Convention 2012

TMA Motion Denied!

Chiropractic IN the Movies

Supreme Court Upholds Health Reform

Texas Privacy Law Effective Sept 1st

July/August 2012

The Texas Chiropractic Association represents chiropractic professionals throughout the state.

First formed in 1916, this historic association has existed for nearly 100 years and has represented the interests of Texans who desire safe and effective health care from chiropractic professionals.

TCA serves to protect chiropractic professionals, their patients, and the right for Texans to choose chiropractic as one of their health care options.

ABOUT OUR COVERThe TCA annual convention was held in Austin, Texas early in June. This issue shares reports and photos from convention. The food and fellowship this year offered one of the best conventions in many years. Grab some chips

POLICIESAnnual subscription to the Texas Journal of Chiropractic is included in TCA membership dues. Contact the TCA for subscription rates for non members.

The print-format Texas Journal of Chiropractic is published up to six times per year by the Texas Chiropractic Association under the supervision of the TCA Communications Committee.

Opinions expressed are those of the contributors and do not necessarily reflect the policy of the Texas Chiropractic Association or the Texas Journal of Chiropractic. Publication of an advertisement does not imply approval or endorsement by the Texas Chiropractic Association.

The association shall have the absolute right at any time to reject any advertising for any reason. For advertising rates contact the TCA Office, or check online at www.chirotexas.org. All advertising material must be in graphics ready format and submitted as a .jpg, .jpeg, .gif, .swf, or .png file type.

InsideTMA Moves for Rehearing in TMA v TBCE! 3MOTION DENIED!! ! ! ! ! 3TCA Insurance Committee Report ! ! ! 8 Texas Council of Chiropractic Orthopedists! 11Discount Legally! ! ! ! 11TBCE PROPOSES RULES UPDATES! ! 11Lack of HIPAA Compliance Can Now Shut Down Your Practice, or Worse! ! ! ! 12Convention Photo Pages Pages 15, 18, 19, 24, 25, 28 Medical Inc. The Movie! ! ! ! 16Smart Training Addresses Needs of HB 300 ! 17New Web Address for Online Journal! ! 20Doing the Right Thing the Wrong Way Can Cost You 21Supreme Court Upholds Obama’s Healthcare Law 22ACA Report ! ! ! ! ! ! 23

Texas Chiropractic Association

Texas Journal of ChiropracticVolume XXVII, Issue 4 July/August 2012

Texas Journal of ChiropracticThe Official Publication of

The Texas Chiropractic Association

1122 Colorado, Suite 307Austin, TX 78701

Phone: 512 477 9292Fax: 512 477 9296

E-mail: info@chirotexas.orgwww.chirotexas.org

Executive OfficersPresident: Jorge Garcia D.C.

President Elect: Jack Albracht D.C. Secretary: James Welch D.C.

TCA StaffMembership Development: Amy Archer

Editor: Chris Dalrymple D.C.

Board of DirectorsDistrict 1! Paul Munoz D.C.District 2! Nancy Hinders D.C.District 3! Jason Clemmons D.C.District 4! Mark McGarrah D.C.District 5! Dr. John Quinlan D.C.District 6! Cody Chandler D.C.District 7! Lorin Wolf D.C.District 8! Shawn Isdale D.C.District 9! Mark Roberts D.C.District 10! Shane Parker D.C.District 11! Max Vige D.C.District 12! Thomas Hollingsworth D.C.

PoliciesAnnual subscription to the Texas Journal of Chiropractic is included in TCA membership dues. Contact the TCA for subscription rates for non members.

T h e p r i n t Te x a s J o u r n a l o f Chiropractic is published up to six times per year by the Texas Chiropractic Association under the supervision of the TCA Publication Committee.

Opinions expressed are those of the contributors and do not necessarily reflec t the po l i cy o f the Texas Chiropractic Association or the Texas Journal of Chiropractic.

Publication of an advertisement does not imply approval or endorsement by the Texas Chiropractic Association. The association shall have the absolute right at any time to reject any advertising for any reason. For advertising rates contact the TCA Office. All advertising material must be in graphics ready format and submitted as a .jpg, .jpeg, .gif, .swf, or .png file type.

Copyright 2012 All Rights Reserved: Texas Chiropractic Association

Coming Soon…

A New Executive Director for the TCA. The ED Search Committee has worked these past months to search for and recommend a new ED for the TCA. Watch for an announcement in the coming weeks about the outcome of their efforts.

TMA Moves for Rehearing in TMA v TBCET h e T e x a s M e d i c a l Association filed a motion for rehearing in the Court of A p p e a l s . A m o t i o n f o r rehearing asks the court to reconsider part of its decision.

In particular, TMA asked the Court of Appeals to reconsider its decision about whether TMA waived its argument that the Board’s rule improperly a l l ows ch i rop rac to rs t o diagnose.

In the trial court, TCA won a declaratory judgment saying t h a t c h i r o p r a c t o r s c a n diagnose, and TMA did not appeal that decision. By not appealing that decision, TCA believes that the TMA waived its opportunity to do so.

Now, TMA is arguing that the Board rule is invalid because chiropractors can’t diagnose at all. TMA effectively asked the Court of Appeals for the opportunity to reverse that declaratory judgment, even though TMA did not appeal the decision.

The full motion may be found here.

MOTION DENIED!CLICK HERE For the full court document

“The motion for rehearing filed by appellee Texas Medical Association is denied.”

On motion by the Texas Medical Association to the Third Court of Appeals in Austin, on July 6, 2012, the court has ruled “The motion for rehearing filed by appellee Texas Medical Association is denied.”

Pertinent excerpts from the newly issued opinion include:“We withdraw our opinion and judgment dated April 5, 2012, and substitute the following in its place. The motion for rehearing filed by appellee Texas Medical Association is denied.” “ T h e Te x a s B o a r d o f Ch i rop rac t i c Exam ine rs (TBCE), its executive director, and the  Texas Chiropractic Association appeal a final d i s t r i c t c o u r t j u d g m e n t i n v a l i d a t i n g p o r t i o n s of  TBCE’s recently adopted administrative rule defining the scope of practice of ch i ropract ic . …The ru le provisions at issue purport to authorize TBCE’s licensees to perform procedures known as m a n i p u l a t i o n u n d e r a n e s t h e s i a a n d n e e d l e electromyography, and to “diagnose” certain conditions.  We will affirm the judgment in

part and reverse and remand in part.” “In five issues on appeal, TCA challenges the district court’s judgment invalidating TBCE rules regarding needle EMG, MUA, and ‘diagnoses.’ TBCE brings three issues challenging only the portions of the judgment invalidating the needle-EMG and MUA rules.” “It follows that the three challenged rule provisions p u r p o r t t o a u t h o r i z e chiropractors to perform ‘incisive’ procedures that are beyond chiropractic’s statutory s c o p e [ a n d ] a u t h o r i z e chiropractors to perform needle EMG, [stating] that a procedure involving a needle is ‘incisive’ only if it results in removal of tissue. In so doing, these ru les exceed the statutory limits of chiropractic by, at a minimum, authorizing chiropractors to perform needle EMG with beveled-edged needles that are made to cut or incise tissue. They were, accordingly, beyond TBCE’s statutory authority and void.” “In contrast to TBCE, TCA vigorously disputes that MUA is “described in the surgery section” of the CPT Codebook in any sense relevant to chiropractors. Whi le not disputing that the “surgery” section of the book has contained a description of MUA at all times relevant to our inquiry here,TCA insists that the reference “does not encompass ch i rop rac t i c

3 Texas Journal of Chiropracticwww.chirotexas.org

procedures.” It emphasizes a cross-reference that appears in the 2007 CPT Codebook’s description of MUA …. there is no dispute that MUA was described in the “surgical” section of the CPT Codebook throughout the period at issue … . A s t h e r e i s n o constitutional barrier … we must give it effect and hold that MUA is a “surgical procedure” excluded from the statutory scope of chiropractic practice. … Consequently, subsection 75.17(e)(2)(O), which purports to authorize chiropractors to perform MUA, is beyond TBCE’s statutory authority and void.” “In its remaining issues, TCA (but not TBCE) challenges the distr ict court ’s judgment invalidating rules authorizing c h i r o p r a c t o r s t o m a k e certain’”diagnoses.’”   ”In their live pleadings, the Physician Parties sought two declarations that 75.17(d) was invalid for exceeding the scope of chiropractic practice and permitting chiropractors to practice medicine without a medical l icense, in turn violating the Medical Practice Act and, alternatively, article XVI, section 31 of the Texas Constitution.”

“ F i r s t , t h e y s o u g h t a declaration that 75.17(d)’s use o f “ d i a g n o s i s ” i n i t s e l f rendered this rule and various r e l a t e d r u l e s i n v a l i d , reasoning that the statutory scope of chiropractic permits l i c e n s e e s t o “ a n a l y z e , examine, or evaluate” certain

c o n d i t i o n s , b u t n o t t o “diagnose” them, and that “diagnose” is instead reserved to the practice of medicine and certain other health care professions. … Second, they sought a narrower declaration that 75.17(d) exceeded the statutory scope of chiropractic by permitting licensees to “diagnose” conditions beyond the biomechanical condition of the spine and musculoskeletal system.” “Subsequently, the Physician Parties filed a second motion for partial summary judgment seeking relief only as to two portions of 75.17(d)–(d)(1)(A), which authorized “analysis, diagnosis or other opinion” concerning a list of six specific sub jec ts ‘ regard ing the biomechanical condition of the spine or musculoskeletal system’; and (d)(1)(B), which a u t h o r i z e d ‘ a n a l y s i s , diagnosis or other opinion’ concerning a list of three specific subjects ‘regarding a subluxation complex of the spine or musculoskeletal system.’”

“… In this motion, they relied on their narrower claim that these provisions exceeded chiropractic’s statutory scope of practice and also violated article XVI, section 31 of the T e x a s C o n s t i t u t i o n by  permitting chiropractors to “diagnose” conditions, such as d iseases , tha t were beyond the “biomechanical condition[s] of the spine and musculoskeletal system of the h u m a n b o d y ” t h a t chiropractors were statutorily

p e r m i t t e d t o “ a n a l y z e , examine, or evaluate.” … The C h i r o p r a c t o r P a r t i e s c o u n t e r e d … t h a t “diagnose” (which, again, they viewed as synonymous or i m p l i c i t i n “ a n a l y z e , ” “examine,” and “evaluate”) encompassed diagnosis of diseases and any other matter listed in 75.17(d)(1) and (2).” “Thus, the plain language of (d)(1)(A) limits chiropractors to diagnosing–i.e., “analyzing, examining, or evaluating”–biomechanical conditions of the spine or musculoskeletal system. … In other words, the non-exclusive list of example opinions or diagnoses cannot be read in isolation; rather, they must be read as being dependent upon or bounded by the restriction that they also regard the biomechanical condition of the spine or musculoskeletal system. To that extent, this complies with t h e s t a t u t o r y s c o p e o f chiropractic.” “The Phys i c i an Pa r t i e s counter that this provision does not restrict chiropractors to the biomechanical condition o f t h e s p i n e o r muscu loske le ta l sys tem because i t a l lows them to  diagnose diseases without limitation. … Specifically, they a s s e r t t h a t b e c a u s e “biomechanical” refers only to the application of mechanical principles–i.e., the action of forces on matter or material … to living bodies and does not involve diseases of any kind, chiropractors may not render a diagnosis, which by

Texas Journal of Chiropractic 5 www.chirotexas.org

d e fi n i t i o n i n v o l v e s t h e identification of a disease. Relatedly, they point to the rule’s use  of “pathology” and “etiology,” which also involve the study of disease … to argue that this provision of the scope-of-practice rule allows chiropractors to diagnose a wide range of diseases and conditions, including various c a n c e r s , a r t h r i t i s , osteoporosis, gout, ALS, and bone fractures.”

"But apart from the fact that t h e c o m m o n , o r d i n a r y meaning of “diagnosis” also includes the identification of a “condition” or an “injury,” … t h e P h y s i c i a n P a r t i e s ’ argument presumes that “d isease” wou ld ex tend beyond the biomechanical condition of the spine or musculoskeletal system of the h u m a n b o d y . T h i s construction, as previously suggested, ignores the plain language of the rule restricting any such  diagnosis to the biomechanical condition of the spine or musculoskeletal system. The text and format of this provision plainly shows that “the system” discussed in each of the examples is “the biomechanical condition of the spine and musculoskeletal system” referred to at the beginning of the provision.”

“Stated another way, each of the listed examples is limited to the Legislature’s standard of ‘biomechanical condition of the spine and musculoskeletal system.’ Thus, regardless of whether diagnosis, pathology, or etiology invoke concepts of

disease as the Physician Parties suggest, the  bottom line is that paragraph (d)(1)(A) l i m i t s c h i r o p r a c t o r s t o diagnoses regarding ‘the biomechanical condition of the spine and musculoskeletal system’ as required by the s t a t u t o r y s c o p e o f chiropractic. Accordingly, the provision does not exceed the s t a t u t o r y s c o p e o f chiropractic.” “In a related argument, the Physician Parties challenge TBCE’s use of the phrase “could include, but are not limited to” in subpart (d)(1) of the scope-of-practice rule, s u g g e s t i n g t h a t  i t , i n combination with the issues discussed above, eviscerates any purported limitation on chiropractors’ authority to d i a g n o s e b y a l l o w i n g chiropractors to “diagnose any diseases (pathology) that relate to the biomechanical condition of the spine and muscu loske le ta l sys tem (redefined to  include nerves and other tissues), determine their origins (etiology) and p r o v i d e a p r o g n o s i s on the disease’s effect.”

“But this argument requires reading 75.17(d)(1) in an u n n e c e s s a r i l y strained  manner.”"[The rule states] that chiropractors “may render an analysis, diagnosis, or other opinion regarding the findings of examinations and evaluations. Such opinions could include, but are not limited to, the following[.]” … [the words] ‘But are not limited to’ as it is used here merely

m e a n s t h a t t h e l i s t o f examples that follows is not a comprehensive list of every type of authorized opinion–i.e., there could be other types of opinions that fit within the parameters of the provision that are not mentioned in the list.”

“Also, use of this phrase does not alter the limitation in the rule that the “diagnosis” referred to must regard the findings of “examinations and evaluations,” … Thus, the plain language of 75.17(d)(1) provides that chiropractors m a y r e n d e r d i a g n o s e s r e g a r d i n g fi n d i n g s a n d examinat ions wi th in the s t a t u t o r y s c o p e o f chiropractic, and offers a non-exclusive list of examples of such opinions. It does not, by its plain language, allow them to render diagnoses that do not involve the statutory scope of chiropractic. As such, it does not exceed the s t a t u t o r y s c o p e o f chiropractic.”

"We sustain TCA’s third issue.” “Relatedly, the Physician Parties argued successfully to the district court that the following paragraph of TBCE’s scope-of-practice rule, (d)(1)( B ) , a l s o e x c e e d s t h e s t a t u t o r y s c o p e o f chiropractic: (1) In the practice of chiropractic, licensees may render an analysis, diagnosis, or other opinion regarding the findings of examinations and evaluations. Such opinions could include, but are not

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limited to, the following: . . .(B) An analysis, diagnosis or other opinion regarding a subluxation complex of the spine or musculoskeletal system including, but not limited to, the following: ….”

“Initially, the Physician Parties argue that this paragraph of the scope-of-practice rule is invalid because it allows chiropractors to diagnose a subluxation complex despite the fact that the statutory scope of chiropractic only allows chiropractors to treat the subluxation complex.”

“… Stated another way, the Physician Parties argue that while chiropractors–again assuming our procedural limitations as to “diagnosis”–m a y d i a g n o s e t h e biomechanical condition of the spine or musculoskeletal system, they can only treat, b u t n o t d i a g n o s e , t h e subluxation complex. We find this argument unpersuasive.”

“This argument suggests that the Legislature intended to allow chiropractors to treat a condition that is undisputedly unique to the practice of ch i roprac t i c , wh i le a lso deliberately depriving them of t h e a b i l i t y t o a n a l y z e , examine, evaluate, or (given our procedura l posture) “diagnose” that condition. We cannot see how a chiropractor w o u l d k n o w t o t r e a t a subluxation complex if he had not first determined from an analysis, examination, or evaluation/ “diagnosis” that there was a problem with the

subluxation complex that n e e d e d c h i r o p r a c t i c treatment. A more logical i n te rp re ta t i on , and one supported by the text of both the occupations code and TBCE’s scope-of-practice rule a n d b y t h e s u m m a r y -judgment evidence, is that a subluxation complex is part of the biomechanical condition of the spine or musculoskeletal system of the human body and, thus, may be analyzed, evaluated, examined, and diagnosed by chiropractors.” “ T B C E ’ s u n c h a l l e n g e d definition of “subluxation complex” establishes that it is a– ’neuromusculoske le ta l condition that involves an aberrant relationship between t w o a d j a c e n t a r t i c u l a r structures that may have functional or pathological s e q u e l a e , c a u s i n g a n a l t e r a t i o n i n t h e biomechanical and/or neuro-physiological reflections of these articular structures, their proximal structures, and/or other body systems that may be d i rect ly or indi rect ly affected by them.’”

“… The rule also defines “musculoskeletal system” as the “system of muscles and tendons and ligaments and b o n e s a n d j o i n t s a n d associated tissues and nerves that move the body and maintain its form.” … “Neuro-” is a prefix meaning “nerve,” … and “articular” refers to joints, … To a certain extent, then, use of the prefix “neuro-” with the adjective “articular” in c o n n e c t i o n w i t h

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New Licensee and TCA Members May/June 2012 

Jason PellegrinSomphone AmphoneBradley BakerBenjamin CharltonJamon ClaytonJesse CzajkaMitchell DoughertyPhilip ElderStephen FordJuan GarciaDiana GodinezAsa HadsellLee HartmanYvonne HinojosaRyan HuffmanJi Young KwonShukura LeoTaryn LoweryBryant MaysBrian McGaughranScott McLellanNicole MinatreaTankiso MochacheJerald NaumAshlee NiebuhrTony OberleJames Palma, Jr.Christel ParishAlesha PaternostroKrista PerdueNataly PerezTelila RobinsonGena RossDaniel SchererPhilip SledzBrock StrattonWhitney TablerBarrett TerryWilliam UrsprungIan VearyKristen WaltersChristopher Warmath

“ m u s c u l o s k e l e t a l ” i s redundant in that TBCE’s definition of “musculoskeletal system” already includes both nerves and joints.” “Nevertheless, the bottom line here is that 75.17(d)(1)(B) a l l ows ch i rop rac to rs t o diagnose a condition that under unchallenged rules is part of the musculoskeletal system of the human body. To that extent, it comports with t h e s t a t u t o r y s c o p e o f chiropractic.”  

“The Physician Parties also contend that the language of paragraph (d)(1)(B) allows chiropractors, in violation of t h e s t a t u t o r y s c o p e o f chiropractic, to diagnose neuro log ica l cond i t ions , pathologica l and neuro-physiological consequences that effect the spine and musculoskeletal system, and “other body systems” that are affected by subluxation.”

“We d i sag ree t ha t t h i s provision sweeps so broadly. Although the definition of ‘ s u b l u x a t i o n c o m p l e x ’ indicates that its existence may have func t iona l o r pathological consequences or that it may affect essentially every part of the body, the rule

itself only allows chiropractors t o r e n d e r a n a n a l y s i s , diagnosis, or other opinion regard ing a subluxat ion complex of the spine or musculoskeleta l system. Accordingly, i t does not exceed the statutory scope of chiropractic.  We sustain TCA’s fourth issue.”“Having determined that, in the procedural posture of this appeal, the district court erred in its judgment invalidating subparts 75.17(d)(1)(A) and (B) of TBCE’s scope-of-practice rule, we reverse that portion of the judgment.”  In light of our reversal … we remand the case for further proceedings regarding the Physician Parties’ alternative constitutional challenges.” “Having otherwise overruled each of the Chiropractor Parties’ issues on appeal, we affirm the remainder of the district court’s judgment that subparts 75.17(a)(3), (c)(2)(D), (c)(3)(A), and (e)(2)(O) of TBCE’s scope-of-practice rule are void.”

TCA Insurance Committee ReportTCA’s Insurance Committee has been receiving numerous calls and emails from TCA members with regard to some personal insurance protection (PIP) carriers not honoring/i gno r i ng ass ignmen t o f benefits.  This has resulted in

certain carriers paying our p a t i e n t s d i r e c t l y .  Unfortunately, this have left some doctors “holding the bag.” TCA has recently met with Te x a s D e p a r t m e n t o f Insurance regarding this matter.  We have been informed by TDI that there is no statutory PIP/MEDPAY duty to honor an assignment of benefits. 

That means that there is no specific language in the insurance code/ law that forces a carrier to honor our assignments. 

Prior to the 2007 legislative session, all carriers were required by law to use the Texas Standard Auto Policy, w h i c h h a d l a n g u a g e specifically stating that PIP/M E D PAY b e n e fi t s w e r e assignable.  A bill during that legislative session allowed carriers to use “their own” forms.  Some carriers copied and pasted some or all of the Texas Standard Auto Policy, and some re-wrote using their own verbiage. 

In any event, one must now look to the policy language to d e t e r m i n e w h e t h e r t h e insurance company states “we will honor or we won’t honor assignments.”  If their policy language states that they will, and then breach your assignment, then there is potential for legal action.  That said, there are still possible legal arguments to

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TCA Welcomes New Members: 

Dr. Omar Vela, EdinburgDr. Jeff Williams, AmarilloDr. Alan Thompson, PasadenaDr. Jon Swanson, AustinDr. Jay Morgan, AustinDr. Lezlie Maloy, Dallas

be made, regardless whether carrier states they will honor or won’t.  TCA is working on that issue right now and will continue to investigate this.   In the meantime, TDI is sticking with their analysis and will not enforce assignment breaches.  T C A i s s t r o n g l y r e c o m m e n d i n g t h a t a l l doctor’s offices continue to compile complaints regarding this matter.  Please forward those to TCA Insurance Chair, Dr. Todd Whitehead.  Please e m a i l t o dr.whitehead@chiroamarillo.com

Texas Council of Chiropractic OrthopedistsThe first time that the Texas Chiropractic College Post Graduate Department offered its series of lectures leading to the designation of Diplomate, t h e r e w a s a g r o u p o f approximately 150 D.C.’s who enrolled with all intentions of completing the 320 hour course. 

Once a month, these D.C.’s, c l osed the i r r espec t i ve practices, paid the tuition and made hotel reservations in Austin for the weekend.  This continued for the next  3 years. 

Although in any scholastic endeavor, there is attrition and the class decreased  in size to about  50 and then to about  35.  Each module of this series had an examination.   New information was given by the very capable instructors who were already Diplomates in Orthopedics.

Successfully passing  the individual module tests  and the completion of  the hours required, there was one more step to take before gaining the Diplomate status.  A national examination was given. 

It was a two day affair with the written portion of the exam on day 1 and then a practical/oral examination on day 2.  These were given only 1-2 times a year in different parts of the country. 

The results of those tests were reported to the student.  If he/she passed, he/she was awarded the designation of Diplomate.  If the student did not pass, he/she was able to retake the whole examination whenever it was offered.

Now that the student had the status that he/she had worked and sacrificed, what  was next?  The last instructor for the group was Dr. Ronald Evans who had mentioned that in his state, there was a g r o u p o f  o r t h o p e d i c diplomates who formed a c o u n c i l t o e n c o u r a g e education of Chiropractic.  This seemed  like a viable endeavor for the Texas group and Dr. Walter Brzozowske

initiated the beginning of the Texas Council.

Many meetings were held to discuss what  this Council’s objectives and purpose would be.  It was agreed that this Council would be a not-for-p rofi t and an apo l i t i ca l organization.

Seminars were planned with courses  ranging from the cervical spine to extremities, to the lumbar spine.  Each member of the Council  taught a portion of the seminar furnishing class notes and references. The treasury began to grow after paying T C A i t s p o r t i o n o f t h e expenses.    No monies were reimbursed to the T.C.C.O. members for many years.  Due to the expenses being decreased, the tuition of the c o u r s e w a s d e c r e a s e d accordingly to help the field docs.

As a member  of the American Council  of Chiropractic Orthopedists, each member received a pamphlet with the most common orthopedic and neurological tests in an easy re fe rence gu ide .  The T.C.C.O.  bought  over 3000 of the pamphlets and mailed one to each licensed D.C. in the state of Texas as a gift.   Some D.C.’s still use these in their offices.

Worker ’s Compensa t ion began to require additional education for its Designated Doctor program.  Dr. Don Handley  had a medical professional friend, Dr. Mark

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Taylor, who had influence  with the AADEP group who was teaching the Designated Doctor course and invited the Chiropractic Orthopedists to teach during their seminars.   T h i s r e l a t i o n s h i p h a s continued to this date.

To become a member of the T.C.C.O., you must  have completed the course in orthopedics, be a member in good standing of the T.C.A., complete the application and have a face to face meeting with the membership.

With the short history of this organization, one can easily o b s e r v e t h e l e v e l o f commitment  to education and the promotion for graduate study  of  Chiropractic Orthopedics.  It is encouraged to become a member of the ACA’s Council on Chiropractic Orthopedists.

The T.C.C.O. has been elected as the only state o rgan iza t ion w i th equa l privileges and voting rights with the national organizations of A.C.C.O., the C.C.O. as we l l as the A .C.O ( the Academy of Chiropractic Orthopedists) .  This alone, bodes well with the character and zeal of its members.  Throughout the years, the T.C.C.O. gave large sums of money to help T.C.C. in its f u n d r a i s i n g p r o j e c t s , reference books for the library and  speaking engagements from its members.  Today, t h e r e a r e m a n y o f t h e members who now and in the past, have been selected to

serve on governing boards of n a t i o n a l o r g a n i z a t i o n s , represent ing Texas, the T.C.C.O. and Chiropractic.

Congratulations  to T.C.C.O. for 31  productive years of educat ion and selflessly promoting Chiropractic in Texas and  in the national arena.

Discount Legally“Is it possible to structure your f e e s t o m a x i m i z e reimbursements and sti l l provide care to those without coverage at a fee they can afford and one YOU can live with?

Is it possible to offer discounts to cash and Medicare patients for exams, x-rays and therapy without having a dual fee schedule or triggering an inducement violation with hefty fines and penalties?

Y e s , i t ’ s c a l l e d ChiroHealthUSA. Patients have the opt ion to jo in ChiroHealthUSA when your staff reviews your office financial policy.  Membership in this Discount Medical Plan O r g a n i z a t i o n ( D M P O ) cons t i tu tes a “cont rac t ” b e t w e e n y o u r c l i n i c , ChiroHealthUSA, and the patient. Now, the patient has access to reduced fees just l ike any other “network patient.”

The existence of a contract allows you to set and offer these rates to our members, solving a host of legal and regulatory problems for you and your patients. For the record, we’re not a fan of discounting and think our doctors should be well for their services. That being said, there is not a doctor in practice that doesn’t offer discounts if they are part of a managed care plan or PPO. So, the issue isn’t IF you d iscount , but HOW you discount. More importantly are the discounts complaint with your State Board, as well as state and federal regulations and your PPO agreements. T h e y c a n b e w i t h ChiroHealthUSA!

T h e C h i r o H e a l t h U S A membersh ip covers the patient and dependents for a small annual fee of $39.00 and the membersh ip i s effect ive instantly. Many patients save the enrollment fee on their very first visit!

TBCE PROPOSES RULES UPDATESTBCE Proposes Updates to Specialty Rule 75.15

TBCE Proposes Alteration of Chiropractic Scope of Practice Defined in Rule 75.17

TBCE Proposes Changes to Rule 80.7 Out of Facility Practice

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Lack of HIPAA Compliance Can Now Shut Down Your Practice or WorseBY:   Dr. Ty Talcott and Martha Mckinney C.P.O.

The risk

Protecting the profession–relative to HIPAA, Medicare and Insurance compliance–is a major task, but if it is not taken seriously many more doctors will pay the individual price of major fines (HIPAA has a new 50k minimum fine, up to 250k), the loss of their license or their practice–OR worse yet–face cr iminal charges (now that the Justice Department is involved with the Office of the Inspector General [O.I.G.] to enforce many of the aspects of  H I P A A a n d M e d i c a r e compliance as criminal fraud).This is real–our profession IS a target!

Our intent is not to scare doctors (or their key staff or compliance officers), it is to prepare them.

The mythsThe most disturbing myths are born of ignorance, denial or intentional and willful neglect.O f fi c i a l s o f H I PA A a n d Med ica re have dec ided

chiropractors and certain other specialists have ignored becoming compliant for too long, therefore deficiencies in compliance will be considered ‘willful’ in many cases. This is the reason they have asked the Justice Department to participate in the enforcement o f c r im ina l p rosecu t i on relative to their audits and investigative findings.

Maybe the most damaging m y t h i s t h a t H I P A A compliance is accomplished in your office as long as you have ‘some kind’ of release form to be signed prior to releasing patient records and you don ’ t leave pat ient informat ion ( l ike pat ient charts) laying around the office or you have an EMR s y s t e m t h a t i s H I PA A compliant, etc.- nothing could be further from the truth!

There is no way in an article to teach and train what it takes to make an office compliant. (It can at least be stated that there are eight required release forms you must have in your compliance manual–just one small fact known by few).

Think of it this way: It takes eight forms to fulfil l the requirement of one ‘chapter’ of your compliance manual and there are about a dozen critical ‘chapters’ you need to have in your manual–each with requirements you must meet!

Lack of knowledge is rampant in the chiropractic profession.

This was further confirmed for us this year during our time teaching HIPAA compliance for license renewal at the M i n n e s o t a C h i r o p r a c t i c Convention.

Most disturbing is what my partner, Martha McKinney C . P. O . d i s c o v e r e d a n d realized–clinics are not aware of the new dangers posed by regulatory agencies and the need to protect themselves–NOW!

In a past life Martha was a senior medical claims auditor f o r a m a j o r i n s u r a n c e company. She is still on those audit committees and has most recently been through the training for the most recen t round o f nationwide audits being launched by Medicare and the O.I.G. (the Office of the Inspector General (O.I.G.) is the enforcement arm for HIPAA and MEDICARE and they have now stated, to the auditors, that “when you find a problem in one area, check out the other”).

These trainings are taught by M e d i c a r e , t h e J u s t i c e D e p a r t m e n t a n d O . I . G . officials. She has already been called upon, as a senior auditor, for opinions relative to the new round of audits and knows of chiropractors in Texas who have been fined, repor ted , den ied fu tu re payments and have had re-payment demands issued.

What she is learning is very, very concerning for our

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profession. We are officially a target of both HIPAA and Medicare, along with certain other specialists.

New Medicare laws, such as the mandate that YOU must find your own billing errors and RETURN THE MONEY P A I D T O Y O U B Y MEDICARE, IN ERROR, WITHIN 60 DAYS or you have the potential of being charged with fraudulent billing, makes it that much easier to levy fines, report you to the board and /or charge you criminally.

(This is mainly concerning chiropractors continuing to bill for adjustments after they have become ‘maintenance’ adjustments, per Medicare definition of maintenance– not your definit ion–and then failing to issue and ABN correctly and alter your billing coding correctly and therefore receiving money you are not entitled to under the Medicare system).

Here are samples of other issues doctors did not realize:This year CHIROPRACTORS ( A L O N G W I T H A F E W OTHER GROUPS) HAVE BEEN TARGETED BY NEW FEDERAL TASK FORCES of aud i tors for HIPAA and Medicare compliance.

As recently as May 2, 2012  task forces seized documents, filed charges against 107 suspects and suspended payments to 52 providers–in one day–across the U.S.A.

There are required clinical file and denied claims a u d i t s t h a t m u s t b e performed by your office, documented and official c o r r e c t i v e a c t i o n s documented and followed through on a yearly basis.

There are basic required forms with required language that must be stored within your HIPAA compl iance manual.

That privacy policies should no longer be posted on the wall and given to each patient and this has been replaced by a new required procedure.That you must document follow up dates for certain HIPAA activities and they must be recorded in your compliance manual.

W h e n a n d h o w t o CORRECTLY use and audit ABN forms.

That you must conduct and document HIPAA training and a t tendance o f a l l t eam members yearly  (plus there are required topics you must cover in that training).

That there is an official p r o c e s s a n d t h e r e a r e required forms for naming your compliance officer and demanding confidentiality from outside vendors…

T h a t y o u m u s t h a v e a compliance manual with the proper headings in the index to assure the proper content.That just because a new EMR software system says it is

HIPAA compliant that has nothing to do with all the other areas of required compliance l isted above…Along with many others.

The reality

This is all happening because Medicare and HIPAA have been criticized for not finding and stopping those who are breaking the rules, thus allowing billions of dollars in fraud to continue.

W e h a v e b e e n t e l l i n g everyone ‘this day is coming’ and that chiropractors ARE a target. This is very lucrative for the Medicare program. This most recent raid will net up to $450,000,000.000 dollars!

Health and Human services (the umbrella over the OIG) is touting a new data system aimed at allowing authorities t o s p o t b i l l i n g a n d documentation trends more quickly. They stated they have quadrupled the number of str ike teams around the country.

You need to get your internal H I P A A a n d M e d i c a r e programs in place ASAP! Update them and improve them with official, documented and recorded correct ive a c t i o n s s t o r e d i n y o u r compliance manual and stay v i g i l a n t . D o c u m e n t t h e changes you make, as they are your best chance of escaping fines and charges! Remember, if they come to your clinic, they can do so

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WITHOUT  warning and their first demand will likely be for y o u t o p r o d u c e y o u r compliance manual!

N o o n e c a n b e 1 0 0 % compliant and therefore safe, so, it is even more critical to do all you can to avoid fines and criminal charges. Effort goes a long way to avoiding fines and charges as this p rog ram was o r i g i na l l y designed so doctors could police themselves. Showing you have documentation to prove you have been doing so can go a long way.

When deficiencies are found and there is no reasonable w r i t t e n a n d s i g n e d documentation of efforts being made to correct them, on a continuous basis, you are a sitting duck! With multiple improvement policies in place there is a MUCH better chance you will be informed of required changes and given a chance to comply verses being fined the new minimum $50,000 (up to $250,000) or charged with fraud.

Solutions:

You can never be 100% compliant, so it is even more critical you do all you can. Due to the complexity and changes relative to HIPAA compliance, we recommend you get assistance. In our opinion it is now too risky to guess and a bad idea to go into denial… that worked in the past, but it is exactly what the HIPAA regulators are now saying our profession has

done for the last several years and they are out to STOP chiropractors from ignoring HIPAA rules.

What can you do?

Get help!

There are seminars, there is license renewal and there are resources. Make sure the information is up to date and complete.

It is TOO RISKY to just figure it out on your own and hope you have the bases covered in today’s environment and it does NOT take a full time c o m p l i a n c e o f fi c e r t o accomplish this. A staff person can easily add the majority of the ongoing needed activity to their job description.

There a few good choices. As the doctor, cl inic owner, compliance officer or office manager you have access to the information within the office needed to:

Assist professionals who can come on site and put your program together for you. For many clinics this is preferable as it saves many hours of staff and doctor time that can be used for practice development activities and patient care.

Or

Fol low d i rect ion f rom a complete training series and for all practical purposes ‘Do it y o u r s e l f ’ . T h i s i s l e s s expensive and can be done at your own pace.

OrCompetently identi fy the areas in which you are deficient and get only the training you need to improve your weak areas. This is helpful for clinics that truly know all the requirements and what is current, but still need help in one or two areas.

It can be a big task to get a comprehensive program in place, but once established it should only take three or four hours per quarter of the year to keep it current.

You can find information r e l a t i v e t o o p t i o n s a t www.hipaacomplianceservices.com

One thing we will offer to TCA members is a free review to a s c e r t a i n y o u r H I PA A compliance score. We will leave this offer in place until we are unable to handle the volume.What is a good starting place?Schedule a time to get your free HIPAA Compliance Score at: www.

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TCA Members obtain your CE hours online at www.ChiroCredit.com/tca and 25% will go to support the TCA.

The 2012 TCA Convention saw the unveiling of a new Chiropractic Development Initiative. The CDI saw not only the unveiling of the new initiative, but also the unveiling of a new feature film documentary Medical Inc. Tens of thousands of dollars were raised and pledged during the unveiling.

Contributions to the CDI resulted in

smiling faces all around.

New TCA Board Members were

sworn into office

Dr. John Nash presented

information for Recycled

Baseball Items for military oversees

TCA staff member

Amy Archer reports office

status to the board

of directors

Many doctors, schools, organizations, family members, and others donated or pledged funds for the defense and development of the chiropractic profession from assault in Texas.

CLICK HERE TO DONATE.

hipaacomplianceservices.com  , while they last.

Click on a-la-carte on the home page. This will take you to explanations of the major components of a compliance s y s t e m a n d h e l p y o u determine your individual needs.

Ask to be put on a free HIPAA update list by requesting it at the website contact page.Be safe, stay in practice, heal the world. Ty Talcott D.C. is the C.E.O. of HIPAA Compliance Services. He has been consulting, relative to developing chiropractic business practices for many years and is now assisting in protecting the profession from regulatory risk.

Martha McKinney is C.O.O. of HIPAA Compliance Services. She has been assisting chiropractors relative to their business development for nearly a decade and has a background rich in claims review, auditing, Medicare and HIPAA compliance as well as being a feasibility expert relative to integration of physical medicine into hospital settings.

You can follow them on Facebook, Twitter, LinkedIn or check out their blog at www.hipaacomplianceservices.com

Medical Inc. The Movie

What if everything you know about your health was bought and paid for?

Medical Inc. is a theatrical documentary exposing the modern medical monopoly. Learn more about the movie at this link:  Medical Inc.

T h e m o v i e p r o d u c e r presented excerpts from the movie at the TCA Convention and received a standing ovation, and received hugs from the audience for “finally presenting our story in a truthful way.” 

Says the  Medical Inc. producer: “It was great to be with all of you at the TCA’s 2012 Annual Convention, it was an honor to share a little about the film Medical Inc. which will be released later this summer. Texas has been good to us and this project, a measurable percentage of the footage we have shot comes from the great state of Texas. We are excited to share this film with the world, and all the i n c r e d i b l e t h i n g s t h a t chiropractic is doing in your great state.”

“As was mentioned when Jeff Hays spoke, we have set up www.supportchiromovie.com as a destination to provide your support to the film and claim your own signed copy of the DVD among other great rewards. This has also been a powerful tool to easily share and spread the word for the project with everyone that is passionate or is affected by

this message, so please pass it on.”

“We would love for you to join us and stand up in support of this effort.”

“We cannot wait for everyone to see what we have here, we a r e c o m m i t t e d t o b l o w everyone away with a film worthy of your support. Movie trailers represent a collection of a handful of the 80 plus interviews shot so far that our editing team put together.”

“Pease consider supporting us by purchasing a copy for yourself, or 5 copies for $100; for those that really want to share the film and feel they can get 100 copies out, please consider stepping up at $1000 and make a huge difference.”

Thank you all!The Medical Inc. Team

National Certification for Chiropractic AssistantsDynamic Chiropractic reports that at “the Federation of Chiropractic Licensing Board’s (FCLB) 86th Annual Education Congress in San Antonio, Texas this year … the FCLB was announcing an important new educational initiative – a

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national certification program for chiropractic assistants …”

“The program is designed for CAs who provide or assist patients with their physical therapy. It will certify that they are adequately trained and award them the title “Certified C l i n i c a l C h i r o p r a c t i c Assistant” (CCCA) or “triple CA.”

“According to Donna Liewer, F C L B p r e s i d e n t , t h e organization decided to take action after hearing that a number of major insurance carriers were deliberating whether they would continue to reimburse chiropractors for s e r v i c e s p r o v i d e d b y unreg is tered ass is tants . Insurance carriers answer to underwriters or accreditors, who demand they require anyone touching a patient to be credentialed.”

“The FCLB suggested a program of certification or registration rather than full licensure, which would have required that each state open the i r regu la t ions to the leg is la t i ve p rocess and p o s s i b l y t a k e y e a r s t o accompl ish. I f that had happened, doctors would have been faced with the dilemma of providing therapy without an assistant, providing therapy without insurance reimbursement, or eliminating the provision of therapy altogether.”

“The FCLB didn’t create the CCCA program on its own; it enlisted the help of college

postgraduate departments, experts from the field and regulators from states with existing programs. It is also drafting sample language to help states create their regulations.”

“The NBCE has the expertise and credentials to satisfy accreditors. Its online test will be ready this fall, and in the meantime, a number of online educat ion prov iders are gearing up to deliver the training. The training and exam will consist of four primary subjects: foundational knowledge, patient safety procedures, documentation, and boundaries / ethics.”

Smart Training Addresses Needs of HB 300Texas health care providers must comply with a new health care privacy law that requires an update to policies and procedures, Notice of P r i v a c y P r a c t i c e s , a n d employee training and the deadline will soon be upon us–September 2012.  TCA is in the process of providing access to such training at a discount.  More information will be made available shortly, but here are some of the things that you need to know about HB 300.Texas House Bill 300 (HB 300) mandates new patient p r ivacy pro tec t ions and

harsher penalties for privacy violations related to electronic health records (EHR). The requirements of the Texas law are more stringent than those of its federal counterpart, the Health Insurance Portability a n d A c c o u n t a b i l i t y A c t (“HIPAA”).

Under the Texas law health care entities must provide customized employee training regarding the maintenance and protection of electronic protected health information (PHI).

Covered entities are required to tailor the employee training to reflect the nature of the covered entity’s operations and each employee’s scope of employment as they relate to t h e m a i n t e n a n c e a n d protection of PHI.

N e w e m p l o y e e s m u s t complete the training within 60 days of hire and all employees must complete training at least once every two years. Covered entities m u s t m a i n t a i n t r a i n i n g attendance records for all employees.

The Texas law requires covered entities to provide patients with electronic copies of their EHR within fifteen days of the patient’s written request for the records. This provision of the Texas law reduces the time frame a covered entity has to produce EHR following a patient’s request from thirty days under HIPAA.

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Convention saw new officers interesting seminars, new vendors and lots of gratitude for the soon to be released movie Medical Inc.

Texas Journal of Chiropractic

Dr. John Nash received the Keeler AwardDr. Tyce Hergert was

named Young Chiropractor of the year.

Dr. Jeff Brown Received both the President’s Award and the

Director’s Award -->

Good Food, Good Fellowship, Good times were the order of the day

Dr. Curtis McCubbin Presents the Keeler Committee’s donation to the CDI

The law charges the Texas Health and Human Services Commission with establishing a s t a n d a r d f o r m a t f o r releasing patient EHR that is consistent with federal laws.

The new law contains severe civil penalties for violations of the law. Penalties can range from $5,000 up to $1.5 million p e r y e a r f o r u n l a w f u l disclosure of a patient’s PHI.  These pena l t i es a re in a d d i t i o n t o t h e s i m i l a r p e n a l t i e s t h a t c a n b e assessed by HHS under HITECH, so a covered entity could be facing fines up to $3 million per year for the same violations under state and federal law.

T h e l a w i s e f f e c t i v e September 1, 2012.  Texas health care entities should be aware of the new law and its requirements, which are more expansive than HIPAA or HITECH.

Journal.chirotexas.orgThe Texas Ch i roprac t i c Association implemented an updated, more streamlined and easier to access online news Journal. 

T h e Te x a s J o u r n a l o f Chiropractic can now be r e a c h e d b y g o i n g t o “journal.chirotexas.org.”  You don’t need the quotation

marks and you don’t need “www.” either.    Just type journal.chirotexas.org into your web browser and you will be at the new Texas Journal of Chiropractic, Online.

Not only is this new format easier to access, but it is easier and more powerful.  Currently we are syndicating news from a dozen different sources, publishing multiple news stories per day.  Check journal.chirotexas.org for the latest in current events of interest to the chiropractic profession. 

Here you will find articles from the New York Times, the ACA, the AMA, MedPageToday, and Health and Wellness f e a t u r e s f r o m m u l t i p l e sources.  We wi l l add additional sources as they become available.  Each day there will be numerous new pos ts f rom the va r ious sources of interest to the chiropractic profession in Texas. 

Stop here first and you’ll be able to catch up on the health and professional news you need.

There are a dozen different categories of news from which you may choose.  The latest postings are always on the front page, easy to see.  If you want to check out some of the older postings,  just check out the categories:

• Associat ion news (news from  Texas and national chiropractic

associations, the AMA, a n d o t h e r associations);

• Notable News (stories to take note of);

• News (other news);

• Legis la t ive ( s ta te pol i t ica l news and information);

• F e d e r a l H e a l t h Reform;

• Federal and

• State Government news;

• Chiropractic College News;

• Clinical news;

• O p i n i o n s a n d editorials;

• Health & Wellness (news for everybody, n o t j u s t s c i e n t i fi c professionals); and

• Business News.

In upcoming months TCA will also be publishing a new association website based on similar technology so watch for regular changes in the coming months, this is but the first step!

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Doing the Right Thing the Wrong Way Can Cost YouBy Dr. R. A. FOXWORTH, D.C., FICC, MCSP

Doing the Right Thing the Wrong Way Can Cost You?   Yes, I know. Sounds strange doesn’t it?

Strange as it sounds, it is far too familiar to those of us who work with doctors on a daily basis to help improve their documentation, billing coding and collections. We see examples of doing the right thing the wrong way every day in chiropractic clinics across the nation. It happens when doctors attempt to do the right thing in helping patients with no insurance or limited benefits by “tweaking” their documentat ion and coding to result in an overall lesser charge for the patient.

Be honest. Have you ever had a patient that required more than a routine workup but you used a lower level exam code because you knew they had no insurance coverage? Perhaps a 99202 instead of a 99203?  No big deal right?WRONG! 

Or, as long as we are being honest, have you had a patient that you adjusted full spine, 4-5 levels, and you only charged a 98940 for 1-2 levels?  No big deal right?WRONG! 

Ok, let’s try one more. How about this scenario? Have you ever had a Medicare patient that required a detai led workup and x-rays and you charged a lower level exam code or just billed for 2 x-rays when you actually performed 4 , b e c a u s e y o u k n o w Medicare doesn’t cover your exams or x-rays? No big deal right? WRONG!

All of these are examples of down coding your services in an attempt to strike a balance between what insurance coverage may allow and what y o u f e e l y o u r c a s h o r underinsured patients can afford.

We all know if you don’t perform a service you should not bill for it…it is called fraud. However, few may be aware that if you DON’T report what you did and DON’T charge for services you would normally bill to insurance because you are seeing a cash patient, there is also the potential for fraud because of a dual standard of care and a potential dual fee schedule.

Not to mention, down coding or failure to bill Medicare patients can be considered an inducement and subject to serious fines and penalties according to the Office of Inspector General and CMS.

The bottom line is that down coding can be perceived as illegal and inappropriate just as up coding is when it is used to allow you to bill differently based on whether

the patient is insured or a cash patient. It is “gaming” the system pure and simple. It is doing the right thing to help the patient, but it is being done the wrong way and it can cost you.

What drives doctors to down coding or not charging for all their services?  It’s really quite simple. There is the need to maximize reimbursements by billing your UCR fees or contract rates to insurance companies, but you haven’t found a good way to make care as affordable as you would like for your cash and underinsured patients.

So the only tool you have is to “tweak” the documentation, coding or billing to allow you to do what you would like to do. It really is that simple, but it can REALLY be very costly if you are audited!

So how can you document as you should, bill as you should a n d c o d e p r o p e r l y f o r maximum reimbursement when there is insurance available and still be able to help the cash patients?  You MUST join and encourage your patients to join a cash discount program.

It really is one of the most logical, legal, and ethical ways to allow you to accept a lower fee than your normal UCR clinic fees. It allows you do what you are attempting to do n o w … h e l p t h e c a s h o r underinsured. But, with a network contract, you can do it without “tweaking” your

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documentation, coding and billing and you avoid running afoul of dual fee schedules or illegal inducements.

So , do the r igh t th ing ! Document properly. Code properly. Bill properly. And, consider joining one of the cash discount plans that allow you to “contract” with cash and underinsured patients.

The contract model is not new. The contract model is what allows you to contract w i th mu l t i p le insurance companies for different rates for the same codes without it being considered a “dual fee schedule”.

Cash discount plans simply provide you the protection of a “contract” and allow you to document, code and bil l properly and still pass on some savings to your cash and underinsured patients.

I f you are document ing properly, coding properly and billing properly, good for you! Just make sure you don’t do the right thing the wrong way b y t r y i n g t o u s e a “bookkeeping reduction” or Time of Service discount that can be open to interpretation as to what is a “reasonable” discount. Far too many clinics use these tactics or strategies improperly in trying to help cash and unde r i nsu red patients.

Most all patients are familiar with “buying clubs” like Sam’s C l u b a n d n e t w o r k s . Experience shows they don’t

hesitate to join these to save money! A good cash discount plan solves so many of the potential problems for you and really helps the patient…the RIGHT WAY!

THE MAIN THING IS…. Doing NOTHING is not an option! Dr. Foxworth is a certified Medical C o m p l i a n c e S p e c i a l i s t a n d President of ChiroHealthUSA. A practicing Chiropractor, he remains “in the trenches” facing challenges with billing, coding, documentation and compliance.

Dr. Foxworth is a 1984 Honors G r a d u a t e , ( C u m L a u d e ) , o f Cleveland Chiropractic College in Kansas City, MO. He served as Staff Chiropractor for the G.V. Sonny Montgomery VA Medical Center for 4 years and is a member of the American Chiropractic Association and a 3 term past-president of the Mississippi Chiropractic Association.

He was voted by his peers as Chiropractor of the Year for several years and is currently a Fellow of the In te rna t iona l Co l lege o f Chiropractic. He was appointed to the Mississippi State Board of Health by Governor Kirk Fordice and again by Governor Ronnie Musgrove and served 12 years, two of them as Chairman. Dr. Foxworth c a n b e c o n t a c t e d t h r o u g h w w w . c h i r o h e a l t h u s a . c o m , info@chirohealthusa.com, and 1-888-719-9990

Supreme Court Upholds Obama’s Healthcare LawThe court began its session much as it always does. At 10 a.m. sharp, the marshal’s familiar cry of “Oyez! Oyez! Oyez!” rang out as the nine just ices entered through heavy scarlet drapes and took t h e i r s e a t s a t t h e t a l l mahogany bench.

The looks on their faces gave nothing away. As he took a seat, Chief Justice Roberts smiled slightly in the direction of the justices’ guest seats, where his wife, Jane, was sitting.

As he and other justices read s t a t e m e n t s , i t b e c a m e o b v i o u s t h a t R o b e r t s , appointed by Republican President George W. Bush in 2005, had been the crucial vote upholding Obama’s law.

Roberts showed he had taken control over a divided bench. He highlighted flaws in the administration’s arguments and stressed the majority was not comment ing on the wisdom of the law.

Rather, he said, if it could be upheld, the court must uphold it. He said it was not the job of the judiciary “to save” the

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nation from policy choices made by elected legislators.

As he read excerpts from the m o m e n t o u s d e c i s i o n Thursday, Roberts seemed to downplay the drama of the morning. His voice was steady and even. He kept to his script. There were few rhetor ical flour ishes. He occasionally looked out at the spectators. Among them was Justice John Paul Stevens, a liberal who had served with Roberts until he retired two years ago at the age of 90.

Following the usual decorum in the white-marble and crimson-draped room, the nearly 300 people listening to the chief justice gave no audible response. Roberts then named the justices who had joined him in various parts of the decision, and those who had not. All told, it took about 20 minutes.

Romney and the Republicans had hoped the Supreme Court would gut the law. Deprived of that outcome, they can now continue pressing the attack on Obama on the campaign trail, but their hopes for a rollback or repeal will hang on legislation, unlikely before the elections, and on the voting public, whose views are mixed.

“What the court did today was say that Obamacare does not violate the Constitution,” Romney said. “What they did not do is say that Obamacare is good law, or good policy.”

ACA President’s Report–June/JulyThe following is a compilation of the President’s Report from ACA President, Keith Overland D.C.

Chiropractic Summit, Sports Chiropractic; National Health Reform;  Give our Veterans a Hand

Chiropractic Summit

The Chiropractic Summit began in 2007. It was created based on an idea by then ACA Chairman Dr. Lewis Bazakos. Since its inception, the Summit has met 15 times and has grown from 13 members to more than 40. The purpose of the Summit is to work toward five goals on behalf of the chiropractic profession.

Those goals are:

• Parity for chiropractic physicians in national health care reform and M e d i c a r e r e f o r m initiatives

• Increased prac t ice satisfaction and self-esteem for doctors of chiropractic (DCs)

• C o l l a b o r a t i o n a n d grassroots mobilization across the profession

• Anti-discrimination/fair reimbursement

• Public relations: “telling the chiropractic story” and promot ing the brand while building cultural authority

T h e S u m m i t ’ s s t e e r i n g committee is made up of ACA, ACC, COCSA and ICA. We discuss the best ways for the Summit to continue to help the profession achieve its goals. There is very high a g r e e m e n t w i t h i n t h e profession on all five goals, and the committee believes that the Summit can and should cross organizational boundaries to help achieve them. It is my opinion that the Summit has the leverage to do something important for the profession, and that the profession is begging for something important to be done!

ACA Considers its Agenda

T h e A C A ’ s B o a r d o f Governors met recently for its midyear meeting. As one would expect, the agenda was jam-packed w i th i ssues ranging from budgets to planning. ACA Chairman Dr. Michael Simone led the meeting over a day and a half.

Some o f the top areas discussed were:

• All legislative initiatives

• T h i r d - p a r t y p a y e r insurance issues

• Next steps regarding t h e M e d i c a r e demonstration project

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More Convention fun!

• R igh t -s iz ing ACA’s physical office space

• Deve lopmen t o f a planning meeting to discuss ACA’s 10-year plan

• M e m b e r s h i p d e v e l o p m e n t opportunities

• C o n t e m p o r a r y c o m m u n i c a t i o n s vehicles

• Updating ACA’s policy o n D C s a s c o n s e r v a t i v e physicians

• ACA 50th anniversary celebration

• Po l i c i es rega rd ing i n t r a - a n d i n t e r p r o f e s s i o n a l relationships

• A p p r o v a l o f t h e  2012-2013 budget , which now goes to the House of Delegate for consideration

• Deta i led p lans fo r on l i ne , v i deo web collaboration for ACA meetings

• Class action litigation that ACA is involved in

• ACA’s online store and corporate partnerships

At the end of the meetings t h e r e w a s a n a i r o f excitement, a palpable sense of opportunity and a feeling

that we were beginning to lay the foundation of a bridge to the future.

Additionally, there were three moments that I will remember for quite some time:

• A tribute to our past Cha i rman Dr. Bob Mastronardi

• Passing a budget with a surplus

• A realization that we have seen successes from across the full spectrum of our efforts thanks to the incredibly hard work of a staff of 35 and a volunteer pool of almost 300

To see a recap of ACA’s hard work from last year, please take a look at the recently released  2011 Annual Report online.

Sports Chiropractic

Dr. Spencer Baron has been a leader in sports chiropractic for many years, and those of us at the 2012 National Ch i roprac t i c Leg is la t i ve C o n f e r e n c e h a d t h e opportunity to hear him speak in-person.

Dr. Baron recently shared some very cool statistics with me about DC’s who work with professional sports teams:

• In the National Football League, 97 percent of teams have worked with DCs (in other words, 31 of 32 teams have a DC referral)

• I n M a j o r L e a g u e Baseball, 88 percent of teams work with DCs (28 of 32 teams have DCs)

• In the National Hockey League, approximately 50 percent of teams, or more, work with DCs

• I n t h e N a t i o n a l Basketball Association, a p p r o x i m a t e l y 6 0 percent of teams, or more, work with DCs

National Health Reform

Regardless of what happens in the months leading up to the November elect ions, please be aware that ACA will need your help more than ever. 

ACA and its Chiropractic S u m m i t p a r t n e r s a r e preparing for any and all eventualities in the Health Reform decision. From our perspective this is not a “red” or “blue” issue; this is an issue about patient choice and patient rights.

We cannot stand for the continuation of a health delivery system that has been failing for decades. We have example after example of the poor polices third-party payers and political medicine have made when they are given too much control.

It is now time for patients to take the reins of their own health care, so that they are able to make well-informed health care decisions based

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o n t h e b e s t e v i d e n c e regarding cost effectiveness, safety and patient satisfaction. It’s time to tear down the artificial barriers that prevent patients from choosing a DC.Yet it seems a level playing field for health care providers is just not what political medicine wants. Here is a paragraph from a policy adopted by the American Medical Association’s (AMA) House of Delegates just a few weeks ago:

“Our AMA will work to repeal the new Public Health Service Act Section 2706, so called provider ‘Non-Discrimination in Health Care,’ as enacted in PPACA, through active direct and grassroots lobbying of and formal AMA wr i t ten c o m m u n i c a t i o n s a n d / o r comment l e t te rs to the Secretary of Health and H u m a n S e r v i c e s a n d Congressional leaders and the cha i r s and rank ing members of the House Ways and Means and Energy and C o m m e r c e a n d S e n a t e Finance Committees.”

Remember, the National Association of Chiropractic Attorneys called Section 2706 one of the most important pieces of legislation for the profession and its patients in the last 50 years.I’ve always wondered what s o m e w i t h i n o r g a n i z e d medicine are so afraid of, and this week I was reminded of a study by Liberty Mutual’s Center for Disability Research that I think answers the question. It found that workers

with disabling low-back pain who are treated by physical therapists or MDs may have a harder t ime permanently returning to work than those treated by DCs or those who receive no treatment at all. Chiropractic physicians clearly offer a better option for patients. Our care is safer, more cost effective, offers high patient satisfaction, and research now shows we prevent reoccurrence in workers’ injuries.Please take time in the next few weeks to make an a p p o i n t m e n t w i t h congressional candidates in your area. Invite them to have coffee. Go to a fundraiser. Let them know you represent hundreds if not thousands of patients. Talk to them about the facts ACA has shared with y o u f o r m o n t h s n o w , p a r t i c u l a r l y t h e c o s t effectiveness studies. Explain that it is time for provider discrimination to come to an end and that patients must be given equal access to all appropriate, evidence-based providers. Our economy, our health care system and most of all our patients deserve no less.

This past weekend, many within ACA’s leadership were on the road again. ACA Chairman Dr. Michael Simone attended a meeting hosted by the Arizona Association of Chiropractic. Vice President Dr. Anthony Hamm was recognized with a presidential award at National University o f H e a l t h S c i e n c e s ’ Homecoming event . Dr.

Richard Bruns and ACA Immediate Past President Dr. Rick McMichael attended a board meeting at Logan Col lege of Chiropract ic /University Programs, and I divided my attention between two meet ings that were happening simultaneously.

First, I Skyped into the C a l i f o r n i a C h i r o p r a c t i c A s s o c i a t i o n ’ s B o a r d o f Directors meeting, and five minutes later I addressed a room full of doctors at a Pennsylvania Chiropractic Association meeting.

Additionally, I had the honor of speaking at the Pennsylvania Association’s presidential banquet and at a private meet ing of i ts board of directors. As ACA’s leadership visits associations around the country, we hope to remind both the doctors in attendance a n d t h e a s s o c i a t i o n ’ s leadership that ACA is their partner. We can do far more together than we can do alone.

Please consider supporting our CHAMP advocacy fund with even a small monthly contribution. In addition, with our pending lawsuits against several insurance giants, the NCLAF legal fund could use your support, as well. Every contribution helps; and there is always a need for every DC to join ACA so that the rest of us are not carrying their weight.

Please take the time to talk to your non-member colleagues

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TCA Gavel Club

TCA Past President’s Luncheon

TCA Executive Officers

TCA Dept. Coordinators

a b o u t b e c o m i n g A C A members. Tell them about ACA’s numerous member benefits. They will be glad they joined.

Give Our Veterans a Hand

I also want to make you aware of a very interesting program run by the Congress o f C h i r o p r a c t i c S t a t e Associations (COCSA). It’s called “Healing Hands 4 Heroes. ” Th is endeavor started to help our nation’s military heroes in all branches of service, including active duty, reserve, guard, veterans, retired and family members. It is very exciting.

COCSA is a vital organization in the profession. For more than 30 years it has provided invaluable information sharing o p p o r t u n i t i e s f o r s t a t e a s s o c i a t i o n s . C O C S A’s mission is to provide an open, nonpartisan forum for the a d v a n c e m e n t o f t h e c h i r o p r a c t i c p r o f e s s i o n through service to member state associations.The American Chiropractic Association (ACA) remains committed to advocating for the rights of patients to choose the provider and treatments they feel are best suited for them, following the Supreme Court’s decision t o d a y u p h o l d i n g t h e constitutionality of the Patient Protection and Affordable Care Act (PPACA). Allowing patients to choose providers who offer less expensive, conservative treatments is one important way to both reduce health care costs and

address the growing primary care shortage in this country.

In respect to patient choice, today’s decision means that t h e p r o v i d e r n o n -discrimination provision within PPACA remains intact. This part of the law makes it illegal for health plans and insurers to discriminate against health care providers based solely on their license. For patients, this means they can visit the provider of their choice for the type of treatment they desire, as long as the service is covered by their health plan.

Patients are becoming more aware of the downsides of over reliance on prescription drugs and the premature use of surgery for common health conditions such as low-back pain. These treatments also come with high price tags. For example, many patients prefer t o u t i l i z e d o c t o r s o f chiropractic (DCs), who offer d r u g - f r e e , n o n - s u r g i c a l options. Further, the services provided by DCs have been proven to be effective and less costly than traditional medical care.

Ensuring provider choice can also help the country address the growing shortage of primary care physicians. According to the Association of American Medical Colleges, by 2015 the U.S. will face a shortage of more than 60,000 physicians across primary care, surgical and medical specialties. To meet the needs of the public, every qualified health care provider will have

to practice to the fullest extent of his or her scope of practice. Enabling patients to seek primary care services from doctors of chiropractic and other non-MD/DO providers who are qualified to provide these services will help take some of the strain off the health care system.

“As our nation continues in its quest to improve the health care system, it will need to look at options outside the s t a t u s q u o , ” s a i d A C A President Keith Overland, DC. “Doctors of chiropractic can provide conservative primary care that saves money. ACA will continue to work with legislators to ensure that health reform is implemented in a responsible way that removes artificial barriers to patients’ choices.”

The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA p r o m o t e s t h e h i g h e s t standards of patient care and ethics, and supports research that contributes to the health and well-being of millions of chiropractic patients. Visit www.acatoday.org

We invite you to join with t h e c h i r o p r a c t i c professionals of Texas to insure that chiropractic care remains available to all Texans.

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The Association of Chiropractic professionals

in Texas

The Texas Chiropractic Association represents chiropractic professionals throughout the state.

First formed in 1916, this historic association has existed for nearly 100 years and has represented the interests of Texans who desire safe and effective health care from chiropractic professionals.

TCA serves to protect chiropractic professionals, their patients, and the right for Texans to choose chiropractic as one of their health care options.

Texas Chiropractic Association1122 Colorado, Suite 307

Austin, TX 78701Phone: 512 477 9292

Fax: 512 477 9296E-mail: info@chirotexas.org

www.chirotexas.org