands free ultra Sound, Bowflex machine, health Star Elite Decompression Table, Computerized Range of Motion and Manual Muscle Test Functional Outcome Assessment Machine. Call SpinalAid at 317-272-4100. Posted 6/09/08

TerraQuant laser mQ2000 All-in-one Cold laser: only 1 year new - like brand new! $2,950.00 obo Chattanooga Decompression Table CDTu4: purchased one year ago and rarely used. Combines Tx Head with an Elevation table, Cervical, Carpal Tunnel Traction & Spinal Decompression, Complete with: 4 piece elevation table, hand control, tilt head & tilt back rest, casters, Saunder Cervical Traction device, CarpalTrac, Split knee Bolsters & exclusive eZ-

grip Thoracic & lumbar belting System. electric hi-lo adjustment from 21" to 41". full 27"x77" working surface. $7,500.00 obo. phone: 317-915-9800 email: [email protected] 5/14/08

Equipment for sale in southwestern Indiana Barely used, great condition, only 4years old Complete x-ray package Includes all of the following for only $ 13,000 DTr high frequency x-ray unit - generator, bucky stand, cathode and board Mini Med AFP processor and processor stand & processor Chemical storage containers Id flasher x-ray bin floor model Calipers 1 double bank view box 2 single bank view boxes 8 - 8x10 x-ray cassettes 4 - 14x17 x-ray casstettes Also available: metal X-ray storage rack $750.00 for offers contact us at 1-765-914-8943 or 812-858-1008. e-mail us at [email protected] 4/1/08

ZeNITh 95 flexion Distraction table. pancake elevation switch. Barely used burgundy cushions. No scratches, tears, or mechanical issues whatsoever. Great table in great shape. $4000 ($8395 new). GAlAXy stationary adjusting table with armrests, face slot and paper attachment. Brown/tan color. very good shape. $100. Call 765-935-1000. I have pics of both tables.Posted 3/26/08

entire chiropractic office of equipment available; 3 years old; all in excellent shape; x-ray machine, office desk, chairs, stationary tables, 1 power-activated table, exercise equipment. office suite for lease in historic downtown Noblesville. Great opportunity for a chiropractor to have an office ready to go. Call 317-774-1010.Posted 3/20/08

fleXIoN DISTrACTIoN TABle-manual table made by Barnes. Good shape, burgundy upholstery, extra ankle straps. $1000 or best offer, Call Dr John 299-3330 or [email protected] 2/19/08

PosT a cLassIfIed adISCA members may place classified ads for free and will run for two consecutive issues unless otherwise requested. Non-members may place ads for $25 per ad per issue.

To place a classified ad visit us online at www.indianastatechiros.org or call 317.673.4245.

IndIana sTaTe chIroPracTIc assocIaTIon cLassIfIeds

Isca report200 S. meridian St. Suite 350Indianapolis, IN 46225317.673.4245www.IndianaStateChiros.org

PrSrt StD U.S. POStage

PaiDiNDiaNaPOliS, iN Permit NO. 779

Documents

ISCA Sept/Oct Newsletter 2008