Pennsylvania Chiropractic Association

PCA’s Fairness in Copayment Act Introduced in Senate

URGE YOUR SENATOR TO SUPPORT SB 1391

PCA-initiated and supported Senate Bill 1391, sponsored by state Senator Charles McIlhinney (R- Bucks) and a host of bi-partisan co-sponsors, was introduced on to the floor of the Senate on February 13, 2012. In addition to McIlhinney, he was joined by the following co-sponsoring senators: John Rafferty (R- Chester), Lisa Boscola (D- Northampton), Michael Waugh (R- York), Richard Alloway (R- Franklin), Jay Costa (D- Allegheny), Richard Kasumic (D- Fayette), Donald White (R- Indiana), John Gordner (R- Columbia), Bob Robbins (R- Mercer), John Wozniak (D- Cambria) and Edwin Erikson (R- Delaware).

The legislation, designed to alleviate the problem of excessive and multiple health insurance companies’ copayment requirements, was referred to the Senate Banking and Insurance Committee.

PCA members should continue contacting their respective state senators, urging their support of the bill and an expeditious review process and movement through the state Senate.

Click here to view SB 1391

FIND YOUR LEGISLATOR

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MARK YOUR CALENDAR!

PCA Coding Institute Set for March 31 in Pittsburgh

PCA President Dr. John E. McCarrin announced that the first Coding Institute of 2012 will be held on March 31, 2012 at Pittsburgh’s Clarion Hotel on Holiday Drive. In November 2011, the re-launched program sold out two weeks before the event and member demand for the program has remained strong.

According to Dr. McCarrin, the Pittsburgh program is designed for a smaller audience of approximately 125 doctors and office staff. The non-CE program will start promptly at 8:00am and end at 4:30pm. There will be four exhibitors at the program and sponsorship opportunities for breakfast ($500), luncheon ($500) and AM/ PM breaks ($250 each).

Early registration discounts will be available until close of business on March 14; no exceptions after March 14. Registration fees are (early bird parenthesized):

PCA Member: $99 ($79)

Office Staff of PCA Member: $59 ($48)

Non-Member Chiropractor: $249 ($199)

Office Staff of Non-Member: $179 ($143)

An administrative cancellation fee of $25 per registrant will be applied to any cancellations after March 14 or any registrant who does not show for the program.

Further information will be sent to members later this month. To get your name on a waiting list, contact info@pennchiro.org.

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Mark Your Calendar: 2012 Annual Convention

PCA’s Annual Convention Committee announced that the 2012 Annual Convention will be held June 22-24, 2012 in Lancaster, PA at the recently built Marriott at Penn Square and the Lancaster County Convention Center. The convention will offer 24 hours of CE to doctors and office staff. Deep discounts for PCA members will apply, including an early bird discount. More details to follow shortly.

Because the 30 exhibitor booths sold out at the 2011 convention, the 2012 Annual Convention will offer 40 exhibitors, with booths open from Friday morning, June 22 through Sunday morning, June 24.

Members should watch for additional information which will be available in

late February/ early March.

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PCA MEMBERS WEBSITE NOTICE

AS OF JANUARY 27, 2012

The Pennsylvania Chiropractic Association's website is undergoing major changes in organization, content, and member features that will improve the quality and user-friendliness for you, the member of PCA.

Today, you received an email notice to explain how to access the MEMBERS' ONLY section of this website. Remember to check your JUNK MAIL if you do not see the email notice.

Thank you for your understanding and patience regarding these improvements.

We think you will be very pleased.

To visit the MEMBERS' ONLY section, click here and enter the password.

The MEMBERS' ONLY pages include What's New?, Insurance, Regulations, Issues-News, and Helpful Resources.

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Court Permits Licensed Chiropractors to Delegate Certain Adjunctive Procedures to Unlicensed Support Personnel

By Jason B. Martin, Esquire

The Martin Law Firm, P.C.

Read more. . .

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Fair Health Care Provider Contracting Act Hearing Slated for November 29 in Harrisburg

The Pennsylvania House of Representatives Insurance Committee announced a 1pm hearing on November 29 for House Bill 1763 (Printer’s Number 2257), the Fair Health Care Provider Contracting Act, sponsored by Representative Nick Miccarelli (R- Delaware) and others (Barrar, Costa, Creighton, Cutler, Davidson, et al).

PCA was a long-time supporter of the legislation that preceded HB1763 (HB1759), which contains many measures that would level the playing field between the provider community and insurance industry. PCA was extremely dismayed to see that only "physicians" and their organizations were included in the bill, which is a reversal of the prior legislation. On its own or in collaboration with other "non-physician" associations, PCA will aggressively argue for the inclusion of Chiropractors in HB1763 through written testimony that will be submitted to the House Insurance Committee.

HB 1763 - (PLS Summary)

(PN 2257) The Fair Health Care Provider Contracting Act provides for physician contracts with health insurers. The bill outlines criteria that shall apply to the availability of fee schedules and scheduled payment dates. A health insurer shall develop and implement a plan to reasonably permit its participating physician, participating physician group or participating physician organization to view on a confidential basis, complete fee information showing the applicable fee schedule amounts for the participating physician, participating physician group or participating physician organization pursuant to that participating physician's, participating physician group's or participating physician organization's direct written agreement with the health insurer. Each health insurer shall post to its provider website those services or supplies for which precertification is routinely required for its products, and shall update the posting to the extent the services or supplies for which precertification is routinely required changes. Notice of 90 days is required for any material adverse changes in the terms of its contracts, participating physician groups or participating physician organizations. The bill provides for disclosure of and commitments concerning claims payment practices and outlines a dispute resolution process for physician billing disputes.

HB 1763

Primary Sponsor: Miccarelli

Caption: Act providing for physician contracts with health insurers.

State Title: Providing for physician contracts with health insurers. (FIL)

Co-Sponsors: Barrar, Costa, D, Creighton, Cutler, Davidson, Haluska, Harhart, Harkins, Hornaman, Miccarelli, Murphy, Murt, O'Neill, Rock, Swanger, Youngblood

Click here for full version of HB 1763

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Is Your Practice Prepared for the 1/1/12

New Electronic Claims Format??

PCA Insurance & Coding Consultant David Klein, CPC, CHC

In preparation for the transition to ICD-10, all entities covered by the Health Insurance Portability and Accountability Act (HIPAA) that submit transactions electronically are required to upgrade from Version 4010/4010.A1 to Version 5010 transaction standards by Sunday, January 1, 2012.

The PCA stresses that it is important to remember that the upcoming Version 5010 transition is not only mandatory, but is also an integral step toward a successful ICD-10 transition. This change does NOT affect paper claims.

What should you do to prepare?

If you or your EHR system has not yet begun external testing, the PCA advises that you should take the following steps to ensure a smooth transition:

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Communicate with your software vendor and/or clearinghouse. If they already haven’t, encourage them to take action now and establish a communication plan.

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Take advantage of available resources. There are many different resources offering valuable information to organizations looking to streamline their Version 5010 transition. Additionally, CMS offers several tools to help you plan and execute your transitions to Version 5010 and ICD-10. Visit their website: https://www.highmarkmedicareservices.com

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CALL TO ACTION

Fairness in Co-payment Act

PCA’s legislative language regulating patient co-payments, currently in draft form in the PA Senate, is seeking co-sponsors for the bill. Do you know of a state senator who is pro-patient and pro-Chiropractor? Please ask her/ him to actively co-sponsor and support the patient co-pay legislative language by co-sponsoring the legislation that is being circulated by Senator McIlhinney. For further information, contact the PCA’s lobbyists at The Winter Group, 717-909-9560 and tell them your name and the state senator you have confirmed as a co-sponsor. THANK YOU!

Click here to read the Senator's memo and to share with your colleagues.

Click here for the Fairness in Co-payment Act draft

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CALL TO ACTION!

Open Letter to PCA Members about Insurance Complaints

on Behalf of the PCA Board of Directors

The PCA makes every effort to document provider complaints and take necessary action to help PCA members. In this case, PCA took your concerns to the PA Insurance Department Commissioner. Click here to read more!

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PCA’s November 12 Coding Institute a Sell-out Hit with Members

If there’s one complaint worth reading from Pennsylvania’s doctors, it’s “I want more…” With apologies to 80s disco vocalist Andrea True, “more, more, more” is exactly what PCA received in the form of feedback from the 232+ registrants of the re-launched PCA Coding Institute. In fact, other than a thirst for more programming like that presented at the November 12 event, the doctors were unanimously raving about the program’s quality content and high-level faculty. Read more. . .

Insurance Companies that Discriminate Against Doctors of Chiropractic

Third Party Discount Programs

Unnecessary Retroactive-Reviews that are Costly to Doctors

Professional DC Reviewers who Deny Care Without Supporting Documents and for no Good Reasons

Unnecessary Utilization Reviews

Limiting X-Rays

Limited Care

Unnecessary Paperwork

Chiropractic Riders

The Hassle-Factor: Restrictive Rules and Regulations that Inhibit Sound Clinical Care, Resulting in Problems for Patients and Doctors

A Unified Chiropractic Profession

ALL Philosophies of Chiropractice Care

YOUR Patients

Fair & Equitable Reimbursements

Access to ALL Insurance Plans; No Closed Panels

Access to Hospitals

Quality Continuing Education Programs

Legislative Protection of Act 188: Chiropractic Licensure Act

Chiropractic Wellness

Accurate Coding & Documentation

ONE Place for ALL of Your Professional Needs

YOUR Legal Rights

YOU!

PCA Fights Against:

Top Ten Reasons Why PCA Makes Good Business Sense for YOU!

Phone calls…do we ever get phone calls. One of my favorite calls to field is from former members or “never-been-affiliated” members, asking the same question (or a variation on the same theme): why should I belong to PCA?

I thought I’d share my response with you. I hope that one or more of the points resonates with each of you. Feel free to add to or cut from your list and pass it along to a non-member of PCA when you get the opportunity. Here we go: