The National Association of Chiropractic Attorneys (NACA) completed its 1990 annual meeting in San Antonio, Texas, November 9-11. Representatives from 26 state chiropractic associations, 3 chiropractic colleges, the ACA, the ICA, and the CCE attended.
The attorneys met to solve problems on insurance discrimination, independent medical examination discrimination, hospital staff privileges, malpractice protection, HMO discrimination and more. Ideas on more effective representation of chiropractic in state legislatures, congress, state and federal courts, state insurance commissions, local governments, and hospitals were presented to the lawyers to put to use.
NACA
The NACA is an association of attorneys who represent chiropractic associations, societies, and colleges. The NACA was organized over 20 years ago by lawyers from chiropractic associations desiring a network of communication. The NACA now has members representing associations from 42 states, the American Chiropractic Association, the International Chiropractic Association, and chiropractic colleges.
The NACA is apolitical and meets without regard to any philosophical position. Any political position is "left at home" and put aside when the lawyers attend NACA meetings or conferences.
The NACA meets twice each year: in November for the main business meeting, and in June for mid-year meetings when specific subjects are focused upon. Throughout the rest of the year the attorneys share information to keep current with events in other states, share important judicial decisions, and help each other with issues important to chiropractic. The NACA members participate on a voluntary basis to better represent chiropractic associations and chiropractic patients. In other words, the purpose of the NACA is to learn the "soup to nuts" about how to better represent chiropractic.
National Issues
George McAndrews, ACA counsel and lawyer representing the chiropractors in the Wilks et al. case and progeny cases, gave an update on the AMA appeal of the Wilks et al. decision, predicting a favorable ruling. True to predictions, the U.S. Supreme Court upheld the lower court's decision in favor of chiropractic just three weeks later. This will give a boost to the lawsuit that George McAndrews filed last year attacking an MD boycott of other MDs who associate with chiropractors. Tom Daily, ACA counsel, reported on the ACA briefs filed with the U.S. Supreme Court on the pending case attacking ERISA exemptions from state insurance laws. Unfortunately, the U.S. Supreme Court ruled three week later that ERISA plans are exempt from state insurance laws.
The ACA is continuing to work on correcting the discriminatory rule of the U.S. Department of Transportation which does not authorize chiropractic physicians to perform "truck driver's" physicals. Encouraging reports were given by Tom Daily about the ACA's new lobbyist for Congress who represents chiropractic concerns in the capitol. James Harrison, ICA counsel, gave encouraging reports about efforts by ICA to continue attacking discrimination against chiropractic on a national basis.
State Issues
The attorneys for each of the states reported on increasing success for chiropractic.
Mike Schroeder, attorney for the California Chiropractic Association, John Vos III, representing the Michigan Chiropractic Counsel, and Steve Dickerson, representing the Kansas Chiropractic Association each reported on successful million dollar law suits filed against insurance companies for bad faith discrimination in resolving claims for payment for chiropractic treatment. Attorneys from several states reported on apparent concerted efforts by the insurance industry to lobby state legislatures to authorize group insurance plans "stripped of all mandated benefits." Chiropractic is being included in the list of "mandated benefits" to be excluded in these "stripped down plans." Several states have adopted legislation authorizing these "stripped down plans." Several states have successfully fended off the attack but do not know how much longer they can hold out against the powerful insurance industry.
The 1990 Florida legislature passed a "non-mandated group insurance bill" without excluding payment to chiropractors. The lobbyist for the Florida Chiropractic Association convinced the legislators that physicians, including chiropractic physicians, are not "mandated benefits." Insurance policies pay for diagnosis and treatment of diseases, injuries or conditions; provisions for those payments is termed "medical expense benefits." Physicians diagnose or treat those diseases, injuries, or conditions included in the covered "medical expense benefits."
For example, diagnosis and treatment of a lumbrosacral sprain may or may not be covered as a "medical expense benefit." A physician who treats a covered lumbrosacral sprain should be paid without discrimination as to the health care discipline of the physician, if that injury or condition is covered as a medical expense. That is insurance equality.
Mike Kelly, attorney for the South Carolina Chiropractic Association, Robert Sherman, representing Ohio State Chiropractic Association, Arly Richau, representing the North Dakota Chiropractic Association, Steve Elliot, attorney for the Miami Valley Chiropractic Society, Jim Hogan, representing the New York Chiropractic Association, Scott Mayer, attorney for the Minnesota Chiropractic Association, Kevin Snell, representing Chiro Care, Ed Harker, representing the New Jersey Chiropractic Society, Des Taylor, representing the Texas Chiropractic Association, Philip Patton, representing the Kentucky Association of Chiropractors, and Aubry Villines, Jr., representing the Georgia Chiropractic Association each reported positive achievements for chiropractic in their states.
Paul Begich, from Minnesota, reported on the suit against the U.S. Department of Health and Human Services that he is lawyering on behalf of chiropractic and senior citizens. Paul Begich is seeking to eliminate discrimination in HMOs supported with Medicare funds that are not providing the manual manipulation benefits mandated by Congress. NACA members pledged continuing support by furnishing information and data from their states for the lawsuit.
Personal Notes
Ed Harker was recognized as the dean of chiropractic attorneys. Ed has represented chiropractic since 1946, longer than any other attorney! Ed Harker is responsible for establishing the foundation upon which other chiropractic attorneys have built their success. We are all lucky to have had Ed Harker representing chiropractic these many years!
An interesting personal note developed: It was discovered that NACA member Aubry Villines, from Georgia, is the great,-great,-great-grandson of William Travis, who was commander of the defense at the Alamo, located a block away from the NACA meeting. Aubry Villines was quite a celebrity when the lawyers visited the Alamo!
Need for Good Record Keeping Emphasized
Rod Phelps, from Parker College in Texas, Phil Buuckwalter, from L.A. Life College and Shawn Steel, from L.A. College each reported on the importance of chiropractic students, both in school and postgraduated, to learn the importance of good record keeping as the basis of good physician care. Each of the lawyers agreed to emphasize in their states the importance of better record keeping as a key to eliminating discrimination against chiropractic care.
Chiropractic is advancing quickly in some states, slower in others, but chiropractic is advancing. Each chiropractic attorney agrees that chiropractic will continue to advance as chiropractors continue to work in harmony for the good of their patients. Chiropractic is big enough and strong enough to accommodate different points of view within the profession.
NACA Resolution Against False Research Programs
The NACA members expressed deep concern over pseudo-research programs that are used as a guise for soliciting patients on behalf of chiropractors participating in these so-called research programs. It was reported to the membership that ersatz research programs are being promoted to chiropractors as a practice building mechanism. These programs solicit the public to participate in research projects and refer them to participating chiropractors, who then convince them of problems or conditions that need treatment. These people are then "signed up as paying patients."
These programs are not true research programs. They have no academic foundation, nor are they conducted in a scientific manner. Legitimate research projects that use people as subjects usually do not charge them for treatment or participation in the research programs. It is not uncommon for legitimate research programs to pay their subjects, rather than the other way around!
The NACA is concerned that chiropractors may become unwitting participants in these so-called research programs and be subjected to charges of fraud or malpractice.
The NACA adopted a strong resolution against false research programs that are not scientifically and academically founded, and which do not conduct recognized research programs. The NACA cautions all chiropractors to the potential liabilities of participating in such programs. Serious damage to chiropractic can result from public airing of such false research programs.
Future NACA Meetings
The NACA will hold its mid-year meeting in Toronto, Canada on June 29-30, 1991. The lawyers will conduct a seminar on suing insurance companies for bad faith in paying claims for chiropractic treatment. Also, the lawyers will focus on developing an informed consent form for use by chiropractors nationwide.
The annual business meeting of the NACA will be held November 8-10 in Miami, Florida.
The NACA lawyers work hard to learn to better represent chiropractic. These lawyers are the "best of the best" and do their best for chiropractic!
Paul Watson Lambert, Esq. is serving a fourth elected term as president of the NACA. Mr. Lambert practices law in Tallahassee, Florida and represents the Florida Chiropractic Association as general counsel. He has represented chiropractic for over seventeen years beginning as the Florida Assistant Attorney General representing the Florida State Board of Chiropractic Examiners. He later represented Florida Chiropractic Legal Affairs, Inc. and has represented the Florida Chiropractic Association since 1977. Mr. Lambert has authored numerous articles on chiropractic law, government law and professional licensing law. He is also contributing author of Florida Administrative Practice, published by the Florida Bar Association, and is the author of the soon to be published The Florida Law of Chiropractic. Mr. Lambert has served as president of the Florida Government Bar Association, of the Florida Second Judicial Circuit Nominating Commission, and as a member of the Florida Medical Examiners Commission.