isca report: summer 2013

SUMMER 2013

PRESIDENT'S MESSAGE: T I M E T O T H I N K

What do we have to be thankful for?

•Ouruniqueknowledgeandapproachtohealthandwellness.Wegivepatientshope!•Oureducationandunderstandingtowhatittakestobeandstaywell.•Ourfamilies,friendsandpatients,whosupportusthroughthickandthin.•Ouropportunitiestopartnerwithpatientsintheirpursuitofwellness.•Aprofessionalcareerofservice.AlbertSchweitzeroncesaidtherewasnothingmoresatisfying.

• Theopportunitytoberealpioneersinhealthcare.• Thechallengesthathelpusgrow.• Dedicatedleadersandstaff,committedtotheadvancementofthechiropracticprofession.• Bright,energetic,service-orientedstudentsinchiropracticcolleges.• Excellentchiropracticcolleges,academicians,administrators,facultyandresearchers.• Altruisticvendors,suppliersandsupporterswhodefendourprofessionastheirown.

What do we have to look forward to?

• Non-discriminationinhealthcarein2014.Alevelplayingfieldinhealthcarewhereallprovidersareequalpartners,valuedfortheuniquebenefitstheybringtothepatient.

• ExpandedMedicarecoverageforseniorsthatincludesthefullspectrumofservicesthatDC’sareeducatedandlicensedtoprovide.

• Doctorsofchiropracticfullyintegratedandengagedthroughoutthehealthcaresystem----DepartmentofDefense---VeteransAdministrationPublicHealthServiceCorps,hospitals,integrativepracticeclinicsandmultidisciplinaryfacilities.

• Aunitedchiropracticprofession,championingthebestofsafe,effective,conservative,high-touch,highsatisfaction,whole-person,patient-centeredhealthcare.

• Chiropracticscientistsengagedinalllevelsofhealthcareresearch,openinganewparadigminhealthcareresearchandpractice.

• Endlessopportunitiesforourfuture,ifweworktogether.

Inthenext10years,wewillseepositivechangesinhealthcareandwewillseethebroadintegrationofchiropracticphysiciansintoallareasandlevelsofourhealthcaresystem.Ourprofession’scommitmenttoexcellenceinconservativecareandtobringingouruniqueapproachtopatientsandthehealthcaresystemasawholewillfinallyberealizedandgreatlyappreciated.Wecandothistogether!

Lovewhatyoudoandshowit.Expectgreatthings!Never,nevergiveup!

Let’stakechiropractictothetop!

YourPresident,

RobertW.Tennant,D.C.F.I.C.C.

SUMMER 2013ISCA REPORT2

PresidentRobert Tennant, D.C., FICCShirley, [email protected]

First Vice-PresidentJames Cox II, D.C., LACFort Wayne, [email protected]

Second Vice-PresidentThomas Carrico, D.C.Lawrenceburg, [email protected]

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

TreasurerLewis Myers, D.C.Valparaiso, [email protected]

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

Past President RepresentativeRobert Clements, D.C.Kokomo, IN [email protected]

DIRECTORS AT LARGE

Toby Harmon, D.C.Jasper, [email protected]

Douglas Breger, D.C.New Albany, [email protected]

Frank Laux B.S., D.C. Indianapolis, IN [email protected]

ALTERNATE DIRECTOR AT LARGE

Keith Bartley, D.C.Jasper, [email protected]

Christopher Paprocki, D.C., FICCGreenwood, [email protected]

Joseph Paun, D.C.,Highland, [email protected]

DISTRICT DIRECTORS

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

District TwoGerard Hofferth, D.C.South Bend, [email protected]

District ThreeJason Russell, D.C.Fort Wayne, [email protected]

District FourPeter Furno, D.C.Zionsville, [email protected]

District FiveDiane Vuotto, D.C.Indianapolis, [email protected]

District SixDavid Davis, D.C.Winchester, [email protected]

District Seven Kristen Hartwell, D.C.Indianapolis, IN317.784.9311 [email protected]

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

District NineE. Curtis Harris, D.C.Franklin, [email protected]

ALTERNATE DISTRICT DIRECTORS

District OneRobert Hall, D.C.Merrillville, [email protected]

District TwoWilliam Garl, D.C.Bremen, [email protected]

District ThreeTroy Byall, D.C.Fort Wayne, [email protected]

District FourAdam Cline, D.C.West Lafayette, [email protected]

District FiveJoseph Fortunato, D.C.Indianapolis, [email protected]

District SixDonna S. Cray, D.C.Muncie, IN [email protected]

District SevenRichard Hilton, D.C., L.A.C.New Palestine, IN317.861.4300 [email protected]

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

District NineScott Auton, D.C.Franklin, [email protected]

INDIANA STATE CHIROPRACTIC ASSOCIATION BOARD OF DIRECTORS

INSIDE THIS ISSUE

PRESIDENT'SMESSAGE......................................................................................1ISCABOARDOFDIRECTORS................................................................................2EXECUTIVEDIRECTOR'SMESSAGE.....................................................................3NBCECONTRIBUTESGRANT...............................................................................4UPDATECONTACTINFO........................................................................................4INTRODUCINGISCA'SSECONDVICEPRESIDENT..............................................5CHOOSINGANAMEFORYOURPRACTICE..........................................................6

PROTECTYOURPATIENT'SMEDICALRECORDS.................................................7UNITEDHEALTHCARE'SLAWSUIT.........................................................................8INDUCMENTS........................................................................................................9ISCASPRINGCONFERENCE.......................................................................10-11HIPAASUMMARY............................................................................................12-14ISCACLASSIFIEDS..............................................................................................15

THE ISCA REPORT WILL BE DISTRIBUTED ONLINE FOR YOUR CONVENIENCE. PLEASE KEEP THE ASSOCIATION OFFICE UPDATED ON YOUR MOST CURRENT EMAIL ADDRESS AS WELL AS PRACTICE

AND HOME ADDRESSES SO THAT WE CAN PROVIDE YOU THE MOST TIMELY COMMUNICATIONS.UPDATE YOUR INFORMATION ON PAGE 4

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.

SUMMER 2013 ISCA REPORT 3

EXECUTIVE DIRECTOR'S MESSAGE: PATRICIA MCGUFFEY, ESQ.

Greetings,

Ihopeallofyouareenjoyingyoursummer!YourISCAisworkinghardonyourbehalf.TheISCAhasprovidedtestimonytoCMS(FederalGovernment)askingthemtomakesureiftheHIPprogrambecomesthevehiclefortheimplementationofAffordableCareAct’s(ACA)Medicaidexpansion,tomakesurethatspinaladjustmentisincludedintheHIPprogram.

Inaddition,wehavetestifiedbeforetheHealthFinanceCommissionandimploredthelegislatorstoensurethattheACA’sHealthcareexchangeincludeschiropractictreatmentservices.

Ourworkneverends!NumerousLegislativeinterimstudycommitteesaremeetingtodeterminelegislationtobeforwardedinthe2014legislativesession.YourISCAistheretoprotectyourinterests.Inaddition,legislatorsarehostingfundraisersonadailybasistoraisemoniesfortheirreelectioncampaigns.TheISCAistheretosupportthelegislatorsthatsupportchiropracticbecauseofyourgenerousdonationstotheBackPAC.

Also,IrecentlyattendedtheNationalAssociationofChiropracticAttorneys'(NACA)seminar/meetings.Ilearnedaboutthelawsuitsthatarebeingforwardedonyourbehalfthatarechallenginginsurancecompanies'discriminatorypracticesagainstchiropractors.Inaddition,weweremadeawareofallthecuttingedgelegalissuesfromadvocacyformoreMedicarecoverageforchiropractictreatmentservicestosocialmediaandwhatchiropractorsneedtoknowinordertobecompliantwithanti-trustHIPPAlaws(seelaterinthenewsletter,theNACAresolutionsupportingMedicarecoverageforchiropractictreatmentservices.)Ialsolearnedwhatthemajormalpracticeclaimsareinordertoalertourmembershipandtoensureyouarenotinjeopardyofamalpracticeclaim.

Regardlessofallourwork,wecouldnotbesuccessfulwithoutyoursupport!YoursupportoftheISCABackPAC,legislativeassessment,aswellasyourmembershipiscrucialtooursuccess.Thankyoutoallofyouwhoprovidesupportthroughyourmoniesandyourtime.YoumaketheISCAoneofthebestchiropracticassociationsinthecountry.OurlawsaretheenvyofourchiropracticcommunitythroughouttheUSandthenation.Thanksforallyoudoonbehalfofthenoblechiropracticprofession.

PleasecontactmeifyouwouldliketobemoreinvolvedintheISCAthruserviceontheBoardoracommittee.Inadditionwewelcomeallfeedbackonhowwecanimproveorwhatwecandotobetterserveyou.Thanksforyourgeneroussupportandhappysummer!

YoursinChiropractic,PatriciaMcGuffey,Esq.ExecutiveDirector


NATIONAL BOARD OF CHIROPRACTIC EXAMINERS CONTRIBUTES GRANT IN SUPPORT OF FOUNDATION FOR CHIROPRACTIC PROGRESS

CARMICHAEL, Calif. – May 30, 2013 – TheFoundationforChiropracticProgress(F4CP),anot-for-profitorganizationdedi-catedtoraisingawarenessaboutthevalueofchiropracticcare,ispleasedtorecognizetheNationalBoardofChiropracticExaminers(NBCE),theprincipaltestingagencyforthechiropracticprofession,foritsgrantinsupportoftheF4CPpositivepresscampaign.Thegenerouscontributionwillbringattentiontotheadvantagesofchiropracticeducationviapressmateri-als.

“WeareexcitedtopartnerwiththeFoundationforChiropracticProgressandtheAssociationofChiropracticCollegestopro-motechiropracticasacareerchoice,”saysDr.NormanOuzts,president,NBCE.“Ourfutureisdependentuponnewpeopleenteringourprofession.”

Establishedin1963,theNBCEisanot-for-profitorganizationthatdevelops,administers,analyzes,scoresandreportsre-sultsofstandardizednationalexaminations.TheNBCEestablishesandmaintainsconsistenthighstandardsofexcellenceinthechiropracticprofessionandchiropracticeducationthroughsuperiorexaminations.

GratefultohavegainedthesupportoftheNBCE,KentS.Greenawalt,chairman,F4CP,states:“SimilartotheF4CP,theNBCEisdedicatedtoadherenceofthehigheststandardsinadvancingthechiropracticprofession.Iamthrilledthattheorganizationhaselectedtosupportourcampaign--andhopefulthatotherswillfollowitsleadandinvestinthefutureofchiropractic.”

About The Foundation for Chiropractic ProgressAnot-for-profitorganization,theFoundationforChiropracticProgressinformsandeducatesthegeneralpublicaboutthemanybenefitsassociatedwithchiropracticcare.TolearnmoreabouttheFoundation,pleasevisitusonthewebatwww.yes2chiropractic.comorcall866-901-F4CP(3427).

UPDATE YOUR CONTACT INFORMATION - Return to: ISCA 200 S. Meridian Suite 350 Indianapolis, IN 46225

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The ISCA Report will be distributed online for your convenience. Please keep the Association office updated on your most current email address as well as practice and home addresses so that we can provide you the most timely and cost effective communications.

UPDATE YOUR RECORDS


Dr. Thomas Carrico sees these as important times to be involved in the Association.

“Theseareexcitingtimesinhealthcare,”saysDr.Carrico.“ISCAmembershaveadirectimpactonhowchiropracticwillbeincludedinthehealthcaresystemtoprovidepatientsthebest,mostcost-effectivecare.ItisimportantthatallIndianachiropractorssupporttheprofessionthroughmember-ship.”

InvolvedwiththeAssociationformorethan30years,Dr.Carricoseesmembershiphavingbenefitateverystageofprofessionaldevelopment.“Theeducationalprogramsandinteractiveconversationsthattakeplaceatseminarshavebeeninstrumentalinhelpingdevelopphilosophicalandbusinesspractices,”hesaid.

Dr.CarricojoinedthisfallastheISCA’snewestmemberoftheExecutiveCommitteeinthecapacityoftheSecondVicePresi-dent.“Iamapersonwhohasalwaysbelievedyoushoulddoyourparttohelpthewhole,”hesaid.“Iamhumbledtobeworkingtowardasimilarvisionwithsuchhighlymotivated,educatedpeoplewhohavegoodhearts.”

Dr.Carricohasnowretiredfrompracticingbutremainsactiveinmanagingamulti-disciplinepracticeinLawrenceburg,Indi-ana.Heandhiswife,Karenareparentsofthreeadultchildren,Brian,MattandNickandarefirst-timegrandparentstotwingirls.

Heisproudofhischiropracticprofession.“Thesatisfactioncomesfromthedifferencethatwemakeinpeoples’livesandthegratitudeandappreciationthatyoureceivefrompatients.Whatmatterstohimmost,isthatotherpeoplesaythatyouhavemadeadifferenceintheirlives,”hesaid.

INTRODUCING ISCA SECOND VICE PRESIDENT DR. THOMAS CARRICO

WELCOME NEW MEMBERS

Dr.PeterDyer,Monticello

Dr.JosephEsposito,Peoria,Ill.

Dr.PaulaFuccillo,Fishers

Dr.JennaGogel,Huntington

Dr.GregoryHough,FortWayne

Dr.KevinKaurich,SouthBend

Dr.AlfredPinto,Mishawaka

Dr.EdwardSchmit,Portland

Dr.NathanSermersheim,FortWayne

Dr.DuaneA.Snider,Frankfort

Member TransitionsCongratulationsDrs.ShannonandJacobRobertswhowelcomedJasonMichaelRobertsintotheirfamilyinJune.


NACA ADOPTS RESOLUTION

CHOOSING A NAME FOR YOUR PRACTICE By: Mark K. Sullivan & Associates, P.C.

Whenchoosinganameforyourpractice,therearenumerouspointsofdecisionyou’llencounter.You’llneedtoconsidermarketing,location,practicescope,andevenneighboringbusinesses,butyoushouldalsobeawareofafewlegalconsiderations.

It’sverycommonthatwhenchoosingabusinessname,ahealthcareproviderattemptstocastaswideanetaspossible.Notonlydoestheproviderwanttobeaccessibletoalargepopula-tion,buttheprovideralsowantstobeabletomarketthepracticetoindividualswithavarietyofhealthcareneeds.Thisearnestdesiremayleadsomeproviderstochooseanamethatutilizes

wordslike‘medicine,’‘physician,’‘medical,’orothersimilarwords.ChiropractorsshouldavoidthetemptationtousesuchwordsasitmayviolateIndianalaw.

Indianalawprohibitsachiropractorfromholdinghimselforherselfouttothepublicasbeingengagedinthepracticeofmedicine.Therefore,utilizingthesetypesoftermscanprovideabasisforachargethatthechiropractorisengagingintheunauthorizedpracticeofmedicine.

Inadditiontoavoidingtheuseoftermsprohibitedbystatelaw,it’salsoimportanttoadheretoIndianalawwhenutilizingD/B/Anames.Youarenotprohibitedfromutilizingdifferentnamesifyourpracticehasmultiplegeographiclocationsorinor-dertoutilizemarketingstrategies.However,ifyouholdyourselfouttothepublicunderanamethatdiffersfromyourentity’slegalname,youmayberequiredtofileaCertificateofAssumedBusinessName.Forexample,achiropractormaychoosetoformalegalentitynamedABCHealthcare,Inc.,butmaywanttoutilizeanothernameforpracticeslocatedindifferentareasofthestate,suchasABCHealthcareofSouthernIndianaorABCHealthcareofNorthernIndiana.InordertoproperlyusetheseD/B/Anames,thechiropractorshouldensurethattheCertificatesofAssumedBusinessNameareproperlyfiled.

Thesearejustafewexamplesofthevariouslegalconsiderationstoaddressbeforenamingyourcompany.Inordertoavoidpotentialheadachesdowntheroad,it’simportanttothinkabouttheselegalpointsbeforethebusinesscardsareprintedandthesignabovethedoorisordered.Ifyouhaveanyquestionsaboutnamingyourpractice,utilizingD/B/Anamesproperly,orotherformationalconcerns,youcancontacttheattorneysatMarkK.Sullivan&Associates,P.C.

Executive Director Patricia McGuffey attended the National Association of Chiropractic Attorneys (NACA) conference in June. The NACA joins other associations’ across the nation in adopting a resolution regarding EMS in Medicare. The resolution is described below:

National Association of Chiropractic AttorneysResolution,BEITRESOLVEDthat:TheNationalAssociationofChiropracticAttorneysnotestherecentreleasefromtheU.S.DepartmentofHealthandHu-manServicesbywhichitseekstogaininformationpertainingtothepossibleexpansionofMedicarecoveragetoincludeEvaluationandManagementServicesprovidedbyDoctorsofChiropractic.Webelieveallintheprofessionwillrecognizetheimportanceofthisdevelopment.WethereforecallonallinterestedchiropracticorganizationstocoordinatewiththeAmericanChiropracticAssociationinitseffortstoformulatearesponsibleandeffectiveresponsetotheHHSrequestandquestions.


PROTECT YOUR PATIENT’S MEDICAL RECORDS: THE NOTICE OF PRIVACY PRACTICEBy: Stephanie T. Eckerle, Esq., Plews Shadley Racher & Braun

TheHealthInsurancePortabilityandAccountabilityActof1996(“HIPAA”)isacriticallawthateverychiropractorshouldunderstand,especiallyinlightofthepenaltiesimposedforfailuretocomplywithHIPAAandtheauditsnowbeingconductedbytheU.S.DepartmentofHealthandHumanServices(“HHS”).SinceHIPAAhasbeenimplemented,HHShasreceivedover81,790HIPAAcomplaintsandover20,056ofthosecomplaintshaveresultedininvestigationandcorrectiveactions.Moreover,privatemedicalpracticesarethemostcommontypeofcoveredentitythatarerequiredtotakecorrectiveactionbyHHSinordertocomplywithHIPAA.

OneofthemostbasicaspectsofHIPAAthatallchiropractorsshouldcomplywithisprovidingtheirpatientswithaNoticeofPrivacyPractice(the“Notice”).In2010,theNoticewasoneofthetopfiveissuesinvestigatedbyHHSincasesthatresultedinthecoveredentityhavingtotakecorrectiveactiontocomplywithHIPAA.TheNoticeprovidesyourpatientswithinformationabouttheusesanddisclosuresoftheirprotectedhealthinformation.YourworkforceshouldalsounderstandtheNoticeasitisabasicoutlineofwhattheycanandcannotdowithapatient’smedicalrecords.AsrevealedbyHHSinvestigations,however,notallcoveredprovidersaregivingpatientsaproperNoticeandtheyarepayingtheprice!

Does HIPAA Apply to Me? Mostlikely,yes.HIPAAappliestoallhealthcareprovidersthattransmitanyhealthinformationinelectronicforminconnectionwithatransactioncoveredbyHIPAA.Thiswouldincludeanychiropractorthattransmitshealthinformationinelectronicformforhealthcareclaims,healthcarepayments,coordinationofbenefits,determiningeligibilityinahealthplan,healthplanpremiumpayments,referralcertifications,firstreportsofaninjuryandothertransactions.

Must I Have a Notice of Privacy Practice?Yes.Ifyouhaveadirecttreatmentrelationshipwithyourpatients,whichyoumostlikelydo,aNoticeofPrivacyPracticemustbeprovidednolaterthanthedateofthefirstservice,includingservicesdeliveredelectronically,tothepatient.Inaddition,ifyouhaveanoffice,youmustposttheNoticeofPrivacyPracticeinaclearandprominentlocationandhavecopiesoftheNoticeofPrivacyPracticethatpatientscantakewiththem.Ifyoumaintainawebsite,youmustalsoposttheNoticeofPrivacyPracticeonyourwebsite.

May I Email The Notice of Privacy Practice to My Patients?Maybe.YoumayonlyemailtheNoticeofPrivacyPracticetoapatientifthepatientagreestosuchelectronicnoticeandthatagreementhasnotbeenwithdrawnbythepatient.

Should Patients Sign an Acknowledgement That They Received the Notice of Privacy Practice? Yes.EverypatientshouldberequiredtosignasimpleacknowledgmentstatingthattheybothreceivedandreadtheNoticeofPrivacyPractice.

Must the Notice of Privacy Practice Contain Certain Elements?Yes.HIPAAisveryspecificaboutwhattheNoticeofPrivacyPracticestates.Forexample,allNoticesmustcontainaheaderwiththefollowinglanguage,“THISNOTICEDESCRIBESHOWMEDICALINFORMATIONABOUTYOUMAYBEUSEDANDDISCLOSEDANDHOWYOUCANGETACCESTOTHISINFORMATION.PLEASEREVIEWITCAREFULLY.”TheNoticeofPrivacyPracticemustalsodescribehowthechiropractorcandiscloseprotectedhealthinformationbothwithandwithoutthepatient’swrittenauthorization.Forexample,thechiropractormaybeabletodiscloseprotectedhealthinformationfortreatment,paymentandhealthcareoperationswithoutthepatient’swrittenauthorization.Yourstaffshouldalsobetrainedandunderstandwhenitisappropriatetodiscloseprotectedhealthinformationwithoutoralternatively,with,awrittenauthorizationfromthepatient.TheNoticeofPrivacyPracticemustalsoexplainapatient’srightswithrespecttotheirownprotectedhealthinformation.Forexample,apatienthastherighttoinspectandcopytheirmedicalrecordsor,incertaincircumstances,amendtheirmedicalrecords.

Should the Notice of Privacy Practice Name a Specific Contact Person in My Office?Yes.TheNoticeofPrivacyPracticemustcontainthenameortitleofacontactpersonandtheirtelephonenumberincasepatientshavequestionsabouttheNoticeortheirmedicalrecords.Furthermore,theremustbeastatementthatapatienthastherighttocomplaintothechiropractorortheSecretaryofHHSiftheybelievethattheirprivacyrightshavebeenviolated.

Does HHS Penalize Covered Entities for Failure to Provide a Notice of Privacy Practice?Yes.HHSmaydiscoverthatyoudonothaveaNoticeorfailtocomplywithotheraspectsofHIPAAthroughacomplaintoranHHSaudit.Forexample,amentalhealthcenterdidnotprovideaNoticeofPrivacyPracticetoafatherorhisminordaughter,apatientatthecenter.ThiswasdiscoveredduetoacomplaintlodgedwithHHS.Asaresolution,thementalhealthcenter’spolicieswererevisedsothataNoticewasgiventopatientsduringtheintakeprocessandthepatientswereaskedtosignanacknowledgementform.

Itiscriticalforallchiropractorstocreateacultureintheirofficewherebyallemployeesunderstandhowtosafeguardapatient’sprotectedhealthinformationincompliancewithHIPAA.Thiscanbedonethroughmultiplechannels,includingtrainingyourworkforce,ensuringyourpatientsunderstandprivacyexpectations,implementingphysicalandelectronicsafeguardstoprotectmedicalrecordsandtakingallthreatenedandactualbreachesofprotectedhealthinformationveryseriously.Inaddition,theNoticeofPrivacyPracticeisjustoneofmanystepsthatchiropractorsshouldtaketocomplywithHIPAAandtoensurethattheyareimplementingthebestbusinessandhealthcarepractices.IfyouwouldlikemoreinformationabouthowyoucancomplywithHIPAA,pleasecontactStephanieT.Eckerle.StephanieisanattorneyatPlewsShadleyRacher&BraunLLPandcanbereachedat317-637-0700oratseckerle@psrb.com.Stephanieregularlycounselsawidevarietyofhealthcareclientsincorporateandregulatorymatters,includingcompliancewithvarioushealthcarelawssuchasHIPAA.


ACA, COCSA, OTHER PLAINTIFFS DEFEAT UNITEDHEALTHCARE’S MOTION TO DISMISS CLASS ACTION LAWSUITProfession Can Now Pursue Alleged ERISA Violations

Arlington,Va.—TheAmericanChiropracticAssociation(ACA)todayannouncedthatit,alongwithotherplaintiffsinaclassactionlawsuitagainstUnitedHealthcare(United),defeatedamotiontodismissthecase.Amongco-plaintiffsinthelitigationaretheCongressofChiropracticStateAssociations(COCSA),theMissouriStateChiropractorsAssociation(MSCA)andtheOhioStateChiropracticAssociation.

ThedecisionbytheU.S.DistrictCourtfortheDistrictofNewJerseyupheldtheviabilityoftheplaintiffs’central,underlyingclaimsagainstUnitedanditsco-defendants,includingtheinappropriaterecoupmentofreimbursementspreviouslypaidtoproviders.Attimes,themoneyisrecoupedfrompatientaccountsthatarenotactuallyinvolvedintheallegedoverpayment—aclearviolationofERISA.

Thedefeatofthedefendant’smotiontodismissnowallowsplaintiffstopursueinjunctiverelieffortheinappropriateandabusivepracticeslongfoughtbythechiropracticprofession,whichhaverestrictedpatientcareand,theprofessionbelieves,harmedthecareersofdoctorsofchiropractic.Thesepracticesinclude:

•InviolationofERISA,appealrightshavebeeninconsistentlyaffordedtopatientswhenthecareauthorizeddiffersfromthedoctor’scareplan.

•InadeliberateefforttoavoiditsobligationsunderERISA,Optum,aco-defendantinthecase,refusestoallowproviderstorequestaparticularnumberofvisitsorprocedures,ortosubmitadequateclinicalinformationnecessaryforutilizationreview.

•Providersaresubjectedtothreateningcommunicationsinanefforttopressurethemtoreduceutilizationrates.

•Optumreliesonstatisticallyinvaliddatatodetermineaverageutilizationrates.Itfurthermanipulatesdataandpressuresproviderstoreducecare,therebyovertimecontinuallyreducingwhatisreportedasthe“communitystandard”forproperlevelsofcare.

•Eventhoughdoctorsonlyprovidetheservicespre-authorizedbyOptum,thenetworkcontinuestodeclaretheaveragesderivedfromthoseauthorizationsinappropriateandtheypressureproviderstofurtherreducecare.

“Thecourt’sdecisiontorejectUnited’smotiontodismissisagroundbreakingvictoryfordoctorsofchiropracticandtheirpatientsacrossthecountry.Theprofession’scriesforanendtoUnited’sattemptstointimidateandcoercepatientsandprovidershavebeenheardandvalidatedinacourtoflaw,”saidACAPresidentKeithOverland,DC.“Plaintiffsarenowfreetocontinuetheirfightfortheirpatients’rightstoreceivemedicallynecessarycare,andtoholdinsurersaccountableinrespecttoreimbursingprovidersforcarepatientshavepaidforthroughtheirinsurancepremiums.”

"Thisdecisionisamulti-facetedvictoryfortheprofession,”saidCOCSAPresidentKateC.Rufolo-Dreher,DC.“Itisanimportantstepinthisparticularlawsuit,andtheactiontakeninthelitigationtodatemarksanextremelyimportantstepfortheprofessionandthepatientswecarefor."

Thelitigation,filedonJan.24,2011,representsanationwideclassofhealthcareproviderswhoweresubjectedtoUnited’simproperrecoupmentofpaymentsforservicesprovidedtoUnitedsubscribers.ACAjoinedthelawsuitinApril2011.

Thecourt’sdecisionalsoallowsplaintiffstomoveforwardtoclasscertification,thenextstepinthislandmarklitigationfortheprofession.

The American Chiropractic Association (ACA), based in Arlington, VA, is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest 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.


Sometimes,beinginpracticeanddealingwithregulatoryagenciescanfeellikebeingaboutfouryearsold:wegettold“No!”or“Youcan’tdothat!”—butaren’tgivenenoughclearinformationtounderstandwhy.

Caseinpoint:youcan’tofferinducements—eventhemostinnocent-seemingdiscount–tofederallyinsuredpatientsto“help”themreceivecarefromyourpractice.Incaseyoumissedthisruling,itwassetforthbytheOfficeoftheInspectorGeneral(OIG)backin2002.Here’swhattheysaid:

“Undersection1128A(a)(5)oftheSocialSecurityAct(theAct),enactedaspartofHealthInsurancePortabilityandAccountabilityActof1996(HIPAA),apersonwhooffersortransferstoaMedicareorMedicaidbeneficiaryanyremunerationthatthepersonknowsorshouldknowislikelytoinfluencethebeneficiary’sselectionofaparticularprovider,practitioner,orsupplierofMedicareorMedicaidpayableitemsorservicesmaybeliableforcivilmoneypenalties(CMPs)ofupto$10,000foreachwrongfulact.Forpurposesofsection1128A(a)(5)oftheAct,thestatutedefines“remuneration”toinclude,withoutlimitation,waiversofcopaymentsanddeductibleamounts(oranypartthereof)andtransfersofitemsorservicesforfreeorforotherthanfairmarketvalue.(Seesection1128A(i)(6)oftheAct.)Thestatuteandimplementingregulationscontainalimitednumberofexceptions.”

WhatdoesthatmeaninplainEnglish?Basically,youcan’tgiveawayordiscountyourservices,andyoucan’twaivedeductiblesorcopays.Doctorswhodothis(and,sadly,therearemanykindheartswhodojustthissortofthingwiththeverybestofintentions)areputtingtheirpractices—andtheirlicenses—atrisk.

Whathappensifyoudo?TheFedsaren’tkiddingonthisone.Whentheyauditapracticeanduncoveranykindofinducement,theycanslamyouwithupto$10,000infinesforeachwrongfulactorlineitem.ConsiderhowmanylineitemstherecanbeonjustoneCMS1500form!

Wearenottalkingpocketchange!

SowhatdoyoudowithaMedicarepatientwhoisonafixedincome?Easy:becomeaproviderwithChiroHealthUSA.WithChiroHealthUSA,youcantransitionMedicarepatientstoourfeescheduleforallnon-coveredservices.(Exams,x-rays,therapiesandextremityadjustments)

UsingyourChiroHealthUSAproviderfeeschedulestreamlinesyourpracticeandmakesitmoreaffordableforyourpatients.Mostimportantly,itkeepsyoulegal—andwithauditsontherise,runningafouloftheOIGisarisknooneshouldrun.

Why?Yes,theansweristhesameasitwaswhenyouwerefour:becausetheysaidso.

IfthissoundslikeaperfectwaytokeepyousafewhileyoucareforyourMedicarepatients,itis.LearnmoreabouthowChiroHealthUSAcanhelpyourpracticewithlessriskandmoresatisfaction.Joinusonafreewebinarthatwillgiveyouallthedetailsabouthowyoucanbecomeaprovider.Gotowww.chirohealthusa.comtoregistertoday.(More webinar information below)

Dr. Foxworth is a certified Medical Compliance Specialist and President of Chi-roHealthUSA. A practicing Chiropractor, he remains “in the trenches” facing challenges with billing, coding, documentation and compliance. Dr. Foxworth is a 1984 Honors Graduate, (Cum Laude), of Cleveland Chiropractic College in Kansas City, MO. He served as Staff Chiropractor for the G.V. Sonny Montgomery VA Medical Center 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 International College of 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. You can contact Dr. Foxworth at 1-888-719-9990, [email protected] or visiting the ChiroHealthUSA website at www.chirohealthusa.com

JointheIndianaStateChiropracticAssociationandCertifiedMedical

ComplianceSpecialistDr.RayFoxworthonTuesday,September10th,at2:15PMEDTforastatewidewebinarforIndianaChiro-practorsOnly.

Doctor,you'vespenthoursandhoursincontinuingeducationclasseslearninghowtodocumentcorrectly,codecorrectlyandbillcorrectly.Spend45minuteslearninghowtoDISCOUNTcorrectly.

Thereisarightwayandawrongway.Doingitthewrongwaycancostyou.

Dualfeeschedules,impropertimeofservicediscountsandOIGviolationsforofferinginducementsputyouatseriousrisk.Therisksarerealandthesolutionissimple.Webinarislimitedtothefirst100clinics.RegisterNOW!SystemRequirementsPC-basedattendeesRequired:Windows®7,Vista,XPor2003Server

Mac®-basedattendeesRequired:MacOS®X10.6ornewer

MobileattendeesRequired:iPhone®,iPad®,Android™phoneorAndroidtablet

Reserve your Webinar seat now at:https://www3.gotomeeting.com/register/471197734

LEARN ABOUT THE CHIROHEALTHUSA BENEFIT NOW AVAILABLE TO ISCA MEMBERS - JOIN US FOR A WEBINAR ON SEPTEMBER 10

INDUCEMENTS…By Dr. R. A. Foxworth, FICC, MCS-P


ISCA SPRING CONFERENCE: APRIL 12-14, 2013

ThebandNEXUSentertainedwhileISCA/ICAIleaders(fromleft)PatriciaMcGuffey,ExecutiveDirectorandDr.MaryGracePennellacelebrated.

Dr.KirkSteketeeprovidedthekeynoteaddressattheconference.

LeadershipfrombothISCAaddressedattendeesduringaspecialmembershipluncheon.

(picturesfromLeft),PatriciaMcGuffey,Dr.RobertTennant,Dr.andMrs.Paprocki,Dr.CoxSr.,Dr.MaryGracePennellacelebratethefirst-everevent.Dr.KirkSteketeedrawsnamesduringaspecialeveningraffle.

ISCA SPRING CONFERENCE: APRIL 12-14, 2013


ISCA SPRING CONFERENCE: APRIL 12-14, 2013 ISCA SPRING CONFERENCE: APRIL 12-14, 2013

INAUGURAL ISCA/ICAI JOINT SPRING CONFERENCE: APRIL 12-14, 2013

“Workingtogetherwearestronger.Workingtogetherwecandosomuchmore.”

ThesearethewordsofKeynoteSpeakerDr.KirkSteketeewhoaddressedthemorethan150participantsattheISCA/ICAIJointSpringConference,April12-14,2013attheCrownePlazaIndianapolisAirport.

Thefirst-evereventjoinedtheeffortsoftheIndianaStateChiropracticAssociation(ISCA)andInternationalChiropracticAssociationofIndiana(ICAI)inaJointConferenceCommitteecomposedofDr.JamesCox,II,Dr.JonJ.Ferguson,Dr.MaryGracePennella,Dr.DuaneBinderandPatriciaMcGuffey,ISCAExecutiveDirector.

“TheinauguralJointConferenceprovidedanexceptionalvenueformembersoftheISCAandICAItocombinetheirstrengthsandtalents,”saidISCAPresidentDr.RobertTennant.“Theeventfueledanewenthusiasmandenergyfortheprofession.”

Theeventbroughttogetheragreatline-upofspeakersincludingDr.PatrickGentempo,Dr.JeffreySpencerandDr.TerryRobertYochum.

OnSaturday,April13,conferencemeetingsconcludewithaspecialISCA/ICAIFamilyReunionGetTogether,whereconferenceattendees,theirspousesorsignificantothersaswellasnon-attendeescelebratedandmixedandmingledwithcolleaguesfrombothAssociations.NEXUSprovidedthemusicalentertainmentandparticipantsdinedonaspecialfamilyreunionindoorpicnic.

SpecialthanksgoestoAnabolicLabs,ASEA–RedoxSignalingMole,CancerTreatmentCentersofAmerica,CentersforDiagnosticImaging,Chirotouch,CLA–InsightDiagnosticCo.,Erchonia,FoundationforChiropracticProgress,FootLevelers,Freeform,FutureHealthSoftware,HaffnerX-RayCo.,LeannaBrennanCoaching,LifeUniversity–CollegeofChiropractic,Lubrisynhu,PalmerCollegeofChiropractic,RealTimePainReleif,RPSImaging,NHD,SmartviewImagingandStandardProcess.

Mark your calendar for the ISCA Fall Conference, October 18th- 20th at the Caribbean Cove in Indianapolis. The event brings together a great line-up of speakers including Dr. Mario Fucinari, Dr. Thomas Hyde and Ronda Nelson, PhD.

(fromleft)Dr.PatrickGentempo,Dr.JefferySpencerandDavidVaughnwerespeakersatthefirst-everevent.


Thefederalgovernmenthaspublisheditslongawaitedfinalregulationsimplementingthe“HealthInformationTechnologyforEconomicandClinicalHealth(HITECH)Act,”enactedaspartofthe“AmericanRecoveryandReinvestmentActof2009”(ARRA),describedbytheheadoftheOfficeforCivilRights(OCR)intheDepartmentofHealthandHumanServices(HHS)as“themostsweepingchangestotheHIPAAPrivacyandSecurityRulessincetheywerefirstimplemented.”Ingeneral,thenewrulesexpandtheobligationsofphysiciansandotherhealthcareproviderstoprotectpatients’protectedhealthinformation(PHI),extendtheseobligationstoahostofotherindividualsandcompanieswho,as“businessassociates,”haveaccesstoPHI,andincreasethepenaltiesforviolationsofanyoftheseobligations.TheAmericanMedicalAssociation(AMA)willbepublishingmoredetailedguidanceconcerningtheimpactoftheserulesonphysicians.ThefollowingoutlinesthechangesphysicianswillneedtoconsiderastheyimplementthenewHIPAArequirementsnecessarybytheSeptember23,2013,compliancedate.Therearethreeareasthatphysicianswillneedtofocusontocomplywiththenewrules:•Privacy,Security,andBreachNotificationpoliciesandprocedures(andinsomecases,newworkflowsandforms);•NoticeofPrivacyPractices(NPP);and•BusinessAssociate(BA)Agreements.

Thefollowingsummaryprovidesahelpfuloverviewofthestepsphysicianswillneedtotakeineachoftheseareastomeetthenewrequirements.Physiciansalsoshouldbefamiliarwiththeirstatepatientprivacyandconfidentialitylaws,whichmaybemorestringentthanHIPAA.

PrivacyandSecurityPoliciesandProceduresThenewruleswilllikelyrequirechangestoaphysicianpractice’sHIPAApoliciesandproceduresinatleastthefollowingareas:

•Breachnotificationrequirements–TheobligationtonotifypatientsifthereisabreachoftheirPHIisexpandedandclarifiedunderthenewrules.Breachesarenowpresumedreportableunless,aftercompletingariskanalysisapplyingfourfactors,itisdetermined,thatthereisa“lowprobabilityofPHIcompromise.”Thephysiciansmustconsiderallofthefollowingfourfactors:

•thenatureandextentofthePHIinvolved–issuestobeconsideredincludethesensitivityoftheinformationfromafinancialorclinicalperspectiveandthelikelihoodtheinformationcanbere-identified;

•thepersonwhoobtainedtheunauthorizedaccessandwhetherthatpersonhasanindependentobligationtoprotecttheconfidentialityoftheinformation;

•whetherthePHIwasactuallyacquiredoraccessed,determinedafterconductingaforensicanalysis;and

•theextenttowhichtheriskhasbeenmitigated,suchasbyobtainingasignedconfidentialityagreementfromtherecipient.

Thisrebuttablepresumptionofbreachandfourfactorassessmentofthe“riskofPHIcompromise”replacestheprevious,moresubjective“significantriskoffinancial,reputational,orotherharm”analysisforestablishingabreach.Thenewrulesfurtherclarifythatthereisnoneedto

haveanindependententityconducttheriskassessmentandindeed,noriskassessmentneedbeconductedatallifthebreachnotificationismade(although,physicianswillwanttoundertakeanappropriatereviewandstepstomitigatetheharmandreducethelikelihoodoffuturebreachesinanycase).ThenewrulesfurtherconfirmthatthebreachnotificationrequirementmaybedelegatedtoaBA,andphysiciansareencouragedtocoordinatewiththeirBAssothatpatientsreceiveonlyonenotificationofthebreach.

ThenewrulesdonotmodifytheactualreportingandtimeframerequirementsforBreachNotification;thatis,coveredentitiesmuststilladheretorequirementsforindividualnotification,HHSnotification,andwhereapplicablemediapostingofthebreach.

•Disclosurestohealthplans–Atthepatient’srequest,physiciansmaynotdiscloseinformationaboutcarethepatienthaspaidforout-of-pockettohealthplans,unlessfortreatmentpurposesorintherareeventthedisclosureisrequiredbylaw.ThischangeupdatesthepreviousHIPAAPrivacyRulegoverningpatientrequestsforrestrictionsontheuseordisclosureoftheirPHI.Previously,whilephysicianscouldrefusetoabidebyanysuchrequest,thenewrulerequiresphysiciansandotherhealthcareproviderstoabidebyapatient’srequestnottodisclosePHItoahealthplanforthoseservicesforwhichthepatienthaspaidout-of-pocketandrequeststherestriction.Ofallthechangesmadebythenewrules,thischangeislikelytohavethegreatest

THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)Omnibus Final Rule Summary - American Medical Association

CONTINUED ON PAGE 13...


AMA STORY CONTINUED...

•Marketingcommunications–Thenewrulesfurtherlimitthecircumstanceswhenphysiciansmayprovidemarketingcommunicationstotheirpatientsintheabsenceofthepatient’swrittenauthorization.Generallyspeaking,theonlytimeaphysicianmaytellapatientaboutathird-party’sproductorservicewithoutthepatient’swrittenauthorizationiswhen:

1)thephysicianreceivesnocompensationforthecommunication;2)thecommunicationisface-to-face;3)thecommunicationinvolvesadrugorbiologicthepatientiscurrentlybeingprescribedandthepaymentislimitedtoreasonablereimbursementofthecostsofthecommunication(noprofit);4)thecommunicationinvolvesgeneralhealthpromotion,ratherthanthepromotionofaspecificproductorservice;or5)thecommunicationinvolvesgovernmentorgovernment-sponsoredprograms.Physiciansarealsostillpermittedtogivepatientspromotionalgiftsofnominalvalue(e.g.,pamphlet).

•SaleofPHI–ThenewrulesclarifythattheprohibitiononthesaleofPHIintheabsenceofthepatient’swrittenauthorizationextendstolicensesorleaseagreements,andtothereceiptoffinancialorin-kindbenefits.Italsoincludesdisclosuresinconjunctionwithresearchiftheremunerationreceivedincludesanyprofitmargin.Ontheotherhand,theprohibitiononPHIsalesdoesnotextendtopermitteddisclosuresforpaymentortreatmentnortopermitteddisclosurestopatientsortheirdesigneesinexchangeforareasonablecost-basedfee.

•Childhoodimmunizations–Underthenewrules,physiciansmaydiscloseimmunizationstoschoolsrequiredtoobtainproofofimmunizationpriortoadmittingthestudentso

longasthephysicianshaveanddocumentthepatientorpatient’slegalrepresentative’s“informalagreement”tothedisclosure.

•Decedents–Thenewrulesallowphysicianstomakerelevantdisclosurestothedeceased’sfamilyandfriendsunderessentiallythesamecircumstancessuchdisclosureswerepermittedwhenthepatientwasalive;thatis,whentheseindividualswereinvolvedinprovidingcareorpaymentforcareandthephysicianisunawareofanyexpressedpreferencetothecontrary.ThenewrulealsoeliminatesanyHIPAAprotectionforPHI50yearsafterapatient’sdeath.

•Copiesofe-PHI–Physicianswillnowhaveonly30daystorespondtoapatient’swrittenrequestforhisorherPHIwithone30-dayextension,regardlessofwheretherecordsarekept(eliminatingthelonger60-daytimeframeforrecordsmaintainedoffsite).TheymustprovideaccesstoEHRandotherelectronicrecordsintheelectronicformandformatrequestedbytheindividualiftherecordsare“readilyreproducible”inthatformat.Otherwise,theymustprovidetherecordsinanothermutuallyagreeableelectronicformat.Hardcopiesarepermittedonlywhentheindividualrejectsallreadilyreproduciblee-formats.

•EmailingPHI–Physiciansmustalsoconsidertransmissionsecurity,andmaysendPHIinunencryptedemailsonlyiftherequestingindividualisadvisedoftheriskandstillrequeststhatformoftransmission.

•Chargingforcopiesofe-PHIorPHI–Thenewrulesmodifythecoststhatmaybechargedtotheindividualforcopiestoincludelaborcosts(potentiallytoincludeskilledtechnicallaborcostsforextractingelectronicPHIandsupplycostsifthepatientrequestsapapercopy,orif

electronic,thecostofanyportablemedia(suchasaUSBmemorystickoraCD),assumingstatelawdoesnotsetalowerreimbursementrate.Therulesalsoclarifythatphysiciansmayimposeaseparatechargeforcreatinganaffidavitofcompleteness.

•Researchauthorizations–Thenewrulespermitphysicianstocombineconditionedandunconditionedauthorizationsforresearchparticipation,providedindividualscanopt-intotheunconditionedresearchactivity.Moreover,theseauthorizationsmayencompassfutureresearch.

Notice of Privacy Practices (NPP)PhysiciansmustamendtheirNPPstoreflectthechangessetforthabove,includingthoserelatedtobreachnotification,disclosurestohealthplans,andmarketingandsaleofPHI.Totheextentphysiciansengageinfundraising,theywillalsohavetoamendtheirNPPtoinformpatientsoftheirrighttoopt-outofthosecommunications.Astherulespresumetheseareallmaterialchanges,physicianswillhavetoposttherevisedNPP,andmakecopiesavailableattheiroffice,toallnewpatientsandtoanyoneelseonrequest.PhysicianswhomaintainawebsitearecautionedtoposttheupdatedNPPontheirwebsiteasrequiredbytheexistingHIPAAPrivacyrule.Thenewrulesalsoeliminaterequirementstoincludeinformationoncommunicationsconcerningappointmentreminders,treatmentalternatives,orhealth-relatedbenefitsorservicesinNPPs,buttherulesdonotrequirethatthatinformationberemovedeither.

CONTINUED ON PAGE 14...


AMA STORY CONTINUED...

Business Associates (BAs) ThenewrulesexpandtheuniverseofindividualsandcompaniesthatmustbetreatedasbusinessassociatestoincludePatientSafetyOrganizationsandothersinvolvedinpatientsafetyactivities,healthinformationorganizationslikee-prescribinggatewaysorhealthinformationexchangesthattransmitandmaintainPHI,andpersonalhealthrecordvendorsphysicianssponsorfortheirpatients.Thus,physiciansmustreviewtheirrelationshipsanddetermineiftheymustenternewBAagreementswiththeseentitiesorothersthatcreate,receive,store,maintain,ortransmitPHIontheirbehalf.

TheserulesalsomodifytherequirementsforBAagreements:• PhysiciansnolongermustreportfailuresoftheirBAsto

thegovernmentwhenterminationoftheagreementisnotfeasible,asHHShasconcludedthattheBA’sdirectliabilityfortheseviolationsissufficient.

• BAsarenowresponsiblefortheirsubcontractors.• BAsmustcomplywiththeSecurityandBreach

NotificationRules.• PhysiciansareliablefortheactionsoftheirBAswho

areagents,butnotfortheactionsofthoseBAsthatareindependentcontractors.

PhysicianshaveuntilSeptember23,2014,tobringalltheirBAagreementsintoconformancewiththenewrules.BAagreementsthathavenotbeenrenewedormodifiedbetweenMarch26,2013,andSeptember23,2013,willbedeemedcompliantuntilthedatetheBAagreementisrenewedormodifiedoruntilSeptember22,2014,whicheverisearlier.

Enforcement and Penalties Thenewrulesclarifythefourpenaltytiersasfollows:• Lowesttier–casesinwhichthephysiciandidnotand

reasonablycouldnotknowofthebreach.• Intermediatetier–casesinwhichthephysician“knew,

orbyexercisingreasonablediligencewouldhaveknown”oftheviolation,butthephysiciandidnotactwithwillfulneglect.

• Highesttiers–casesinwhichthephysician“actedwithwillfulneglect”andeithercorrectedtheproblemwithinthe30-daycureperiod,orfailedtomakeatimelycorrection.

HHSmustconductaformalinvestigationandimposecivilmonetarypenaltiesincasesinvolvingwillfulneglect,andisnowfreetoprovidePHItoothergovernmentagenciesforenforcementactivities.

Theassessmentofpenaltiesmustbebasedonfiveprincipalfactors:

(1)thenatureandextentoftheviolation,includingthenumberofindividualsaffected;(2)thenatureandextentoftheharmresultingfromtheviolation,includingreputationalharm;(3)thehistoryandextentofpriorcompliance;(4)thefinancialconditionofthecoveredentityorbusinessassociate;and(5)suchothermattersasjusticemayrequire.Thenumberofviolationsmaybebasedonthenumberofindividualsaffectedorbythenumberofdaysofnon-compliance.

Therulefurtherclarifiesthatthe30-daycureperiodbeginswhenthephysiciankneworshouldhaveknownoftheviolation.

Other Changes Thenewrulesalsomakechangesthatwilllikelyaffectphysicians,butonlyindirectly.ThemostsweepingistheexpansionoftheobligationsofBAstoincludebothdirectliabilityundermostoftheHIPAAPrivacyandSecurityRules,andtheobligationtoenforcetheseruleswithrespecttotheirsubcontractors.ThenewrulesalsoimplementtheGeneticInformationNondiscriminationAct(GINA),whichgenerallyprohibitshealthplansfromusinggeneticinformationforunderwritingpurposes.

Next StepsWiththepotentialfor$1.5millionfines,nottomentionseriousreputationalinjury,thesenewrulesmustbetakenseriously.Clearly,physicianswillneedtodevelopaplantomaketheserequiredchangesinatimelyfashion.TheAMAwillprovidemorespecificguidancewithrespecttoeachofthesethreeareas,includingsampleNPPandBAagreements.


DC'S WANTED

DCNeeded(Noblesville,IN)(10milesnorthofIndianapolis)-Lookingforanaggressive,engergetic,licensedIndianachiropractortojoinawell-established,wellness-basedpracticejustoutsideofIndy.Thisisagreatprofitsharingopportunityforsomeonelookingtobuildapracticewithinapractice.Applicantmustbe

ambitious,havegoodadjustingskillsandmusthaveanopenmindtoCBP/wellnesscaretraining.Newgraduateswelcometoapply!Ifyouarelookingforthistypeofopportunityandwanttolearnmore,pleasecontactDr.AbeBeaberat317-339-8005orinfo@

hamiltoncountychiro.com.Posted3/5/13

ASSOCIATES WANTED

RapidlyexpandingLakeCounty,IndianapracticeinMerrillvillelookingtofillfulltimeposition.Fiftyminutesfromdowntown

Chicago.Enthusiastic,ambitious,growth-oriented,doctorisamust.MustbeproficientinDiversifiedandFlexionDistraction.Send

[email protected]/26/13

ActiveChiropractic&RehabilitationClinic,Evansville,IN,www.evansvillechiro.com.MustbeopentorehabilitationandActiveReleaseTechniqueandalicensedDCinIndianawithexcellentpatientcommunicationandtechnicalskills.Sendconfidential

[email protected]/8/13

FulltimeAssociateposition,Bloomington,Indiana-40Kbasewithabonusplan,paidmalpractice,continuingeducationandvacation.Veryprogressiveoffice,lookingforasolidteammember.Lookingforamotivatedchiropractorwhoisreadytobuildasuccessfulpracticewiththesupportofourstaffandfacility.Veryopento

creatingamutuallybeneficialwin-winrelationship.Initialcontactandinterest,[email protected],attacharesume

andcoverletter.Posted5/6/13

AssociateDoctorNeeded:Busyofficewithmultiplelongtermassociates.Familypractice.ThirtyminutestodowntownChicago.Fulltime,paidvacation,$26/houraftertraining.Payincreaseafteroneyear.ProficientintheThompsonleg-checktechnique.Wearelookingforsomeonewhoisreadyandwillingtoblendinwithaveryupbeat,funandpositivestaff.Interestedapplicantsshouldemailtheirresumetoinfo@trimbolichiro.netorfaxto219-836-2344.

www.trimbolichiro.net.Posted5/7/13

Fantasticopportunitytogrowinanexistingclinicthatprovidesawiderangeofservicesfortheirpatients.Owner/DCstaysbookedandhasoutstandingreputationinarea.Greatopportunitytojoininanestablished,busychiropracticpracticeinLinton,IN.Weareseekingaself-motivated,passionate,detail-orientedassociatechiropractortoworkinouroffice.Newassociateneedstobeaskillfulmanualadjuster(Diversified),possessagreatbedside

mannerandbehard-working,dedicated,outgoingandenergetic.Thechosencandidatewillberesponsibleforpatient-treatment,

excellentdocumentation,patientexams,coordinaterehabilitation,adnsomelimitedmarketingadngohomewithina40hourworkweek.Basesalaryplusbonuses.Replytodocbrinson@gmail.com.

Posted7/19/13

Columbus,IN(50minutessouthofIndianapolis)Growingofficeseekingmotivated,dependable,organized,andgoal-orientedDCforafull-timepositionbeginninginDecember.Candidatemustbeskilledinmanualadjusting,musclereleasetechniques,andwillingtoutilizeCoxandThompsontechniques.Newgraduateswelcometoapply!Basesalarystartsat$40K.ContactDr.MandyWyant,

FamilyChiropracticandWellness,phone:812-373-3376Posted7/23/12

FRANCHISEOPPORTUNITIESAVAILABLE!GAINACOMPETITIVEEDGE&HAVEFUNINPRACTICE!Jointhefastestgrowingsubluxation-basedchiropracticgroup.AlignLifeisagrowingnationalchiropracticorganizationprovidingcomprehensive

wellnesssystems,marketingcampaigns,businessmanagementandnationalbranding.Gainthebenefitsofagroupwhile

maintainingfullownershipTurnkeyClinicConversions&StartUpOpportunities.AlignLifeFranchisehttp://TheDreamPractice.com.Don'twait!CallToday-GainProsperityTomorrow(877)254-4654.

Posted7/24/13

PRACTICE/EQUIPMENT FOR SALE

WabashCounty-SELLERFINANCINGAVAILABLEFamilypracticeatsamelocationfor30years.2,300sqftextensiontoa

residentialhome-forleaseorpurchase.Mainlinetechniques.Trainedandtenuredstaff.Fullyequippedincludingx-rayanddecompressiontables.

Ownerretiring.CallParagonGroup(800)[email protected]/14/13

TwentyfiveyearpracticeforsaleinLafayette,Indianaduetodeathofdoctor.Fulltimepracticespecializinginuppercervicaltech-nique.ModernofficebuildingwithXrayroom,consultationroomandtwotreatmentrooms.Ampleparkingandhightrafficcount.Buildingforsaleorlease.Viewofficeatclarkchiropracticlafayette.comoremailclarklinda123@gmail.comformoreinformation.

Posted3/15/13

ForSale-VT3000NerveConductionDiagnosticUnitw/DellLaptop.Comeswithallaccessories,manuals,extraelectrodesandprogramloadedontheDellLaptopthatcomeswithit.Thisunitisabout6yearsoldandworksgreat.Thelaptopalonewasmorethan$1,000!GetstarteddoingNCVsnow,don'twaittoincreaseyourofficerevenueandmakemoreaccuratediagnosis.$1000orbestoffer.MR4LaserStimUnit-MINTCONDITION!Thisunitwas$8,500new,wasonlyusedahandfuloftimesbeforewegota

packagedealonnewequipment,makingitanextrathatwedon'tneed.Comeswithallthemanuals,accessories,andafactory,high-quality,padded,carryingcase.$1000orbestoffer.MAKEUSANOFFERIFYOUWANTBOTH!Wecanbundlethemforless!Contact

usat317-272-4100andaskforJohnorJames.Posted3/19/13

FORSALE-IhaveanolderZenithHI/LOinperfectworkingconditionfor$500.Interested?ContactMikePhelpsat765-342-

2208.Posted7/9/13

INDIANA STATE CHIROPRACTIC ASSOCIATION CLASSIFIEDS


© 2010 Rising Tide, Kft.

For more information about

treatment options at CTCA,

your patients can call

800-234-9113 or visit

cancercenter.com.

O U R I N T E G R A T I V E T E A M I N C L U D E S :

Chiropractic Care ■ Medical Oncology ■ Spiritual Care

Radiation Oncology ■ Acupuncture ■ Mind Body Medicine

Metabolic Support ■ Interventional Radiology

Naturopathic Medicine ■ Immunotherapy

Oncology Rehabilitation ■ Nutritional Support

Surgical Oncology

Cancer Treatment Centers of America®

If one of your patients receives a cancer diagnosis, please let them know about the unique

Cancer Treatment Centers of America

(CTCA) treatment model. We know

that your patients value chiropractic

treatment, and at CTCA hospitals they

can continue chiropractic care until they

return to your office. CTCA combines

cutting-edge conventional treatments

such as radiation, chemotherapy and

surgery with supportive therapies such as

nutrition, naturopathic medicine, mind-

body medicine and chiropractic care.

This approach helps to enhance patients’

quality of life while undergoing treatment.

isca report: summer 2013

Documents

e t o t h i n kwhat

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past presidentanthony

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