ISCA Winter Newsletter 2010

DECEMBER 2010 ISCA REPORT 1

INSIDE THIS ISSUE

DECEMBER 2010

PRESIDENT'S MESSAGE.....................................................................................1ISCA BOARD OF DIRECTORS & STAFF INFO...................................................2EXECUTIVE DIRECTOR'S MESSAGE................................................................3MEDICARE UPDATES FROM JAMES COX, II D.C......................................4ISCA LEGISLATOR SURVEY...............................................................................5ACA INSURANCE LIAISON REPORT......................................................................7MILESTONE DOC. RELEASED BY THE CENTER FOR HEALTH..............................7FEDERAL DISTRICT COURT RULES IN FAVOR OF CHIROPRACTIC...................8CALL FOR 2011 COMMITTEE MEMBERS.................................................9

ISCA FALL CONFERENCE PHOTOGRAPHS............................................10-11ACA UPDATE FROM ACA REP. DR. ROBERT TENNANT.............................12CHIRO OF THE DAY REGISTRATION...................................................................13CMS TO BEGIN CHIRO SERVICES STUDY.............................................14A CHIROPRACTOR'S BLESSING........................................................................14INSURANCE Q & A SESSION W/ DR. PETER FURNO........................................17ISCA CLASSIFIEDS.............................................................................................19MILITARY EXPANDS OVERSEAS CHIROPRACTIC CARE TO OKINAWA.........19

Like many people, as I begin a new position or control a specific opportunity I often look back and reminisce about the preceding level and try to assess how I have performed in each and every particular situation. I ask myself did I spend enough time with all issues and did I give back all I could and should have?

Although all of these areas are important it is my professional involvement with the Indiana State Chiropractic Association, and yours, that I want to talk about in depth and with inspiration. All of us have determination and an attitude that can surely be a lesson for all of us. We will continually ask ourselves, did I do enough? Will I do enough and most assuredly is there anything more I could have done?

These are the same questions I would like to ask you: Have you done enough for the I.S.C.A.? Was there anything more you could have done this past year to better an idea or situation? Did you recruit a new member, or even ask a colleague to join? Wherever I am or whomever I talk to, I ask people to join the state association. I may or not always get a yes, but I always ask.

Are you a regular contributor---not just a one time donor--- to the State political action fund? Our PAC funds are our ongoing legal efforts on behalf of the profession and make an enormous difference with our legislative friends. Just imagine how much more successful we could be if each of us made even a small ongoing contribution to this important legal fund. It would be incredible to imagine.

Have you called your I.S.C.A. district director to offer your support? Have you considered serving on a committee or offering to call new I.S.C.A. members to welcome them to our state and family? District directors are there for you to access when you need assistance and when you are ready to contribute you time and help. I urge you to call your district director and become involved and you can call your association office for information if you need in concern with the contact of your director.

Did you attend the Legislative Day at the State house to learn about important legislative activities? Have you visited your representatives or senators to give them the latest I.S.C.A. legislative talking points? Even if you can not attend the legislative day, you can make a difference throughout the year when the I.S.C.A. issues a “Call to Action.” This usually involves a pending bill or legislative initiative that will affect our profession. I.S.C.A. will urge doctors to contact their legislators at the State house to make our position known with every detail. Your voice as a constituent carries tremendous weight, so please remember to respond when notified with these announcements.

So I ask you once more: Did you do enough and will you do enough? Was there more you could have done for the Indiana State Chiropractic Association and your professional family? When you ask yourself these questions I hope you will understand that this is the unity we need and the formula for a much stronger future with the help of our membership and the strength of our knowledge and fortitude to be successful in all of our endeavors.

Your I.S.C.A. President Dr. Robert W. Tennant

PRESIDENT'S MESSAGE: WILL I DO ENOUGH?

DECEMBER 2010ISCA REPORT2

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

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

Second Vice-PresidentJames Cox II, D.C., LACFort Wayne, [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

Thomas Carrico, D.C.Lawrenceburg, [email protected]

Douglas Breger, D.C.Austin, [email protected]

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

DISTRICT DIRECTORS

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

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

District ThreeGeorge Joachim, D.C.Fort Wayne, [email protected]

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

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

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

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

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

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

ALTERNATE DIRECTORS AT LARGE

Frank Laux B.S., D.C.Indianapolis, IN317.881.3333

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

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

ALTERNATE DISTRICT DIRECTORS

District OneChristopher Hayes, D.C.Crown Point, [email protected]

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

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

District FourTBD

District FiveDavid Frischman, D.C.Wabash, IN [email protected]

District SixTBD

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

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

District NineTBDALTERNATES: 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.

Patricia McGuffeyExecutive [email protected]

Lori RebuckAssociation [email protected]

Tom Johnson, CPAChief Financial [email protected]

Debra Scott, IOMChief Operations [email protected]

Stephanie HigginsDirector of [email protected]

Stacy QuasebarthDirector of [email protected]

Connie VickeryGovernmental [email protected]

John LivengoodGovernmental [email protected]

200 S. Meridian St., Suite 350Indianapolis, IN 46225info@indianastatechiros.orgwww.indianastatechiros.org317.673.4245 phone 800.572.8002 toll-free 317.673.4210 fax

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INDIANA STATE CHIROPRACTIC ASSOCIATION STAFF & INFO

INDIANA STATE CHIROPRACTIC ASSOCIATION BOARD OF DIRECTORS


EXECUTIVE DIRECTOR'S MESSAGE: PATRICIA MCGUFFEY, ESQ.Indiana Chiropractors lose their physician status and are removed from the Medicaid program! Physical Therapists have Direct Access to perform spinal manipulations!

Now that I have your attention, this has NOT happened yet but we know that

legislation will be introduced in the 2011 Legislative Session that would do exactly that!

The Physical Therapist (PT) Association has already hired additional lobbyists (law firm of Barnes and Thornburgh) to assist with their efforts! In addition, we know that both key legislators and State officials have publicly stated they have heard there is a plan to cut Chiropractors from the Medicaid program.

Now that you have heard the bad news, this is the good news-YOU can stop this from happening. You can stop it now if you contact your legislators and educate them on the efficiency and efficacy of Chiropractic care. You can stop this from happening if you let them know about the many years of education and training you must obtain before you can perform spinal manipulations! Your ISCA has education materials and surveys that you can utilize to educate your legislators and determine where they stand on these crucial issues

It is absolutely imperative that you meet with your legislators whether they are new or returning. The ISCA sent an education document and survey to legislative candidates in open seats and later to the newly elected freshman legislators. Now, we need you to assist us in determining your local legislators’ positions on our key issues. Please contact our office so we can work with you to schedule meetings or send e-mails to survey your legislators. Only you and your involvement will determine the future of Chiropractic in Indiana. (The survey is available on page 5 of this newsletter, please share this with your local State Senator and Representative and report their responses to the ISCA office!)

Now more than ever before, I believe we are at a crucial crossroads that will determine your ability to practice chiropractic medicine in 2011 and beyond.

The political landscape of the Statehouse has changed considerably. Both Chambers are now Republican. There are 19 new Republican legislators in the House of Representatives and 5 new Republicans in the Senate!

I know some of you wonder what your ISCA lobbyists do when the Legislature adjourns. One of our main activities is to attend the numerous fundraisers legislators host. In addition, we attend Legislative Interim Study Committees

that study issues throughout the summer and fall. The Interim Committees have finalized their reports and made their final legislative recommendations for legislation to be introduced in the 2011 Session. The 2011 Session is a long Session (every other year) in which a biennium budget must be passed to fulfill the constitutional mandate.

Since Indiana’s budget projections continue to fall below their estimates and the economy is still less than stellar, everyone has been placed on notice not to ask for legislation that has a fiscal note. Agencies are being asked to cut their budgets. The State is expecting a billion dollar shortfall. This is one reason the Administration will ask for chiropractic and other health care services to be cut from the budget. However, we know the cost effectiveness of chiropractic care. We know that the State will not save money if they remove chiropractic services from the Medicaid program! Be sure you let your legislators know too!

One of the summer study committees, the Medicaid Oversight Commission, reviewed a number of programs and contracts of the Family and Social Services Agency (FSSA). However, they only passed one legislative proposal and that one would require the Indiana check-up plan (HIP) to receive the interest accrued from investments of funds and not revert to the state general fund. It would also require the Office of Medicaid Policy and Planning (OMPP) to post specified information on the Indiana check-up plan's web site before the office stops enrollment in the plan or places applicants on a waiting list for the plan.

In addition, the Health Finance Commission established a Health Care Reform Implementation Advisory Committee pending sign off from Senate Republican leadership. I was able to have the ISCA added to the list of representatives to serve on the Committee. However, the Senate did not sign off on the proposal to make the Advisory Committee official. The “unofficial” Committee will still meet to establish positions on various aspects of Health Care Reform implementation legislation. It will be important to show the Legislature a unified message from the health care provider community. The ISCA will work to make sure chiropractic services are fully included in any and all Health Care Reform proposals.

Once again I must ask you to please make contact with your local State Senator and Representative whether they are newly elected or incumbents. It is important that they know you personally and understand the importance of chiropractic care for their constituents. When ISCA has a crucial issue, this will make the difference in our success or failure. Please contact me if you need additional information. Enjoy your Holidays!


Effective Oct 1-2010, the new ICD 9 code:

724.03Spinal stenosis, lumbar region, with neurogenic claudication *Effective 10/01/2010 Dr's and staff please note this new code.

No other major changes were made to our Chiropractic LCD.

MEDICARE EDUCATIONAL ALERT

MEDICARE ELECTRONIC HEALTH RECORD INCENTIVE PROGRAM AND PROVIDER ENROLLMENT, CHAIN AND OWNERSHIP SYSTEMOne of the requirements to receive an incentive bonus from the Centers for Medicare and Medicaid Services’ (CMS) Electronic Health Record (EHR) Incentive Program is enrollment in the Provider Enrollment, Chain and Ownership System (PECOS). There are a number of ways providers can verify whether they are enrolled in PECOS:

1. Use Internet-based PECOS to look for your PECOS enrollment record. (You will need to first set up your access to Internet-based PECOS.) If no record is displayed, you do not have an enrollment record in PECOS. 2. Check the Ordering Referring Report on the CMS Web site. If you are of a specialty eligible to order and refer in the Medicare program and you are on that report, you have a current enrollment record in PECOS.

3. Contact your designated Medicare enrollment contractor and ask if you have an enrollment record in PECOS. If you do not have an enrollment record in PECOS, you can submit an application online at https://pecos.cms.hhs.gov/pecos/login.do or complete the paper application. If you complete the paper application an electronic enrollment record will be created for you in PECOS. If you have questions, contact American Chiropractic Association's Government Relations Department at [email protected].

You must also be enrolled in PECOS to receive bonus payments from Medicare.

James M Cox II DC 3125 Hobson Rd Fort Wayne,IN 46805www.coxchiromed.comemail [email protected] 260-471-1817ISCA/ ACAMedicare CAC Rep Chiro.

MEDICARE UPDATES FROM JAMES COX, II D.C.

SAVE THE DATE: MARCH 4-6, 20112011 ISCA SPRING CONFERENCE • MARCH 4-6, 2011

SHERATON INDIANAPOLIS CITY CENTRE • 31 WEST OHIO STREET

Why Should I Attend?• KeynoteSpeakersDr.JamesM.Cox&RamGudavalli,PhD.

• RiskManagementCourses• Exhibitorswiththelatesttoolsoftrade• Networkingandsocializingwithfellowchiropractors

FACT SHEET: Indiana State Chiropractic Association

Chiropractic is a branch of the healing arts, which is concerned with human health and disease processes. It is a drug-free, non-surgical science and, as such, does not include pharmaceuticals* or incisive surgery.

The practice and procedures which may be employed by Doctors of Chiropractic (chiropractic physicians) are based on the academic and clinical training received in and through accredited chiropractic colleges; and include, but are not limited to, the use of current diagnostic and therapeutic procedures. Such procedures specifically include the adjustment and manipulation of the articulations and adjacent tissues of the human body, particularly of the spinal column.

Millions of patients love their doctor of chiropractic and appreciate our unique and safe approach to recovery from pain. Chiropractic care has some distinct advantages over more traditional forms of care because it does not involve surgery or drugs.

Significant research suggests that chiropractic is the safest approach available for relief from neck pain, back pain, headaches and other muscular skeletal complaints.

For back pain conditions, patient satisfaction with chiropractic treatment has invariably been shown to be significantly greater than that with conventional management [administered by a primary care physician, or an orthopedist].

The cost advantages for chiropractic are so dramatic that Pran Manga, a Canadian health economist, has concluded that doubling the utilization of chiropractic services from 10% to 20% may realize savings as much as $770 million in direct costs and $3.8 billion in indirect costs.

CURRENT ISSUES OF INTEREST TO THE ISCA

• Physical therapists (PTs) are not trained or educated to perform spinal manipulation. The ISCA would like to prevent PTs from having direct access to patients unless they are prohibited from performing spinal manipulations.

• To provide parity for reimbursement for all chiropractic treatment services in the Health Insurance Program (HIP) and all State Health and private insurance plans.

• Assignment of benefits legislation that would allow patients to choose whether they want their benefit (insurance payment) sent directly to their out of network health care provider

• Open access giving providers the opportunity to run their practice as they wish by granting them the option to stop seeing new patients from one particular insurance plan without closing their doors to all new patients.

•Important insurance reform such as requiring health insurers licensed in Indiana to provide timely and transparent information to the Indiana Department of Insurance to be displayed for consumers to review.

Return to: Indiana State Chiropractic Association200 S. Meridian St. Suite 350Indianapolis, IN 46225

or via fax to 317.673.4210

ISCA SURVEY 2010

1. Are you currently being treated by a chiropractic physician?

Yes

No

2. Have you ever been treated by a chiropractic physician? If so, who? (Please leave Name/City in a comment)

Yes

No Comment:

DO YOU AGREE OR DISAGREE WITH THE FOLLOWING STATEMENTS: 3. Chiropractic care is effective and less invasive than traditional neck and back care.

Strongly disagree

Disagree

Neither agree nor disagree

Agree

Strongly Agree

4. While lacking the proper training and education, some physical therapists want to expand their scope of practice to perform spinal manipulation and have direct access to patients rather than be referred by a medical or chiropractic physician. Physical therapists should not be allowed to expand their scope of practice and have direct access to patients and do spinal manipulations without the training and education in spinal manipulation and differential diagnosis that chiropractors must receive.

Strongly disagree

Disagree


Agree

Strongly Agree

5. Will you oppose legislation that would remove chiropractic treatment services from the Medicaid program?

Strongly disagree

Disagree


Agree

Strongly Agree

6. All chiropractic services, including spinal manipulation, should be available in all state run health programs (Healthy Indiana Plan, Medicaid, and any new health exchange created by health care reform)?

Strongly disagree

Disagree


Agree

Strongly Agree 7. Currently insurance companies refuse to honor patient requests to send payment (assignment of benefits) directly to chiropractic physicians or other health care providers. Requests by patients to send payment directly to chiropractic physicians or other health care providers should be honored.

Strongly disagree

Disagree


Agree

Strongly Agree

8. In many cases commercial insurance carriers are now reimbursing chiropractic physicians less than they did 20 years ago. Insurance companies should be required to reimburse chiropractic physicians fairly.

Strongly disagree

Disagree


Agree

Strongly Agree

RESPONDENT DETAILS:

Name: __________________________________________

Email: __________________________________________

Phone: __________________________________________

ISCA SURVEY 2010


The Foundation for Chiropractic Progress is pleased to announce that the Center for Health Value Innovation (CHVI), experts in value-based design who link superior health outcomes to improved business performance, has released a landmark document: Outcomes-Based Contracting™: The Value-Based Approach for Optimal Health with Chiropractic Services. Cyndy Nayer, CEO of CHVI and the voice of value-based design, along with leaders from the Center, point to chiropractic intervention as one area in which new analysis may define the placement in the care continuum.

"The Foundation asked us to consider the insertion of chiropractic into the value-based benefit designs for low back and neck pain based upon a recently published study,” notes Nayer, citing the 2009 study Do Chiropractic Physician Services for Treatment of Low Back and Neck Pain Improve the Value of Health Benefit Plans? conducted by Niteesh Choudhry, M.D., PhD, Harvard Medical School, Brigham and Women’s Hospital and Arnold Milstein, M.D., MPH, which concluded that chiropractic care could be an effective and cost-efficient service for relief of pain and reduction in disability. “Because of the support from the Foundation, we were able to convene a panel of experts to consider the implications and a framework for contracting that was built on outcomes. The conclusion: there is a basis for including chiropractic in the patient-centered models of value-based design.”

Nayer continues, “We believe the market is ready to broaden the reach of value-based designs into the delivery system, and chiropractic should now be measured prospectively on how it improves workforce performance and economic efficiencies, getting our businesses back to work."

A panel of experts including Ms. Nayer and Dr. Choudhry convened at the Innovators’ Summit on Chiropractic Services held May 1, 2010, Orlando, Florida, including: Ford Brewer, MD – Chief Medical Director, The Little ClinicLaura Carabello – Principal, CPR Strategic Marketing CommunicationsNiteesh Choudhry, MD, PhD – Assistant Professor, Harvard

Medical SchoolGerry Clum, DC – President, Life Chiropractic College WestSteven Delaronde – Director of Medical Informatics, Triad HealthcarePeter Hayes – Secretary, CHVIJack Mahoney, MD, MPH – Chief Medical Officer, CHVICyndy Nayer, MA – CEO, CHVIJerry Reeves, MD – Principal, Health Innovations LLCBruce Sherman, MD – Consultant Medical Director, Whirlpool and Medical Consultant, CHVIMark Ziegler, DC – President, Northwestern Health Sciences University

This newly released authoritative report follows the recent unveiling of the CHVI ground-breaking contracting mechanism, Outcomes-Based Contracting™, an approach that transforms health benefit design. Outcomes-Based Contracting™ (OBC) recognizes value-based benefit design (VBBD) as a superior engagement tool for aligning the delivery system with the goals of the payer to drive accountable care, enhanced health status and cost efficiency. Outcomes-Based Contracting™ emerges as the only sensible contracting mechanism to move the system away from commodity pricing and into measurable, meaningful outcomes.

According to Dr. Clum, Foundation spokesperson, “The CHVI document is a breakthrough for the profession because it weaves chiropractic care into the context of a value-based benefit design. As the paper eloquently states, there is sufficient basis for plan sponsors to reevaluate their current chiropractic benefit for treatment of neck and low back pain.”

MILESTONE DOCUMENT RELEASED BY THE CENTER FOR HEALTH VALUE INNOVATION CALLS FOR INCLUSION OF CHIROPRACTIC IN PATIENT-CENTERED MODELS OF VALUE-BASED DESIGN

ISCA EXECUTIVE DIRECTOR MCGUFFEY APPOINTED TO COCSA EXECUTIVE DIRECTOR SUMMIT LIAISON COMMITTEE

Executive Director Pat McGuffey was selected as one of 11 members of the newly formed COCSA Executive Director Summit Liaison Committee. This committee was established for better communication between the states and COCSA. Understanding the states are a valuable asset, this forum will allow members to highlight state concerns and to make sure everyone is working for the best of the Chiropractic profession.


On October 27, 2010, a Federal Court Ruled against Blue Cross and Blue Shield of Rhode Island's (BCBSRI) overpayment recoupment practice. The Court relied upon a U.S. Supreme Court Ruling in Aetna v. Davila, and ruled that federal ERISA law limits the potential recovery by BCBSRI, and that BCBSRI's state law claims for breach of contract and fraud are completely preempted by the Employee Retirement Income Security Act (ERISA). BCBSRI’s post-payment audit is a fiduciary conduct governed by Federal Law ERISA instead of provider PPO contract.

Hanover Park, IL (PRWeb) November 1, 2010 – The federal district court in Rhode Island ruled on October 27, 2010 against BCBSRI over its recoupment practice for over $400,000 against two healthcare providers. Relied upon recent US Supreme Court rulings, the court ruled that federal law ERISA limits or prohibits BCBSRI from recouping alleged overpayment, and BCBSRI’s state law breach of PPO contract claim and fraud claim are completely preempted by federal law ERISA in BCBSRI’s motion to remand to state court. ERISAclaim.com provided the ERISA compliance assistance and support in the defendant providers’ ERISA administrative appeals and judicial litigation in this case and now offers free Webinars to discuss the profound impact of the court ruling in the popular overpayment recoupment healthcare crisis, estimated in trillion dollars.

"This federal court ruling provides the timeliest and valuable guidance on the remedies, rights and governing laws for everyone in this trillion dollar health-care overpayment crisis faced by every healthcare provider today”, said Dr. Jin Zhou, president of ERISAclaim.com, a national consultant on ERISA compliance and claim appeals.

According to the court papers, "Blue Cross alleges that Defendants purposely miscoded services which resulted in Blue Cross paying them over $400,000 for services that were not covered by "the applicable BCBSRI subscriber contracts”. “Blue Cross stated its conclusion that the miscoding was an "intentional misrepresentation” and demanded repayment of $412,952.93”. BCBSRI sued two providers in the state court of Rhode Island, among other things, alleging: “Count I alleges that Defendants breached their Provider Agreements, by submitting claims for unauthorized services, and, in the case of Defendant Korsen, by terminating the Provider Agreement without proper notice to Blue Cross. Count II is for fraud based on false and fraudulent claims submitted by Defendants for compensation”. “Defendants removed the case to this Court arguing that Blue Cross' state law claims for breach of contract and fraud (Counts I and II) are completely preempted by the Employee Retirement Income Security Act ("ERISA")”. Federal court made following ruling in denying BCBSRI’s motion to remand the case to the state court.

In deciding that BCBSRI’s post-payment audit and overpayment recoupment is a fiduciary conduct governed by ERISA rather than PPO contract, the court explained:

“Based on the allegations in the Amended Complaint, it appears that Blue Cross defines permissible, compensable medical services; it determines which services are medically necessary for its subscribers; and it audits medical providers to determine if their services are medically necessary and generally accepted in the medical community. This is the conduct of an ERISA fiduciary in connection with an ERISA plan. Whether this conduct is directed at, or has an impact upon, subscribers or other parties within the complex ERISA administrative mechanism is not a distinction drawn by the statute. See Aetna Health Inc. v. Davila, 542 U.S. 200, 220 (2004) ("Classifying any entity with discretionary authority over benefits determinations as anything but a plan fiduciary would thus conflict with ERISA's statutory and regulatory scheme.").

In deciding that the overpayment recoupment dispute is not governed by BCBSRI provider contract under state law and but is completely governed and preempted by federal law ERISA, the court explained:

“The Court holds further that there is no independent legal duty controlling Defendants' conduct herein; because, while the Provider Agreements do impose duties on Defendants, these duties are not independent of the terms of the ERISA plans. Consequently, the Court holds that Blue Cross' Count I for breach of contract, alleging that Defendants breached the Provider Agreements by submitting claims using improper CPT codes and submitting claims for services that were inappropriate or not medically necessary, and Count II for fraud are completely preempted by ERISA. The Court converts these claims to a federal ERISA § 502 (a) (3) claim.”

In deciding that federal law ERISA prohibits or limits BCBSRI’s alleged overpayment recovery against healthcare providers, the court explained:

“Though the Court's ruling limits Blue Cross' potential recovery, this holding is consistent with the legislative aims identified by the Supreme Court in Davila: "The limited remedies available under ERISA are an inherent part of the 'careful balancing' between ensuring fair and prompt enforcement of rights under a plan and the encouragement of the creation of such plans." 542 U.S. at 215 (quoting pilot Life Ins. Co. v. Dedeaux, 481 U.S. 41, 55 (1987). Moreover, the Congressional objectives of consistency in regulation and uniform administration of ERISA plans are met”.The court case info: BLUE CROSS & BLUE SHIELD OF RHODE ISLAND v. JAY S. KORSEN and IAN D. BARLOW, filed on October 27, 2010, Case#: 1:09-cv-00317-L-LDA, UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND

View a complete copy of the court decision online at http://www.erisaclaim.com/BCBSRI_V_Korsen.pdf

FEDERAL DISTRICT COURT RULES IN FAVOR OF CHIROPRACTIC


CALL FOR 2011 COMMITTEE MEMBERS

Start the year off right by giving back to your profession by volunteering for an ISCA Committee. We have the following Committees that need your talent.

Please circle the Committee desired and rank your preference.

Acupuncture Committee

By-Laws Committee

Ethics/Grievance Committee

Golf Committee

Insurance Committee

Legislative Committee

Membership Committee

Public Relations Committee

Speaker/Convention Committee

Sports Committee

Name:_________________________________________________________________________________________________

Clinic Name: ___________________________________________________________________________________________

Address: _______________________________________________________________________________________________

Phone Number: _________________________________________________________________________________________

Email: ________________________________________________________________________________________________

Thank you very much for your time and commitment to the ISCA and your profession!

Return to: Lori Rebuck, ISCA, 200 S. Meridian St., Suite 350, Indianapolis, IN 46225 or fax to 317.673.4210

ISCA FALL CONFERENCE: OCTOBER 22-24, 2010

Exhibitors taking a moment to smile for the ISCA camera.

Joy to Life Exhibitor, Robert Ehmann offering free tastings!

Dr. Bernzott and Dr. Tennant.

Dr. Marian Klaes-Lanham swearing in the new 2010-2011 BOD.Dr. Tennant presents an award to Dr. Wolf for his service as ISCA President.

Dr. Robert Tennant enjoying the After Hours Reception.

Chiropractors testing out Haffner X-Ray Equipment.

Dr. Cox II, Dr. Wolf, and Dr. Washington deep in conversation.

ISCA FALL CONFERENCE: OCTOBER 22-24, 2010

ISCA FALL CONFERENCE: OCTOBER 22-24, 2010 ISCA FALL CONFERENCE: OCTOBER 22-24, 2010

Executive Director Pat McGuffey and Dr. Wolf present the 2010 D.C. of the Year Award to Dr. Diane Vuotto.

Dr. Wolf presenting the Lifetime Member Award to Dr. Howard and his wife Joan.

Dr. Paprocki, Dr. Williams and Dr. Tennant.Dr. Cox II won the PAC raffle at the annual membership meeting.

Exhibitors happy to be at the ISCA Conference.Dr. Paprocki and an exhibitor discuss the latest technology.

Conference attendees taking a coffee break.Cory Haffner and Dr. Kielur.


ACA UPDATE FROM ACA REP. DR. ROBERT TENNANTACA HOUSE OF DELEGATES: CHIROPRACTIC PROFESSION QUALIFIED TO FILL THE GAPS IN PRIMARY HEALTH CAREThe American Chiropractic Association (ACA) underscored its position that doctors of chiropractic are qualified and ready to help address primary health care provider shortages in the

United States with a resolution passed by its delegates during their recent annual meeting, held Sept. 28-Oct. 2 in Newport, R.I. The resolution was one of several passed by the House of Delegates (HOD), which also received progress reports on a variety of association initiatives.

This year, for the first time, ACA partnered with state associations in the region to host its annual meeting. The American Chiropractic Association and Northeast Chiropractic Council (NECC) Fall Conference drew hundreds of doctors of chiropractic, who were treated to a selection of programs, educational seminars and networking opportunities, as well as exhibits featuring a wide variety of chiropractic products and services.

In the policy on primary care-which dovetails with ACA's efforts to expand the role of DCs in health care reform initiatives-delegates outlined the educational qualifications, skills and experience of DCs that equip them to help fill gaps in primary care services in the United States. The policy concludes, "Chiropractic physicians/doctors of chiropractic have pioneered conservative healthcare and have been the leading provider of these services, which are safe and effective. Chiropractic healthcare enjoys high patient satisfaction and outcomes that may control costs, enhance the primary care setting and the health of the America people."

ACA delegates also approved resolutions on: • Stages of Care - the policy approves definitions for

management of acute conditions, management of chronic recurrent conditions and management of wellness.

• Hygienic Recommendations - the policy encourages DCs to stay informed about hygiene issues so that they can create a safer environment for their patients and staff. It refers DCs to sources for information on the subject, including CDC, state and local boards of health, state boards of chiropractic, journal articles, OSHA and ACA.

• Ionic Footbaths - the policy discourages DCs from promoting the detoxification benefits of ionic footbaths.

The prospect of new opportunities to expand access to chiropractic care, made possible by pro-chiropractic provisions in the health care reform bill passed in March, was central to many discussions at the conference. Former House Majority Leader Dick Gephardt, who has been working with ACA on health care reform issues, made a special appearance at a panel discussion, which also included ACA President Rick McMichael, DC; ACC President Frank Nicchi, DC; COCSA President Jeffrey Fedorko, DC; and moderated by Chiropractic Summit Chairman Lewis Bazakos, DC.

Gephardt remarked how the chiropractic profession handled itself well during the health care reform debate, making key contacts with members of Congress, speaking with one voice through the Chiropractic Summit and reaching out with individual patient stories to educate decision makers about the benefits of chiropractic care. "You did a good job articulating your values to Congress," he said. "That's huge."

Another panel discussion during the HOD/NECC meeting focused on the findings of the Chiropractic Medicare Demonstration Program and the next steps that ACA will take as part of its continuing efforts to expand covered services for chiropractic patients under Medicare. The results of the pilot project, released earlier this year, are being analyzed by an ACA task force and will eventually be discussed in depth with HHS Secretary Kathleen Sebelius. Panel members included Ritch Miller, DC, ACA Medicare Committee chairman; Susan McClelland, an advisor to the Medicare Committee; John Falardeau, ACA vice president of government relations; Kara Murray, ACA director of federal and regulatory affairs; and Christine Goertz, DC, a research advisor to ACA who was recently appointed to the board of the newly created Patient-Centered Outcomes Research Institute (PCORI).

During its HOD meeting, ACA also approved the induction of four states-Alaska, Connecticut, New York and Indiana-into its State Affiliation Program. This new initiative is designed to strengthen ties between ACA and state chiropractic associations, improve communication and working relationships and make ACA and state associations better equipped to address mutual issues.

Have you attended a Brown Bag Lunch? As an ISCA member benefit, this is your opportunity to spend time with other D.C’s discussing everything from Insurance, Medicaid, Legislative Issues, to business development. Please be sure to mark your calendar and we will let you know the topics and the presenters in our next newsletter. Questions? Contact our office at 317-673-4245. February 9, 2011 May 11, 2011 August 10, 2011 November 9, 2011

SAVE THE DATE – 2011 BROWN BAG LUNCH SCHEDULE


RESERVED

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Please fax to 317.673.4210

NO MEDICARE CUTS FOR 12 MONTHS!

CMS TO BEGIN CHIROPRACTIC SERVICES SUPPLEMENTAL MEASURES STUDY

CMS urges all chiropractors who receive a letter for this chiropractic services supplemental measure study to respond to the request for medical records immediately upon receipt of the letter.

On November 20, 2009, President Obama issued Executive Order 13520 - Reducing Improper Payments and Eliminating Waste in Federal Programs. This order further intensifies efforts to eliminate payment error, waste, fraud, and abuse in Federal programs, while continuing to ensure that the right people receive the right payment for the right reason at the right time. The executive order requires federal agencies to conduct semiannual studies to identify and reduce vulnerabilities in high risk areas, The Centers for Medicare & Medicaid Services (CMS) is conducting these studies under the Comprehensive Error Rate Testing (CERT) program.

Chiropractic Services Chiropractic services claims paid under the Medicare Part B Program were selected as an area of focus. Chiropractic services were chosen as a focus area for several reasons. • Medicare pays only for medically necessary acute

chiropractic treatment.• When further improvement cannot reasonably be

expected from continuing care, the services are considered maintenance therapy and are not payable under Medicare.

• A recent Office of Inspector General (OIG) study found that significant vulnerabilities exist in connection with chiropractic claims, particularly concerning Medicare payments for maintenance therapy.

• In addition, the 2009 Medicare fee-for-service (FFS) error rate for chiropractic services was 31.7 percent, with $174.1 million in projected improper payments.

• The primary causes of the errors were payments for maintenance therapy and missing plans of care.

The chiropractic services supplemental measure study will focus on determining whether chiropractic services billed to Medicare were medically necessary acute chiropractic treatment. For each claim selected, CMS will review medical records up to 12 months prior to the date of service on the claim. CMS will deny claims for services determined to be maintenance therapy and recoup any overpayments.

What to Do If Your Claim is Selected for Review lf one of your claims has been selected for review, you will be contacted by letter from the CERT Documentation Contractor (CERT DC). The letter will instruct you to provide the CERT DC with the previous 12 months of medical records for the identified beneficiary. Failure to respond to the medical records request letter within the specified time period of3O days will result in a full denial of the claim, as well as a possible fraud referral. The universe for the initial phase of this study includes beneficiaries with multiple claims from the same chiropractor in the sample months (April 2010-June 2010). A random sample of 100 beneficiaries was drawn from this universe. CMS urges all chiropractors who receive a letter for this chiropractic services supplemental measure study to respond to the request for medical records immediately upon receipt of the letter.

ResultsCMS will report the results of this chiropractic services supplemental measure study in March 2011 and then semiannually thereafter. The reports will be posted on CMS’ public website at http://www.cms.gov/CERT/. For more information about the chiropractic services supplemental measure study, please contact Jill Nicolaisen at 41O-786-5873 or [email protected].

Source - MAC Journal

A CHIROPRACTOR'S BLESSING

May you have a season Of bright happy days

Filled with good friendsGood health and good cheer

May you be "all lined-up"For some wonderful times

May you stay "Well-Adjusted"All year!

Author Unknown

The American Medical Association reports "Today, the U.S. House of Representatives passed H.R. 4994, the "Medicare and Medicaid Extenders Act of 2010," which would stabilize Medicare physician payments at current rates for 12 months—through the end of 2011—and stop the 25 percent cut that was originally scheduled to take effect on Jan. 1. Because the U.S. Senate passed the same piece of legislation by unanimous consent yesterday, Dec. 8, the bill will now be sent to the White House for President Obama to sign into law."

Source - Texas Journal of Chiropractic Online


The ISCA will soon be uploading its first ever online membership directory. This directory will have a complete listing of all ISCA members, searchable by zipcode, first and last name among other options to make it easy for consumers to find your practice. We will be providing a free basic listing for all ISCA members that will include your first and last name, clinic name and address, business phone number and fax and the year you became an ISCA member.

For the low additional cost of $100 a year, ISCA members can upgrade to a Premium Profile that will expand your listing in our online directory. The Premium Profile includes a description (40 words or less) of your practice, hours of operation, payment types accepted, techniques, specialties, alternative services, social media links, a profile picture and more!

Please make sure to provide us with any changes and updates using the form provided on the back of this page that you would want reflected in this new online directory and fax or mail back this form back to our Association headquarters at 200 S. Meridian St. Suite 350 Indianapolis, IN 46225 or fax to 317.673.4210.

If you have any questions about the new online directory, please call Lori Rebuck at 317.673.4245 or toll-free at 800.572.8002 or email [email protected].

Thank you!

ISCA ONLINE MEMBERSHIP DIRECTORY

I want to upgrade to the Premium Listing at Yearly $100 rate (USE FORM ON THE PAGE OF THIS PAGE)

ONLINE DIRECTORY PREMIUM LISTING PAYMENT OPTIONS (You may also pay by ACH deduction from your checking account -- contact the isca office for information)

AMEX VISA MASTERCARD CHECK (MAKE PAYABLE TO ISCA)

CARDHOLDER:_______________________________________________________________

CARD #:____________________________________________________________________

EXP.__________________________ 3 DIGIT SECURITY #:___________________________

SIGNATURE:_________________________________________________________________

MAIL: ISCA 200 S. Meridian St, Suite 350 Indianapolis, IN 46225

FAX: 317.673.4210

First Name:__________________________________________________Last Name:_________________________________________________

Clinic Name: _________________________________________________________________________________________________________

Clinic Address: ________________________________________________________________________________________________________

City: _______________________________________________________________ State: ________________ Zip: _____________________

Business Phone (______)______________________ Business Fax: (______)______________________ ISCA Member Since: ______________

ISCA Website Membership Directory Basic Free Listing

14

PREMIUM LISTING - $100 A YEAR

Website: ___________________________________________________ Office Email:_____________________________________________

Secondary Office Location(s):___________________________________________________________________ Practicing Since: _________

Education: ____________________________________________ q Profile Picture (Email JPG file to [email protected])

Social Media Links: (Provide URL or username in blank)

q Twitter: ______________________ q Facebook: _____________________________ q Foursquare: _____________________

Insurance Accepted:

About Our Practice (40 words or less): __________________________________________________________________________________

____________________________________________________________________________________________________________________

Hours Of Operation: __________________________________________________________________________________________________

Payment Types Accepted: q Visa/Mastercard q American Express q Discover q Personal Checks q Cash Only

Techniques:

Indiana State Chiropractic Association 200 South Meridian St., Suite 350 Indianapolis, Indiana 46225800.572.8002 toll-free• 317.673.4245 • 317.673.4210 fax • www.indianastatechiros.org • [email protected]

Return to:

Premium Listing - $100 Yearly Rate

q Gonsteadq Activatorq Applied Kinesiologyq Bio-Energetic Synchronization(BEST)q Cox Flexion Distractionq Thompson Terminal Pointq Palmer Toggle Recoil q Sacro-Occipital Technique (SOT)

q Logan Basic q Nimmo Trigger Point Therapyq Motion Palpationq NUCCAq Neural Emotional Techniqueq Atlas Orthogonal/Upper Cervicalq Diversifiedq Pettibon

q Torgue Releaseq Toftnessq Pierceq Myofascial Releaseq Spinal Decompressionq Craniopathy

q Ultra-violetq Ultrasoundq Hydro-Therapy

q Galvanicq Short Waveq Diathermy

q Electrical Muscle Stimulationq Low Intensity Laser Therapy

Modalities:

Specialties:q Diplomate American Board of Chiropractic Orthopedistsq Certified Chiropractic Sports Practitionerq Chiropractic Certification on Spinal Traumaq Fellow, Academy of Chiropractic Orthopedistsq Certified Clinical Nutritionistq Diplomate of American Chiropractic Board of Nutrition

q Diplomate of the American Chiropractic Neurology Boardq Certified Chiropractic Extremity Practitionerq Diplomate—American Board of Chiropractic Internistsq Diplomate, American Chiropractic Board of Radiologyq Diplomate American Chiropractic Board of Sports Physiciansq Board Certified, Rehabilitation, Musculoskeletal System

Alternative Services:q Therapeutic Massageq Physical Therapyq Acupuncture

q Nutritionq Sports Chiropracticq Pediatricsq Rehabilitation

q Homeopathyq Chiropractic Orthopedicsq Orthotics

q Medicare q Anthem Blue Cross Blue Shield q Humana

q Medicaid q Aetna q Sagamore

q Healthy Indiana Plan q United q Other:______________________


INSURANCE Q & A SESSION WITH DR. PETER FURNO, ISCA INSURANCE COMMITTEE CHAIRMAN

CONTINUED...

We thought it would be beneficial to ISCA members to see what types of insurance questions we receive at the ISCA. The ISCA is fortunate to have Dr. Peter Furno as Chairman of the Insurance Committee. He generously shares his vast knowledge of the insurance industry with fellow members.

The letter below was written to Dr. Furno requesting assistance in resolving various issues. We have started with the body of the letter and included the questions and answers below it. (We have removed the names and company information to protect the innocent.)________________________________________

Dear Dr. Furno: A short time ago, Pat McGuffey had attached a note from you along with a template letter to send to insurance companies for dispute claim denials. Among the points in your template, you ask the carrier if the claim was reviewed by a licensed D.C., who is practicing at least 50% of his time. I had heard before that chiropractic claims could only be reviewed by D.C.’s licensed in the state but do not know where that came from. Is there a specific state statute that states this that I could reference? If you could provide me with that information, I would greatly appreciate it.Sincerely, Dr. Chiropractor

Dear Dr. ChiropractorI can sense your frustration in your dealings with these people. I am going to comment to the issues you have raised, and hopefully you will be able to gain some insight as to how to go about approaching your problem. I realize only too well the time and effort you must put into it – this is labor-intensive work - but it will be worth it in the end. You must get to the bottom of the issue.

Your very last recourse, of course, is getting a legal opinion from an attorney specializing in healthcare. However, I would exhaust all other avenues first. Just make sure you are in the right, and are utilizing generally used healthcare conventions in your clinical notes (SOAP) together with the appropriate use of E/M codes, Diagnostic Codes and their correlation to your Treatment Plan.

Dr. Furno’s ResponsePlease know that there is nothing in the Indiana Code that requires a Review Agent for the insurance company to be a resident in the state in which the provider practices. However, by law the Review Agent must have a current license in the SAME healthcare field as the provider whose claim is being reviewed, and be REGISTERED with the Department of Insurance in the State.

Dr. Chiropractor’s Comment/Question As you might guess, we are still struggling with XYZ Insurance Company. Essentially, our reimbursements from them have all but stopped. On the front end, we have to get pre-authorization from Insurance Company where they typically approve 4-5 visits out of a requested 12-14. These also have a time period that they need to be used, they won’t roll over if not used in the time frame (we have to request an extension) and if we use their visits early say in 2 weeks instead of the 4, then we still can’t request additional visits until the 4 weeks is up.

Dr. Furno’s ResponseThis practice by the insurer goes directly to “Chiropractic Standards of Care” and “Chiropractic Guidelines”. It is imperative that you request from XYZ Insurance Company exactly what Chiropractic Guidelines they are utilizing and to substantiate the basis upon which their treatment decisions are based pertinent to the reported diagnosis – carbon copy the XYZ Insurance Company Claims Manager, as well as the IDOI. All this is to establish a “paper trail” for later legal use, if necessary.

Dr. Chiropractor’s Comment/Question On the back end, we have somehow been “flagged” for review.

Dr. Furno’s ResponseYou are entitled to demand to know the exact reason the review is being called for. It appears that although you believe you are submitting all the necessary information, you continue to be flagged for review. State clearly in your communications that you are abiding by the ISCA “Practice Guidelines for Chiropractic – a Standard of Care” – available from the ISCA Office - or whatever other guideline you are utilizing, i.e. Council on Chiropractic Guidelines & Practice Parameters (CCGPP); Council on Chiropractic Practice (CCP); Guidelines for Chiropractic Quality Assurance (Mercy Conference Guidelines);


Milliman Care Guidelines, etc.

Dr. Chiropractor’s Comment/Question Basically, every claim on every patient requires a note documenting every aspect of their care.

Dr. Furno’s ResponseGenerally, this usually reflects a question on “Medical Necessity”, given the E/M code, and Diagnostic Modalities ordered given the Diagnosis Code.

Dr. Chiropractor’s Comment/QuestionAdditionally, they are denying reimbursement for services even when the documentation is there, like x-rays that we sent them an x-ray report on or exercises that are clearly noted in the records. It really seems that they are making us jump through extra hoops just because they can. Now we have to kill more time sending them the documentation that they already have and file an appeal.

Dr. Furno’s ResponseI am getting the sense that their Review Agent, has detected disconcordance in your clinical notes (SOAP - Subjective, Objective, Assessment and Plan), and has “flagged” you because of this. You need to find out if this is indeed the case, and if it is, correct it. Just so you know, most of these reviewers look for basic items, such as the History of Injury, then the E/M code selected, then the diagnostic modalities chosen given the History, then the Physical Exam findings (Orthopedic Tests) that support the Assessment (Working Diagnosis) and then, the decided upon Plan of Treatment. If all of these aspects of the clinical encounter make for a REASONABLE conclusion, then generally, the claim is passed on for payment. If there is a disparity between any of these items, there is reason for pending the claim for closer scrutiny. Dr. Chiropractor’s Comment/QuestionFinally, to add insult to injury, we are having claims denied that were “preauthorized” by XYZ Insurance Company, it seems that they are saying the treatment wasn’t preauthorized even though we have a copy in our records. I do not know if this is some glitch since they are new in this market or something more malevolent.

Dr. Furno’s ResponseIf indeed XYZ Insurance Company is denying “preauthorized” claims, you should make direct contact, per letter (paper-trail, again), with their Claims Manager outlining your concerns, and providing PROOF. Dr. Chiropractor’s Comment/QuestionI have spoken with the woman at the Indiana Department of Insurance (IDOI) and I am preparing a complaint, but as you know, denials have to be past 90 days old before they will act. She did say that I could complain about the pre-authorization issues in a letter. I am not sure how much we will gain with that.

Dr. Furno’s ResponseI know that dealing with bureaucrats can be frustrating, but perseverance must be maintained. Approach this in a systematic manner, by writing the Claims Manager of XYZ Insurance Company always carbon copying the Claims Manager of XYZ Insurance Company, and requesting their basis upon which they relied to deny your claims. Once you have that information, you can decide whether you are doing something wrong, or they are incorrectly reviewing your claims. You must also know what Guidelines they are using so that you are both on a level playing field and not talking past each other.

Make doubly sure that you are using the SOAP format of clinically recording your notes, and have a good grasp on the coding concepts of E/M (Evaluation & Management) Codes relative to Diagnostic Codes. If you believe that you are doing things correctly, then formulate a formal complaint to the IDOI. Complaint forms are available on the IDOI website at http://www.in.gov/idoi/.

WELCOME NEW ISCA MEMBERS!

Monique Levesque-Hartle, D.C.Chiropractic P.C.Fort Wayne, IN

Ryan Kain, D.C.ProActive HealthSouth Bend, IN

Sarah Masterson, D.C.Masterson Chiropractic ClinicWarsaw, IN

Doug Patterson, D.C.ProActive HealthSouth Bend, IN

INSURANCE Q & A SESSION CONTINUED...


Doug Patterson, D.C.ProActive HealthSouth Bend, IN

MILITARY EXPANDS OVERSEAS CHIROPRACTIC CARE TO OKINAWA

Although President Bill Clinton signed into law the "Permanent Chiropractic Benefit for Military Act" in October 2000, we all know that the military has moved at a snail’s pace to implement it.

According to Stars and Stripes, only sixty military clinics and hospitals — out of 232 military treatment facilities worldwide — are currently authorized to provide chiropractic care.

The pace of implementing chiropractic care at overseas military medical facilities is particularly glacial. Prior to July, active duty military personnel at only two overseas facilities — both in Germany — had access to chiropractic care, according to the Department of defense.

In July, a third overseas facility was added when civilian chiropractor Reggie Clifton reported for duty at Naval Hospital Okinawa.

“It’s just another tool in the toolbox for medical care," Dr. Clifton told Stars and Stripes. "I can honestly say that I have not had any pushback at all [from other doctors], we’re all keeping people fit to fight."

“It’s a much-needed specialty," said Navy Commander Bryan Bost, head of the Okinawa hospital’s Department of Physical Therapy, Occupational Therapy and Chiropractic Services.

Clifton, who followed his father’s footsteps as a chiropractor in 1987, is no stranger to the military, having run a chiropractic clinic at Offutt Air Force Base in Nebraska, “When I graduated from school, I never thought I’d see the day chiropractic care would come to be accepted so well by the medical community," he said. "I thought it might happen well after I retired."

Source Allen, David "Military expands overseas chiropractic care to Okinawa,” Stars and Stripes, August 27, 2010

PRACTICES FOR SALEThe practice of Dr. Robert Winchell (recently

deceased) is available in Evansville, Indiana. Thirty year old solid practice with a loyal patient base, specializing in sports and family care. The practice is active and currently managed by Dr. John McCleary. Serious inquires Dr. Tom Hamilton. 812-

457-5885. Posted 12/10/2010 (M)

Rural Southern Indiana. Established 30+ years with impeccable reputation. Practice

emphasis on family care, therapeutic massage and rehabilitation. Nice 1400 sq. ft. fully equipped building with good

signage. Excellent location along busy state highway. Dr. is ill, practicing three days per week, must sell ASAP. Turnkey practice Call

812-630-1822 Posted 9/1/10 (M)

ASSOCIATES WANTEDActive Chiropractic & Rehabilitation Clinic

Evansville, Indiana www.evansvillechiro.comMust be open to rehabilitation and

Active Release Technique and a licensed DC in Indiana with excellent patient

communication, service and technical skills.

Send confidential resume to [email protected] or (812)449-

4888

Rapidly expanding Lake County Indiana practice is looking for a full time position

to be filled. Enthusiastic, ambitious doctor is a must. Must be proficient in diversified,

thompson, inflection – distraction techniques. Salary and profit share of clinic are offered. Emailed resume to Dr. Daniel

Coffman at [email protected] 9/1/10 (M)

VACATION RELIEF 40 years experience. Multiple techniques, Rehabilitation, Extremities. References on

request. Larry E. Phipps, DC, CCEP2425 S. Co. Rd. 825 E. Walton, IN [email protected] 641-751-7755 Cell

Home 574-626-2975

CA WANTEDFront Desk/Patient Relations Position

Available Immediately. Salary Negotiable. Located on the corner of I69 and E 96th

Street in Fishers, IN. We are start up, stand

alone facility that exclusively provides digital motion x-ray to patients. This

position is perfect for the person who is a self starter and highly motivated, works solo / independently alot, is trustworthy with a POSITIVE attitude and will project a great polished image for the company.

UBER Scheduling Abilities, Bilingual, Billing Knowledge, Master PC Skills AND Personal

Injury and Workers' Comp Billing and Scheduling Experience are a PLUS. Inquire today by emailing your resume and letter of

interest to: [email protected] 8/6/2010 (M)

POST A CLASSIFIED ADISCA members may place classified ads for free and will run for two consecutive issues

unless otherwise requested.

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

317.673.4245.

INDIANA STATE CHIROPRACTIC ASSOCIATION CLASSIFIEDS

ISCA Report200 S. Meridian St. Suite 350Indianapolis, IN 46225317.673.4245www.IndianaStateChiros.org

PRSRT STD U.S. POSTAGE

PAIDINDIANAPOLIS, IN PERMIT NO. 779

Documents

ISCA Winter Newsletter 2010