Newsletter

May 2011

May 16, 2011
Just because you personally have not been involved in a Medicare audit does not mean you can let your defenses down!  
Palmetto GBA, the Medicare Carrier of California and Nevada issued a letter to Jurisdiction 1 Health Care Providers talking about November 2010 Medicare fee-for-service (FFS) claims error rate on paid claims error rate results nearly TWICE the national average for services rendered by Part B. All Medicare carriers have this information and are doing the same!     
The letter stated "BY FAR, the major component to the claims paid error rate is the lack of adequate documentation to support services billed."  The letter also stated, "You control the documentation describing the services your patient received, and your documentation serves as the basis for the bills sent to Medicare for the services you provided.  If your documentation does not support the services on the claim, then a payment error exists." 
Palmetto and MOST other carriers will be undertaking an AGGRESSIVE approach designed to address the cause of documentation errors.  They will INCREASE the level and frequency or pre-payment and post-payment reviews across all provider types. 
Medically unnecessary services are the result of:  
1.  Undocumented services. 
2.  Improperly documented services. 
3.  Insufficiently documented services.  
If you, as a Chiropractor and/or staff, do not know specifically what documentation is or believe documentation is only your S.O.A.P. notes please consider our Chiropractic Medicare DVD.  These Medicare Carriers are ALL stepping up audits because they are aware most Chiropractors believe Chiropractic documentation is the S.O.A.P. notes....IT IS NOT!
Chiropractors must do Medicare correctly as a Chiropractor which is different than any other healthcare providers in Medicare. DOCUMENTATION IS WITH A FEDERAL DOCUMENT, NOT JUST S.O.A.P. NOTES!
May 18, 2011
Just like the bill in New Mexico, Illinois Senate Bill 1843 attempts to change the whole meaning of chiropractic by passing a law that does not "broaden the Chiropractic Scope of Practice.... but changes the foundation of chiropractic. Senate Bill 1843 has already passed the Senate and headed to the Illinois House of Representatives. This is NOT an ICA/ACA battle!!!! This is a chiropractic battle to preserve chiropractic as originated. The bill was structured by Dr. Winterstein of National University whose goal is to make chiropractic into Medicine. Illinois, being the only Medical Practices State, has been Dr. Winterstein's dream for changing chiropractic into another health discipline.
Please take a few moments to go online and type in State of Illinois Representatives. Hit search. There you will find a list of Illinois State Representatives. Please call as many as you can and ask them to defeat Senate Bill 1843 or call 1-800-423-4690 for instructions.
ICA Calls for Defeat Illinois Senate Bill 1843 The International Chiropractors Association (ICA) and the International Chiropractors Association Political Action Committee (ICA-PAC), in response to requests from large numbers of members in Illinois, are calling on all Members of the Illinois House of Representatives to vote NO on Senate Bill 1843.   This legislation contains language that states that, “nothing in this Act shall be construed to prohibit a chiropractic physician from providing advice regarding the use of non-prescription products.” The danger in non-prescription drugs being recommended by untrained individuals is of grave concern to ICA and can certainly put the public at risk. Likewise, doctors of chiropractic have no formal training in oxygen therapies that would be authorized by the bill.   The removal of the defining language that expressly states that the practice of chiropractic is without the use of drugs or surgery clearly tips the balance in the direction of the application of drugs and since no additional education or testing or any other qualifications are mandated, this legislation inherently places the public at risk.
We urge you to vote NO on SB 1843 because:
·   It places the public at risk since the new authorities given to chiropractors to advise on “non-prescription products” which incorporates a vast range of over-the-counter substances which if inappropriately used can cause great harm, does not require any additional education or testing.
·   Chiropractic is, by its longstanding educational and definitional history, a drugless profession.
·   The public is entitled to one truly drugless healing profession and chiropractic has filled this role with proven clinical and cost effectiveness for more than 100 years.
At the top of ICA’s concerns regarding this legislation is public safety.  Studies have estimated that as upwards of 300,000 individuals may die each year as a result of pharmaceutical and medical errors. [1] Of this stunning and alarming number, a growing proportion is from non-prescription substances.  According to a 2001 report in the Journal of American Pharmaceutical Association, more than $177 billion in excess costs in the health care supply chain can be attributed to medication errors.  Sadly, estimates indicate that more than eighty percent of life-threatening medication incidents are the result of physician error. [2]   Clearly, this is not an area or an environment in which any practitioner can make a safe and effective contribution with less than a gold standard set of qualifications and credentials.   SB 1843 provides for no additional education and testing as a basis for the expansion of chiropractic scope to include pharmaceuticals.  On this basis and out of other concerns, ICA urges that this bill be defeated.    If you have any questions or would like more information please contact the International Chiropractors Association at 1-800-423-4690 or by e-mail at chiro@chiroprctic.org.
[1] Starfield B. Is US health really the best in the world? Journal of the American Medical Association (JAMA) 2000 Jul 26;284(4):483-5. Starfield B. Deficiencies in US medical care. JAMA. 2000 Nov 1;284(17):2184-5.. [2] Gurwitz, J.H., Field, T.S., Harrold, L.S., et al, “Incidence and preventability of adverse drug events among elderly persons in the ambulatory setting, (JAMA) 2003;289(9) 1107-1116.
May 23, 2011
This past Friday I sent the above ALERT email across the United States in regards to an Illinois Senate Bill 1843 that slipped through the Senate and into the House of Representative for vote. We are asking for chiropractic support to contact all Illinois Representative to either Vote NO for SB 1843 the way it presently stands or vote YES after accepting the amendment to remove language that is confusing and unnecessary.
Illinois House of Representatives are being asked to strike the words "...from providing advice regarding the use of non-prescription products or..."
SB 1843 language creates confusion in that "non-prescription products" is not defined at all.  If the intent is to authorize the Chiropractic provider to provide advice on non-prescription drugs, then extensive additional education and competence testing is absolutely essential, if such authority is desirable at all.  No such educational provisions are included in the bill and this concept has not been thoroughly and forthrightly discussed and debated throughout the legislative process.
If the intent is to authorize advice on such items as braces, pillows, orthotics and related supports, nutritional products and other commonly applied devices, items and products, then the language is unnecessary since such materials and devices have been covered and authorized to be provided by doctors of Chiropractic under the current statutory language for many decades.
Consumers in Illinois are entitled to complete clarity on the professional authorities and qualifications of all health care professionals and without this amendment, SB 1843 represents a step away from this vital goal. 
Ask the Illinois Representative to please support this proposed amendment to SB 1843.
To contact any and all Illinois State representative go to: www.ilga.gov
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

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I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street


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