October 2005

ACA pursues chiropractic network problems

The American Chiropractic Association (ACA) continues to aggressively pursue its campaign against certain chiropractic managed care networks. Recent correspondence indicates that some of the networks in question may be beginning to take notice.

• American Specialty Health. In a recent letter to at least one insurance company, American Specialty Health (ASH) Chief Operations Officer Robert White refutes statements from a recent ACA press release and insists, “ASH does not engage in any wrongful practices regarding patient care or reimbursement.”

The letter also invokes the name of ASH’s vice president of governmental affairs, a two-time past president of the ACA, and states that he has “routinely engaged the ACA over the last six years on behalf of ASH, but unfortunately ACA is choosing a track that is based upon false assumptions and accusations.”

The letter goes on to claim a high satisfaction rating among chiropractors in their program and that each chiropractor “has voluntarily chosen to participate” in their networks.

ACA President Richard Brassard, DC, contends that a recurring tactic of ASH is to attempt to associate the company with a former ACA president to “confuse chiropractors and lure them into believing that ACA condones ASH practices.”

• American Chiropractic Network. The ACA has also written a strongly worded letter to American Chiropractic Network (ACN) CEO Thomas J. Allenburg, DC, requesting that ACN place an immediate moratorium on further terminations under its “professional improvement program” and reinstate those doctors who have already been terminated. ACA’s letter came in response to a letter from Dr. Allenburg contending that ACA’s concerns “result from miscommunication regarding and misunderstanding of our operations.”

Both letters resulted from a July 27 meeting between ACA and ACN officials that did not alleviate ACA’s concerns about the network’s abusive policies. In a follow-up letter, ACN asked ACA to reveal the names of doctors who had responded to ACA’s data collection campaign and to provide specific details about those complaints. The ACA refused, stating privacy concerns and doctors’ fears of retaliation by ACN.

• ACN in New York. In other action, the ACA has sent a letter to the director of Managed Care Certification and Surveillance of the New York State Department of Health challenging a petition by ACN to manage the chiropractic benefit of Oxford Health Plans. The arrangement between ACN and Oxford must be approved before ACN can administer the plan.

In the letter, ACA stated that numerous doctors throughout the country — particularly in New York — have justifiably complained about the practice and policies of ACN. To support its position, ACA included an analysis prepared by Dr. Jeffrey Simonoff, a professor at New York University.

In separate written comments, Dr. Simonoff stated, “The [ACN] summary statistics certainly suggest that such [cost and visit-limiting controls] could be affecting practice by [in effect] truncating the number of visits from above.”

This analysis supports the ACA’s opinion that the services are artificially being reduced by ACN’s statistical maneuvering. Consequently, benefits that have otherwise been promoted and paid for by employers are being denied, which is a detriment to the patient’s health and well-being.

The New York Chiropractic College (NYCC) also included an analysis stating, “If NYCC were to use the ACN material above as a cornerstone of our educational process, we would need to significantly alter our curriculum, protocols, and practices and would expect to see a significant decline in positive patient outcomes.”

State organizations throughout the country are joining ACA in these efforts. The current list includes: Alabama, Arizona, Arkansas, Connecticut, Florida, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, North Carolina, New Jersey, New York, Ohio, Rhode Island, Tennessee, Texas, Virginia, and Washington.

More information on ACA’s continuing efforts with the chiropractic managed care networks is available at the Chiropractic Networks Action Center (CNAC) on ACA’s Web site.

Source: American Chiropractic Association, www.acatoday.com

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