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ACTION NEEDED
The
ACA is seeking state associations support to help end abuses dealt the
profession by some chiropractic managed care networks. Please review
and consider the following…
A
few weeks the ACA scheduled a conference call regarding the actions
of the ACA in dealing with certain chiropractic managed care companies
their request state associations to participate in this effort. They
informed us they had retained the law firm of Milberg Weiss to help
us collect and analyze information that members have told us are particularly
offensive and to explore possible legal remedies. I have attached a
copy of their press release and data collection form that goes into
more details regarding the type of information they are needed from
us.
Over the last couple of weeks the ACA has received over 500 data collection
forms from doctors through out the country laying out their concerns.
Their previous request for data was for examples of down coding, bundling,
reimbursement denials, and more specifics regarding the effects of termination
of provider contracts. The data they have received has been very helpful.
It has, however, revealed some very disturbing issues that we need to
look into more specifically. These issues are related to the extreme
restriction of treatment and its connection to patient outcomes and
performance measurement. For this reason, they are now requesting data
that provide examples of how severe this restriction in treatment authorization
is and detail its effect on individual patients.
We need sanitized examples of: intake forms showing diagnosis and treatment
recommendations, forms showing the patient's description symptoms, and
the actual authorization for care allowed. (For the ACN network, this
includes: the Notification Form, the Patient Health Questionnaire, the
Neck and/or Back Index, and the letter received showing level of care
authorized.) Examples of care restriction may be in any area - level
of CMT or E/M coding, frequency or duration of treatment, number of
modalities, etc. All information should be submitted to their Managed
Care Data Collection Form found at: http://www.acatoday.com/pdf/managed_care_collection.pdf
and faxed to (703) 243-2593, or complete the online "fillable"
version at: http://www.acatoday.com/insurance/managed_care/managed_care_collection.cfm
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