ISCA Fall Newsletter 2010 by Indiana State Chiropractic Association

SEPTEMBER 2010

PRESIDENT'S MESSAGE: ISCA IS "GEARING UP" As I approach the final days of my second term as President of the ISCA, I realize how truly grateful I am for the opportunity to serve this great profession in this capacity. The ISCA is on a path of continued growth and strength representing the chiropractic profession in Indiana. Doctors across the state are “stepping up” to serve our Association and Profession as Board Members, Committee Chairs and Committee Members to keep us on the cutting edge of all issues concerning the practice of chiropractic in Indiana. The National Health Care Reform Movement brings with it uncertainty and great opportunity. Two major opportunities are: 1. Insurance company transparency which requires exposure of Insurance company profits and where their expenses are directed. The current proposed law requires that 85% of insurance company profit is directed toward health care payments to providers. 2. Major changes to ERISA: Currently, insurance companies can discriminate against health care providers by limiting coverage i.e.: 12/60 policies and other limitations pertaining to chiropractic coverage and “hide” behind the ERISA veil. Current language will prohibit such discrimination. The ISCA is heavily involved at the state level working with the Governor and other lawmakers to ensure the inclusion of chiropractic in all health care changes. Be sure to answer the “call” in the coming months when your help is needed. The ISCA is announcing the development of two new committees: 1. ISCA Acupuncture Committee chaired by Dr. Larry Jaggers will address ISCA member concerns and questions regarding acupuncture in Indiana. This committee will work to keep chiropractic at the forefront regarding the ability for Indiana chiropractors to protect their right to incorporate acupuncture in their practices. 2. ISCA Sports Committee chaired by Dr. Curtis Harris will work to

promote chiropractic involvement on all levels of sports events in Indiana. I encourage all of our members to visit the ISCA website to keep informed of current issues and events. Communicate with your District Director, Pat McGuffey, any committee chair or myself with any questions or concerns you may have. The whole idea of an association is communication between its members and acting as one with our strength in numbers. The ISCA membership continues to grow, currently at 400. This leaves 500-600 licensed DC’s in Indiana that are non-members. It is a critical time to have the continued support of our current members and to encourage non-members to join our efforts. Every dollar we spend, every effort we put forth goes DIRECTLY back into our profession. Indiana remains at the forefront as one of the most desired states to practice chiropractic. Through the years, the ISCA and its members have worked tirelessly to enact numerous laws to protect the freedom to practice chiropractic in Indiana and allow for insurance reimbursement. The ISCA works diligently to protect our current laws and advance our profession with future legislation. In closing, it has always been my belief that chiropractic is the greatest profession on Earth! Research and clinical experience continue to show the cost effectiveness and safety of chiropractic. A recent article, according to Fast Company, ranks chiropractic as fourth in the magazines top 25 careers in America. (see “Fast Company ranks Chiropractic No. 4, Vol. 51, Issue 4, page 8.) We need to continue to harness all of the “Good” this profession has to offer and educate society on all levels to bring chiropractic care to those in need. Once again, thank you for the privilege to serve. I am confident that the future ISCA leadership will continue to move this Association forward with the help of our members. I look forward to seeing you at the Fall Convention! May God continue to bless you, your families and this great profession! Anthony C. Wolf, D.C., F.I.C.C.

INSIDE THIS ISSUE PRESIDENT'S MESSAGE.....................................................................................1 ISCA BOARD OF DIRECTORS & STAFF INFO...................................................2 EXECUTIVE DIRECTOR'S MESSAGE................................................................3 OPEN UPRIGHT MRI AT ST. VINCENT CARMEL HOSPITAL.................................4 ISCA ANSWERS TO ADMIN QUESTIONS ON PATIENT PROTECTION ACT............5 CHIRO INTERESTS URGED TO VISIT W/ HOUSE & SENATE MEMBERS.....6 ACA INSURANCE LIAISON REPORT......................................................................7 WELCOME LORI REBUCK!..............................................................................7 HIPAA PRIVACY SERIES FAQS.........................................................................8

SEPTEMBER 2010

DO'S & DON'TS OF PROMO ACTIVITES FROM MEDICARE......................9 FEE-FOR-SERVICE PROVIDER ENROLLMENT REPORTING........................10 COSCA ANSWERS TO ADMIN QUESTIONS ON PATIENT PROTECTION ACT...11 CMS TO INCREASE REVIEW OF CHIRO SERVICES......................................12 ACA UPDATE FROM DR. TENNANT...................................................................12 STIMULUS MONEY............................................................................................12 PEAK ATHLETIC PERFORMANCE.......................................................................15 ISCA FALL CONFERENCE SESSIONS & REGISTRATION FORM......................16 ISCA CLASSIFIEDS............................................................................................19

ISCA REPORT

INDIANA STATE CHIROPRACTIC ASSOCIATION BOARD OF DIRECTORS President Anthony Wolf, D.C. Indianapolis, IN 317.898.1100 Drtony6900@aol.com

District Seven Diane Vuotto, D.C. Indianapolis, IN 317.898.6989 vuottojd@comcast.net

District Three Jason Russell, D.C. Fort Wayne, IN 260.483.5588 jdrussell10@hotmail.com District Four

DISTRICT DIRECTORS

District Eight Shaun Tymchak, D.C. Newburgh, IN 812.858.1008 drshaun@newburghchiro.com

Second Vice-President James Cox II, D.C. Fort Wayne, IN 260.484.1964 drj@coxchiroacu.com

District One Ron Daulton, Sr., D.C. Hammond, IN 219.932.8900 reddcdr@comcast.com

District Nine Nate Unterseher, D.C. Seymour, IN 812.524.2273 drn8@live.com

District Five David Frischman, D.C. Wabash, IN 260.563.8476 ccincpc@comcast.net

Secretary Michael Phelps, D.C. Martinsville, IN 765.342.2208 mikephelps55@att.net

District Two Gerard Hofferth, D.C. South Bend, IN 574.256.1008 drhof@aol.com

ALTERNATE DIRECTORS AT LARGE

District Six

Treasurer Chris Bryan, D.C. South Bend, IN 574.259.3355 cwbdc@aol.com

District Three George Joachim, D.C. Fort Wayne, IN 260.492.8811 drgeorge@aaronchiro.com

Immediate Past President Duane Binder, D.C. Clinton, IN 765.832.7777 Dbinder326@aol.com

District Four Peter Furno, D.C. Zionsville, IN 317.338.6464 pfurno@sbcglobal.net

Past President Representative Gary Billingsley, D.C. Indianapolis, IN 317.784.9311 tabill2k@comcast.net

District Five Derek Dyer, D.C. Huntington, IN 260.356.1616 drderekdyer@gmail.com

DIRECTORS AT LARGE

District Six Matt Howard, D.C. Muncie, IN 765.254.9481 info@howardchiro.com

First Vice-President Robert Tennant D.C. Shirley, IN 765.737.1117 doct@hrtc.net

David Davis, D.C. Winchester, IN 765.584.3665 Drddd@aol.com

Lewis Myers, D.C. Valparaiso, IN 219.464.4444 lew.myers@gmail.com Marian Klaes-Lanham, D.C. Seymour, IN 812.523.6476 drmarian@KlaesClinic.com

Thomas Carrico, D.C. 120 Industrial Dr. Lawrenceburg, IN 47025 812.537.5616 tcarricodc@aol.com C.C. Paprocki, D.C. Greenwood, IN 317.535.7507 John Volbers, D.C. Indianapolis, IN 317.299.3330 ecchiro@cs.com ALTERNATE DISTRICT DIRECTORS District One Chris Hayes, D.C. Crown Point, IN 219.661.8680 hayesfamilydc@hotmail.com District Two Bill Garl, D.C. Bremen, IN 574.546.1111 w.garl@comcast.com

E. Curtis Harris, D.C. Franklin, IN 317.736.7088 drcurtisharris@embarqmail.com

Awaiting Nomination & Board Approval District Seven Sheila Wilson, D.C. Indianapolis, IN 317.297.8800 indysportdoc@iquest.net District Eight Michael Toney, D.C. Terre Haute, IN 812.232.1464 Flopper1968@hotmail.com District Nine Douglas Breger D.C. Austin, IN 812.949.2273 doctorbreger@yahoo.com ALTERNATES: 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 associationâ&#x20AC;&#x2122;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.

INDIANA STATE CHIROPRACTIC ASSOCIATION STAFF & INFO

Patricia McGuffey Executive Director pmcguffey@LMVconsulting.com

Stephanie Higgins Director of Events shiggins@LMVconsulting.com

Lori Rebuck Association Manager lrebuck@LMVconsulting.com

Stacy Quasebarth Director of Communications squasebarth@LMVconsulting.com

Tom Johnson, CPA Chief Finanical Officer tjohnson@LMVconsulting.com

Connie Vickery Governmental Affairs cvickery@LMVconsulting.com

Debra Scott, IOM Vice President of Operations dscott@LMVconsulting.com

John Livengood Governmental Affairs jlivengood@LMVconsulting.com

ISCA REPORT

200 S. Meridian St., Suite 350 Indianapolis, IN 46225 info@indianastatechiros.org www.indianastatechiros.org 317.673.4245 phone 800.572.8002 toll-free 317.673.4210 fax Become a Fan on Facebook! facebook.com/indianastatechiros Follow us on Twitter! www.twitter.com/INchiros

SEPTEMBER 2010

EXECUTIVE DIRECTOR'S MESSAGE: PATRICIA MCGUFFEY, ESQ. Your Practice depends on what the Indiana Doctors of Chiropractic do before the November elections and the 2011 Legislative Session!! Crucial Legislative Summer Study Committees are currently meeting to address important legislative issues that were assigned during the regular Session of the Indiana General Assembly. Some of the most important to the Indiana State Chiropractic Association (ISCA) include the Health Finance and Medicaid Oversight Commissions. The study topics that ISCA will follow closely include: • Methods to increase availability of affordable coverage for health care services for all Indiana residents • The impact of new federal health and health insurance laws on the Indiana check-up plan • A special legislative report on Patient Protection and Affordable Care Act (PPACA) • The administration of public assistance in Indiana, including the process of making eligibility determinations Health Care Reform will be the major topic of discussion this summer just as it will be front and center during the 2011 Legislative Session. The Budget committee as well as the Health Finance and Medicaid Oversight Commissions have already convened meetings with Health Care Reform presentations on the agenda. It is obvious that Health Care Reform now called the Patient Protection and Affordable Care Act (ACA) will be a political football. The debate on Health Care Reform has carried over from the national level to the State where Republicans and Democrats will debate the cost and details of implementation of the “Affordable Care Act”. At the first meeting of the Health Finance Commission, an expert with the NCSL gave us an overview and the major points are below: • Maintains an employer-based health care system • Imposes a penalty on employers that fail to provide coverage or whose employees go to the health insurance exchange for coverage • Expands and modifies Medicaid to become the foundation for the reformed health care system • All individuals with incomes at or below 133% of the federal poverty level (FPL) are eligible • Requires individuals to obtain qualified coverage • Imposes a tax on individuals who fail to comply • Establishes subsidies for premiums and cost-sharing for individuals with incomes between 133% and 400% of the federal poverty level (FPL) • Establishes health care exchanges to help individuals and small businesses (initially) to purchase qualified coverage The Administration (FSSA) has convened and Interagency Task Force that held hearings to get input on three key questions regarding the impact of health care reform. The hearings were held separately for the insurance industry, business community, and health care providers. The ISCA presented testimony during the health care provider hearing that was developed by the ACA and ISCA’s Health Care Reform committee. The ISCA passed out handouts with the answers to the Administration’s questions as well as the answers that were developed by the Congress of State Chiropractic Associations (COSCA). The questions and answers are included in this newsletter. Indiana will establish an “exchange committee” that will over see the development of the exchanges which will be the blueprint for the Indiana’s insurance program for the newly eligible individuals. It will be important for ISCA to be involved with that committee. On another note, this year all 100 members of the Indiana House of Representatives are up for reelection as well as 25 of the 50 members of the Indiana State Senate. This election will be the most important election in more than 10 years because the newly elected Legislature will redraw the districts in 2011. The Districts play a large part in whether the legislator will be elected since they can be drawn to favor a Republican or Democrat in that particular district. It will be important for ISCA to support and elect legislators that support chiropractors. You can help the ISCA to elect legislators that support chiropractors by (1) being a regular contributor to ISCA’s BACKPAC, and (2) by meeting with your State Representative and State Senator and discussing your practice, education, and the

CONTINUED... SEPTEMBER 2010

ISCA REPORT

carmel.stvincent.org

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DOWN.

The Open Upright MRI At St.Vincent Carmel Hospital Standing, sitting, bending, or lying down. The Upright MRI at St.Vincent Carmel is a multiposition tool for joints, spine, instability of the foot and pelvic prolapse that delivers vastly improved diagnostics. Enabling diagnosis of patient weight bearing issues, it lets you view your patients in the situations that actually produce their pain. With conventional tubular MRIs you may be forced to surmise. The Upright MRI eliminates the guesswork. Your patients will benefit too. Not only does the Upright MRI provide higher levels of comfort for everyone, itâ&#x20AC;&#x2122;s also a great relief to those who are claustrophobic. Better imaging for you. Greater ease for your patients. The Upright MRI at St.Vincent Carmel. Call (317) 338-3224 to schedule.

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ISCA REPORT

SEPTEMBER 2010

EXECUTIVE DIRECTOR'S MESSAGE: CONTINUED importance appropriate chiropractic treatment is for your patients. I am asking you to do these two things that can make all the difference and determine whether we will be successful OR NOT in the 2011 Session. The time to start is NOW not after the elections are over in November –that will be too late. The ISCA is sending out surveys to candidates in open seats that ask crucial questions to the candidates regarding their position on chiropractic. The key questions are focused on spinal manipulation for chiropractors only and key insurance issues. If you would like to have the surveys and position papers to present to your local legislators and candidates, the ISCA would be happy to provide them for you. Our plan is to get our local DC members to meet with first members of the Senate and House Health committees and then the entire Indiana General Assembly legislators and candidates before the November elections. The future of Chiropractic depends on our educating legislators and candidates!! If you would like more information on Health Care Reform or other legislative issues, please feel free to contact me at pmcguffey@LMVconsulting.com or 317.673.4215. I hope you have an enjoyable Fall.

ISCA ANSWERS TO ADMINISTRATION QUESTIONS ON PATIENT PROTECTION AND AFFORDABLE CARE ACT What pieces of Patient Protection and Affordable Care Act (PPACA) reform concern you and/or your organization the most? Ensuring that the non-discrimination provision (section 2706) is not diluted through the regulatory process and that it applies to as many plans as possible, is of great concern. This provision of the legislation allows patients to have greater control over their choice of healthcare provider. We believe all patients should have this right. The way that plans are determined to have “grandfathered” status is also of concern to us. If the majority of health plans are granted grandfathered status and are exempt from a majority of the provisions of the legislation, the legislation may not truly impact our healthcare system. Determining the essential benefits for plans offered within the Health Care Exchanges is also of concern. As many states mandate chiropractic and other types of care, we want to ensure that patients obtaining health insurance through the exchanges will have access to non-invasive chiropractic care. The development of the Independent Payment Advisory Board is also of concern. This group will be given unprecedented control over Medicare. While we support efforts to reduce waste and fraud within Medicare, the power of this board of 15 individuals is of concern. What do you see as the current and future impacts of the PPACA to your organization? PPACA will impact all aspects of patient care and running a clinic. From the administrative aspects, such as mandatory participation in the Physician Quality Reporting Initiative beginning in 2015 to managing patient volume in response to the increase in the number of individuals with health insurance coverage. What are your thoughts and concerns regarding the Health Care Exchanges(s)? Again, the essential benefits of plans offered in the exchanges are very important to chiropractic. We want to make sure chiropractic care is an essential benefit. Additionally, an educational effort will need to be undertaken by the state to ensure that residents understand the exchanges, how they operate and how they are to be used to obtain insurance coverage. In addition, we want to make sure the exchanges allow for claims to be reviewed by like specialists. In addition, we want to make sure claims are reviewed using accepted chiropractic guidelines in our State. Basically, we want to make sure our State insurance laws have to be adhered to in the new exchanges.

SEPTEMBER 2010

ISCA REPORT

CHIROPRACTIC INTERESTS URGED TO PERSONALLY VISIT WITH HOUSE AND SENATE MEMBERS DURING SUMMER WORK PERIOD CRITICAL ELECTION YEAR SEEN AS OPPORTUNITY TO MAKE VOICES HEARD AS HEALTH REFORM IS IMPLEMENTED Both the US House of Representatives and the US Senate are currently on an extended constituency work period. This is the optimal time for state chiropractic organizations and individual DCs to seek face-to-face meetings with Congressional representatives and the Chiropractic Summit Government Relations Committee urges you to make this a top priority through August and into the first two weeks of September. The chiropractic profession needs to communicate to House and Senate members from both parties that we are looking to them to protect the openness, inclusiveness and objectivity of the health reform implementation process. More specifically, we need to challenge legislators by letting them know we are looking to them to be personally active in defending us and the patients we serve during the implementation process. We want their support in defeating efforts to repeal the provider anti-discrimination section, Section 2706 of the Patient Protection and Affordable Care Act (PPACA), and that we will also be looking for their support in the appointment of objective members of the commission established under the health care reform act to determine minimum essential benefits. Members of this commission will be appointed by the President in the coming months. Other issues to be addressed during your visits: • For U.S. House of Representatives members: Cosponsor HR 6032. HR 6032 directs the federal government to begin the commissioning of DCs into the U.S. Public Health Service Uniformed Corps. Bill is sponsored by Reps. Gene Green (D-TX) and Lee Terry (R-NE). • For U.S. Senate members: Cosponsor S 1204. S 1204 is the Senate companion to a bill that passed the House in May, with overwhelming support, phasing in chiropractic to all Department of Veterans Affairs major medical facilities by 2013. Bill is sponsored by Sen. Patty Murray (D-WA). If you have questions or need help in securing appointments with your federal legislators, please feel free to contact the Indiana State Chiropractic Association. DO NOT MISS THIS UNIQUE OPPORTUNITY TO MEET WITH YOUR HOUSE AND SENATE MEMBERS ON BEHALF OF CHIROPRACTIC! Indiana State Chirpractic Association info@indianastatechiros.org 317.673.4245 phone 800.572.8002 toll-free

YOUR INDIANA STATE CHIROPRACTIC ASSOCIATION HAS ENTERED INTO AN AGREEMENT TO PRODUCE OUR OWN PRIVATELY LABELED, TOPICAL ANALGESIC, CHIRO-GEL, WHICH HAS THE FOLLOWING BENEFITS: o o o o o o o

Maximum analgesic effect for pain relief No alcohol; therefore, no skin irritation or placebo cooling effect Non-flammable Nourishes the skin Available to ISCA members only Not sold to the general public online Protects your profits while helping fund ISCA programs

FOR MORE INFO LOG-IN TO THE MEMBERS-ONLY SECTION ON THE ISCA WEBSITE - WWW.INDIANASTATECHIROS.ORG

ISCA REPORT

SEPTEMBER 2010

WELCOME NEW ISCA MEMBERS! Hideman Chiropractic Center Kenneth Hideman, D.C. Goshen, IN

Hofferth Family Chiropractic Samantha Hofferth-Francis, D.C. Munster, IN

Payne Family Chiropractic Jessica Payne, D.C. Carmel, IN

Hofferth Family Chiropractic Joseph Hofferth, D.C. 9305 Calumet Ave., Suite A-1 Munster , IN

Lifeline Chiropratic Laura Cooper, D.C. Richmond, IN

Bloomington Sports and Wellness Amanda Smith, D.C. Bloomington, IN

Payne Family Chiropractic Jeremy Payne, D.C. Carmel, IN

Benjamin Jones Ballwin, MO

Green Meadows Chiropractic Brent Warvel, D.C. Greenfield, IN

SAVE THE DATE: MARCH 4-6, 2011

ACA INSURANCE LIAISON REPORT

2011 ISCA SPRING CONFERENCE

By Anthony C. Wolf, D.C., F.I.C.C.

Sheraton Indianapolis City Centre â&#x20AC;˘ 31 West Ohio Street

As the ISCA Liaison, I communicate by e-mail and a monthly teleconference with the ACA and their Insurance Relations staff. The purpose is to communicate various insurance issues affecting ISCA members to the ACA to detect a national trend and to provide support to our members on a state and national level. Have you ever asked yourself if a situation is only happening to you or is it happening to others? The only way to answer that question is to communicate your concerns to the ISCA. Current known issues include: 1. United Healthcare charging a copay for chiropractic manipulation (CMT) and charging a deductible for physical medicine services conducted on the same date of service in the same chiropractic facility.

Here's A Sneak Preview of One of the Keynote Sessions: Dr. James M. Cox and Ram Gudavalli, PhD, will present outcomes of on-going research studies at Loyola Medical Center, Palmer College and National University. They will highlight the federally-funded, research-driven, and proven flexion distraction and decompression spinal manipulation protocols for back and radicular pain with clinical outcome assessments. This will include the most complex back conditions of disc herniation and spinal stenosis which account for 95% of the enormous cost of treating back pain in the United States today.

WELCOME, LORI REBUCK, TO THE INDIANA STATE CHIROPRACTIC ASSOCIATION! It is our pleasure to announce that Lori Rebuck has joined the Indiana State Chiropractic Association on July 29, 2010 in the position of Association Manager.

2. Humana is changing CPT codes to what they feel is appropriate rather than the correct code submitted by the provider for services rendered. 3. Michigan BC/BS is separating chiropractic manipulation from physical therapy services performed on the same date of service and applying separate deductible and copay. 4. Healthways is taking over Humana Networks and applying severe restrictions and preauthorization for chiropractic services. (This is currently occurring in Southern Indiana which will more than likely move North.) If these issues are happening to you please let us know. If you have other insurance issues or concerns, please advise us. We are here to serve each other.

SEPTEMBER 2010

Amber Morton, D.C. San Antonia, TX

Lori brings with her over fifteen years of association management experience with national, state, and local associations with memberships ranging from 1,100 - 15,000 members. She has served as Membership Services Manager, Director of Customer Service, Director of Education, and Interim Executive Director. Lori has a Bachelor of Science in Business Management from Indiana State University. Lori Rebuck - ISCA Association Manager Phone: 317.673.4245 ext. 156 Email: lrebuck@LMVconsulting.com

ISCA REPORT

HIPAA PRIVACY SERIES FAQ’S By: Edie Ruark-Hofmann, President ICCOM, LLC You need to know about HIPAA Privacy and Security. This article is to help you understand your responsibilities under the HIPAA's Rules. Are you HIPAA compliant? Business Associate Agreements What is the intent of business associate agreements? One of the purposes of HIPAA again is to safeguard protected health information (PHI). To the extent you have control of protected health information, you must take appropriate steps to accomplish this security. In a health care practice, many of the provisions of this rule apply to “business associates” who have contact with you and, therefore, access to PHI. You cannot release or disclose PHI to business associates unless both parties have a business associate agreement in place. The business associate agreement must contain a confidentiality clause that holds the business associate accountable for protecting private PHI. The business associate cannot use or further disclose the information in any way that violates the Privacy Rule. When a relationship with a business associate ends, the business associate must return or destroy all PHI within a reasonable time frame. Who qualifies as a business associate? A business associate is any person with whom the practice discloses protected health information (PHI) for the purpose of carrying out, assisting in the performance of, and performing for or on behalf of, a function or activity for the practice. This includes persons or contractors who receive PHI from your practice in the course of providing a service to you. Having good policies and procedures in place, and having your staff familiar with them, is the best place to start. Only disclose confidential PHI to a business associate if the associate has taken steps to ensure the confidentiality of the information. What types of functions do business associates typically perform? Functions or activities typically performed that involve the use or disclosure of individually identifiable health information include claims processing or administration, data analysis, processing or administration, utilization review, quality assurance, billing, benefit management, practice management, and reprising. Who doesn’t qualify as a business associate? The following do not qualify as business associates under the Privacy Rule. • Employees • Contracted employees who perform a substantial portion of their work at your practice, such as a physical therapist • Some government oversight agencies

• Hospitals, unless the hospital performs billing services for staff providers. What about when information is shared for treatment purposes? Any practice or provider may share protected health information (PHI) with a health care provider for treatment purposes without a business associate agreement so long as information is used to treat the patient and not for other unrelated usage, Do I need a business associate agreement for my cleaning service? You are not required to enter into a business associate agreement with your janitorial service because the performance of such service does not involve the use or disclosure of protected health information (PHI). In most cases, a janitor has incidental contact and such disclosure is permissible as long as reasonable safeguards are in place. It would be ideal to lock the records room or store records in lockable cabinets. Since I already have an attorney-client relationship with counsel, do I need a business associate agreement? While the Privacy Rule does not intend to interfere with this relationship and feels access to privileged protected health information (PHI) is limited, it does believe that it is appropriate to have attorneys sign a business associate agreement. What about organizations that act merely as a conduit of protected health information (PHI); The rule does not require a business associate agreement with a person or organization that acts merely as a conduit of information, such as the U.S. Postal Service, certain private couriers, and their electronic equivalents. Since no disclosure is intended and the probability is small for incidental release, no agreement is necessary. Neither are financial institutions considered business associates when it processes consumer-conducted financial transactions by debit, credit, or other payment cards, checks, or electronic funds transfers. Covered entities that initiate such payment activities must meet the minimum necessary disclosure requirements. PHI Return or Destruction: What is the requirement for the return or destruction of protected health information (PHI)? The Privacy Rule requires the return or destruction of all PHI at the termination of a contract only where feasible or permitted by law. When return or destruction is not feasible, the contract must state that the information will remain protected as long as maintained and any further use of this information will be limited to those purposes that make return or destruction infeasible. Destruction of records in your possession should include cross shredding. You can purchase those shredders at your local office supply store.

ISCA REPORT

CONTINUED... SEPTEMBER 2010

HIPAA PRIVACY SERIES FAQ'S CONTINUED... Staff Training: What are the requirements for training my staff and who needs to be trained? There are no set standards for training in the federal regulations except that all start, including professional staff such as doctors, must be trained initially and annually about HIPAA privacy. This training must take place before (effective date). All new employees must receive HIPAA training as part of their initial orientation to your practice. Privacy is very important in health care and training your staff to understand the regulations can help to avoid accidental disclosures of information and privacy complaints from patients. Annual privacy training is strongly advised for your practice. Everyone that handles protected health information (PHI) should be trained in the HIPAA regulations. Everyone who works in your office should be trained about confidentiality. What does my staff need to know about HIPAA? They should understand the patient rights listed in the Notice of Privacy Practices (NPP) and how to handle any questions or requests by a patient. Having good policies and procedures in place, and having your staff familiar with them, is l the best place to start. A HIPAA privacy training agenda is provided below to assure that the basic information is covered. This may be modified to suit your practice needs. All doctors, staff employees, and contract

personnel should sign a confidentiality agreement. Everyone in your office should be trained about patient confidentiality including your cleaning service and maintenance people. How do I prove training took place? Use a sign-in sheet, keep an agenda of issues covered, and document your staff’s training in their employment records. The best way is to test your staff with a written test. Issue each staff person a certificate upon successful testing. You should retain HIPAA training records for six (6) years. State Verses Federal Law HIPAA requires that you know, understand and follow your state law. You are required to be compliant with whichever is more stringent. For further explanation about the HIPAA rules and more about the compliance manuals available visit wvvw.iccom. org/index_files/ICCOMProducts.html. Email any questions you may have to edie@iccom.org Source: MAC - August 2010

DO’S AND DON’T OF PROMOTIONAL ACTIVITIES FROM MEDICARE A recent bulletin from the National Medicare Training Program outlined some of the “do’s and don’ts” of promotional activities. Below are some tips from the bulletin that are intended to assist providers when determining how best to promote their practices. The list, while mostly intended for Medicare Advantage Plan promotion, givers a good summation of things to keep in mind when developing any marketing strategy. PROVIDERS CAN • Provide the names of plans that they contract and/or participate in • Provide information and assistance in applying for low-income subsidy • Provide objective information on specific plan formularies, based on particular patient’s medications and health care needs • Provide objective information regarding specific plans, such as covered benefits, cost sharing, and utilization management tools • Distribute marketing materials, except for Medicare Advantage Plan enrollment application forms • Refer patients to other sources of information from the CMS Web site • Use marketing materials comparing plan information created by a third party that doesn’t provide benefits or health care services • Display posters or other materials that advertise their relationship with the plans • Help beneficiaries enroll in a plan that “best meets the beneficiaries’ needs” PROVIDERS CANNOT • Direct, urge, or attempt to persuade any prospective enrollee to enroll in a particular plan or to insure with a particular company based on financial or any other interest of the provider (or subcontractor) • Collect enrollment applications • Offer inducements to persuade beneficiaries to enroll in a particular plan or organization • Health screen when distributing information to patients, as health screening is a prohibited marketing activity • Offer anything of value to induce plan enrollees to select them as their provider • Expect compensation in consideration for the enrollment of a beneficiary • Expect compensation directly or indirectly from the plan for beneficiary enrollment activities SEPTEMBER 2010

ISCA REPORT

FEE-FOR-SERVICE PROVIDER ENROLLMENT REPORTING RESPONSIBILITIES FOR INDIVIDUAL PHYSICIANS Reportable Physician Changes After enrolling in the Medicare Program, all physicians are responsible for maintaining and reporting changes in their Medicare enrollment information to their designated Medicare contractor. By reporting changes as soon as possible, physicians will help to ensure that their claims are processed correctly. The reportable events listed below may affect claims processing, a payment amount, or a physician’s eligibility to participate in the Medicare Program. Physicians are required to report the following reportable events as soon as possible, but no later than 30 days after the reportable event. • Change in Practice Location occurs when a physician establishes a new practice location, moves an existing practice location, closes an existing practice location, or changes any portion of an existing practice location address where Medicare information is sent. • Change in Final Adverse Action occurs when a physician is debarred or excluded by any Federal or State health care program, has his or her medical license suspended or revoked by a State licensing authority, was convicted of a felony within the last 10 years, has his or her Medicare billing privileges revoked by a Medicare contractor, or has a revocation or suspension by an accreditation organization. Physicians are required to report the following reportable events as soon as possible, but no later than 90 days after the reportable event: • Change of Business Structure occurs when a physician changes his or her business structure (e.g., sole proprietorship to sole incorporated owner or vice versa). • Change in Organization Legal Business Name/Tax Identification Number occurs when a business owner changes the organization’s legal business name and/ or Taxpayer Identification Number with the Internal Revenue Service. • Change in Practice Status occurs when a physician decides to retire or voluntarily withdraw from the Medicare Program. This type of change is referred to as a voluntary withdrawal. Other Reportable Changes Include: • Change in Reassignment of Benefits occurs when a physician adds or voluntarily withdraws his or her reassignment of Medicare benefits. Physicians must report this type of change on the CMS-855R, • Change in Banking Arrangements or any Payment Information occurs when a physician changes his or her bank or bank account or makes other payment information changes. This type of change should be re- ported immediately to the Medicare contractor; a physician can update his or her electronic funds transfer information by submitting the Electronic Funds Transfer Authorization Agreement (CMS-588) to his or her Medicare contractor.

Additional Information: Physicians can apply for enrollment in the Medicare Program or make a change in their enrollment information using either: • The Internet-based Provider Enrollment, Chain and Ownership System (PECOS) • The paper enrollment application process (eg., CMS855I) There are three basic steps to completing an enrollment action using Internet-based PECOS. Physicians and nonphysician practitioners must: 1. Have a National Plan and Provider Enumeration System (NPPES) User ID and password to use Internet-based PECOS. • For security reasons, passwords should be changed periodically, at least once a year. • For information on how to change a password, go to the NPPES Application Help page available at https:// nppescms. hhs.gov/NPPES/Welcomedo and select the "Reset Password Page" on the NPPES Application Help page. 2. Go to PECOS at https://pecoscms. hhs.g0v to complete, review, and submit the electronic enrollment application via PECOS 3. Print, sign, and date the two-page Certification Statement and mail it with all supporting paper documentation to the Medicare contractor within seven days of the electronic submission. NOTE: A Medicare contractor will not process an Internet enrollment application without the signed and dated twopage Certification Statement and the required supporting documentation. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed two-page Certification Statement that is associated with the Internet submission. Physicians who are enrolled in the Medicare Program, but have not submitted the CMS-8551 since 2003, are required to submit a Medicare enrollment application (i.e., lntemetbased PECOS or the CMS-855I) as an initial application when reporting a change for the first time. If a physician has any questions about reporting a change, the physician should contact his or her designated Medicare contractor in advance of submitting the CMS-8551. For additional information regarding the Medicare enrollment process, including Internet-based PECOS, go to http://www.cms.hhs.gov/MedicareProviderSupEnroll on the CMS website.

ISCA REPORT

SEPTEMBER 2010

COSCA ANSWERS TO ADMINISTRATION QUESTIONS ON PATIENT PROTECTION AND AFFORDABLE CARE ACT What pieces of PPACA reform concern you/and or your organization the most? From a macro perspective, the overall question of broadest concern to the chiropractic profession remains the extent to which the provisions of the PPACA in their entirety, and as its various and individual provisions are implemented, results in the achievement of a paradigm shift in health care delivery away from the current and predominantly “sick care” oriented system towards a “wellness” and “patient centered” system that would favor the chiropractic profession’s traditional holistic and hands-on approach to health care with its emphasis on conservative, non-surgical, non-pharmaceutical oriented care. The achievement of such a paradigm shift would clearly result in the broader and more routine use of chiropractic care to treat a range of widespread neuro-musculoskeletal conditions. The aforementioned paradigm shift would clearly seek to maximize the chiropractic profession’s potential to improve our health delivery system by: 1) reducing costs by substituting chiropractic care for more expensive and often less effective forms of care for the treatment for a range of spinal-related maladies, including back pain; 2) expand access to range of providers and treatment options giving consumers greater choice; 3) reduce medical errors via the avoidance of unnecessary surgical procedures and hospitalizations often associated with such errors; 4) reduce the use of drugs; 5) improve patient outcomes and increase worker productivity, including reducing the number of lost work days due to spinal related injuries. Clearly related to the above, is the extent to which policy and decision makers within the employer community, the insurance industry, and provider delivery networks, come to view chiropractic care as an “essential” mainstream health care service and benefit fundamental to the functioning of a true “wellness” oriented delivery system versus the unenlightened and outmoded view that chiropractic care is merely an “add on” service. In addition to the above broad level area of interest, as health care providers, doctors of chiropractic are also concerned about a variety of specific related issues including the following: 1) the extent to which the transition from a largely paper-based record keeping system to one that includes uniform electronic standards, operating rules and electronic health records, takes place in a clear, efficient and cost affordable manner; 2) the extent to which the excise tax on “Cadillac” health insurance plans impacts the coverage and availability of chiropractic care, particularly in the longterm; 3) the extent to which Accountable Care Organizations (ACO’s) include the participation of doctors of chiropractic and the impact of enhanced “horizontal coordination” SEPTEMBER 2010

among providers; 4) the extent to which the work of the Independent Payment Advisory Board (IPAB) serves to result in reimbursement policies and rates that fairly compensate and reward doctors of chiropractic not only in Medicare but in private delivery systems; 5) the extent to which the state-based exchanges remain consumer friendly , expand and become viable marketplaces; 6) the extent to which the state-based exchanges serve to enhance and protect consumer choice and access to chiropractic care; 7) and the extent to which existing “grandfathered” plans trigger the application of the full range of consumer protections embodied in the PPACA including specifically Section 2706 of the Act; 8) the extent to which state-enacted consumer protections and insurance guarantees continue to apply in the marketplace. What do you see as the current and future impacts of the PPACA to your organization? As we represent the interests of a specific health care provider group, our professional association will be called upon to help educate our members (and also to an extent the patient population they serve) as to the various provisions of the PPACA; how to best and efficiently comply with them; how to best address uncertainties and ambiguities that exist now or may come to exist in the future regarding the impact of the PPACA’s implementation. Additionally, our organizations will be expected to not only liaise with appropriate oversight authorities, but to activity work to influence the implementation of the PPACA in such as manner as ensure the fair treatment of our members and that the patient population they serve is afforded adequate access to chiropractic care without the imposition of unfair barriers. What are your thoughts and concerns regarding the Health Care Exchange(s)? Professional associations such as ours must be afforded a permanent and active opportunity to have input into how the Health Care Exchange(s) function in our state – and to gather valuable feedback from oversight authorities over the operation of the Exchange(s). Opportunities to solve problems, address consumer and provider concerns must be established and maintained as part of the Exchange process. The structure and system for operating and governing the Exchange should guarantee maximum transparency and should orient itself towards the preservation of consumer choice and empowerment. Section 1323(d) of the PPACA also calls for the establishment of an advisory council in each state for community health insurance options, related to the exchanges. We believe that, in the interest of provider diversity, a doctor of chiropractic be allowed to serve on this

ISCA REPORT

CMS TO INCREASE REVIEW OF CHIROPRACTIC SERVICES By David Elliott Jose, Esq. CMS recently announced that it would be increasing the level of medical record audit review of chiropractic services. This increased review is in response to the President’s executive order issued on November 20, 2009 regarding “Reducing Improper Payments and Eliminating Waste in Federal Programs.” The executive order is focused on eliminating payment error, waste, fraud and abuse in federal programs, and is focused on federal agencies beyond CMS. CMS is conducting its studies under its Comprehensive Error Rate Testing (CERT) program.

purposes, then it will deny claims and seek to recoup the alleged overpayment. Medical records will be requested from selected chiropractors by the CERT Documentation Contractor. The letter from that contractor will instruct the chiropractor to provide the previous 12 months of medical records for the identified beneficiary. Failure to respond to the request and provide the medical records within the specified period of 30 days will result in a full denial of the claim, and could lead to further investigation for potential fraud. It is anticipated that this initial process will focus on a limited member of beneficiaries with multiple claims from the same chiropractor. However, depending upon the results of the initial effort, this process will be expanded.

CMS is focusing on chiropractic services in part because of its questions regarding the “medical necessity” of chiropractic care for therapeutic purposes as opposed to “maintenance therapy” not covered under Medicare. Under the 2009 Medicare fee-for-service setting, CMS estimated an error rate for chiropractic services of 31.7%. “Maintenance therapy” as well as missing care plans are believed to be principal causes for these anticipated errors.

It is important that chiropractors be prepared for responding to requests for medical records by audit contractors and third party payors. Having a policy in place and protocol for properly responding to such requests is essential and carries important financial and legal implications. If you have questions about the process, you may contact David E. Jose at 317.238.6211 or djose@kdlegal.com. Each situation is different and important, and deserves careful review and response.

CMS will be reviewing medical records up to a 12 month period prior to the date of service on a specific claim. If CMS determines that the claim in question is for “maintenance”

Material contained herein is not to be considered legal advice to any particular person. Each person's circumstances are unique and must be evaluated individually. Competent legal counsel should be sought before taking any action in reliance upon the information contained in this article. The contents of this article may not be reproduced or distributed without the express written consent of Krieg DeVault LLP.

ACA UPDATE FROM ACA REP. DR. ROBERT TENNANT NEW KAISER POLICY EXCLUDES CERVICAL MANIPULATION, ACA RESPONDS

Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group recently revised their Chiropractic Manipulation Medical Coverage Policy to exclude cervical Chiropractic Manipulative Treatment (CMT). The revised policy states, “Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage.”

Last week, ACA sent a letter to Kaiser outlining the extensive data that supports cervical spinal manipulation as both

beneficial and safe. The ACA also released the following statement: "The American Chiropractic Association is aware that Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group have revised their Chiropractic Manipulation Medical Coverage Policy to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage. This restriction, if allowed to stand, will be harmful to chiropractic patients and doctors. We have contacted Kaiser to express our grave concern over this change, and we await its reply. ACA will expend every effort to encourage Kaiser to reverse this new restriction, and we will keep our members and the profession informed along the way." – ACA President, Dr. Rick McMichael

STIMULUS MONEY By James M. Cox, II, D.C. - ISCA/ACA Medicare CAC Rep. Chiro. We have all been led to believe that the stimulus money, namely 44K worth, is all within reach for the taking. You are also being courted by several companies promising help in getting it to potentially buy their EHR product. This article by ACA (Get with the Program), http://www.acatoday.org/ content_css.cfm?CID=4036, explains the criteria, namely you must have $24,000 in allowable charges/year, as well

as how the money is distributed. Just a ball park figure, that's about 1000 cmt procedures per year. With the audits we are enduring, both CERT and local audits, achieving that many without a large amount of scrutiny and interference may be a daunting and frustrating task. I bring this to your attention just so you know the facts of obtaining these monies.

ISCA REPORT

SEPTEMBER 2010

ISCA ONLINE MEMBERSHIP DIRECTORY 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 info@indianastatechiros.org. Thank you!

ISCA Website Membership Directory Basic Free Listing First Name:__________________________________________________Last Name:_________________________________________________ Clinic Name: _________________________________________________________________________________________________________ Clinic Address: ________________________________________________________________________________________________________ City: _______________________________________________________________ State: ________________

Zip: _____________________

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

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 SEPTEMBER 2010

ISCA REPORT

PREMIUM LISTING - $100 A YEAR Premium Listing - $100 Yearly Rate Website: ___________________________________________________ Office Email:_____________________________________________ Secondary Office Location(s):___________________________________________________________________Praciting Since: _________ Education: ____________________________________________

Profile Picture (Email JPG file to info@indianastatechiros.org)

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

Twitter: ______________________

Facebook: _____________________________

Foursquare: _____________________

Insurance Accepted: q Medicare

q Medicaid

q Healthy Indiana Plan

q Anthem Blue Cross Blue Shield

q Aetna

q United

q Humana

q Sagamore

q Other:______________________

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: q

Gonstead

Logan Basic

Torgue Release

Activator

Nimmo Trigger Point Therapy

Toftness

Applied Kinesiology

Motion Palpation

Pierce

Bio-Energetic Synchronization(BEST)

NUCCA

Myofascial Release

Cox Flexion Distraction

Neural Emotional Technique

Spinal Decompression

Thompson Terminal Point

Atlas Orthogonal/Upper Cervical

Craniopathy

Palmer Toggle Recoil

Diversified

Sacro-Occipital Technique (SOT)

Pettibon

Modalities: q Ultra-violet

Galvanic

Electrical Muscle Stimulation

Ultrasound

Short Wave

Low Intensity Laser Therapy

Hydro-Therapy

Diathermy

Specialties:

Diplomate of the American Chiropractic Neurology Board

Diplomate American Board of Chiropractic Orthopedists

Certified Chiropractic Extremity Practitioner

Certified Chiropractic Sports Practitioner

Diplomate—American Board of Chiropractic Internists

Chiropractic Certification on Spinal Trauma

Diplomate, American Chiropractic Board of Radiology

Fellow, Academy of Chiropractic Orthopedists

Diplomate American Chiropractic Board of Sports Physicians

Certified Clinical Nutritionist

Board Certified, Rehabilitation, Musculoskeletal System

Diplomate of American Chiropractic Board of Nutrition

Alternative Services:

Nutrition

Homeopathy

Therapeutic Massage

Sports Chiropractic

Chiropractic Orthopedics

Physical Therapy

Pediatrics

Orthotics

Acupuncture

Rehabilitation

Return to:

Indiana State Chiropractic Association 200 South Meridian St., Suite 350 Indianapolis, Indiana 46225 800.572.8002 toll-free• 317.673.4245 • 317.673.4210 fax • www.indianastatechiros.org • info@indianastatechiros.org

PEAK ATHLETIC PERFORMANCE By Valerie L. Smith, The Georgia Chiropractor Summer 2010 Both professional and recreational athletes are always searching for ways to enhance their performance, and two Georgia doctors of chiropractic say chiropractic care can provide that edge.

Special Olympics athletes are a big part of our practices. We perform physicals for them every year," Wren said. “We evaluate and approve them for various physical activities and provide or refer for treatment if we see a problem."

"Athletes are looking to take a millisecond off a sprint, for help with the placement of a pitch or to be better able to make a basketball shot," explained Dr David Wren of Chiropractic and Sports Injury Center in Leesburg. "We take care of injuries, evaluate previous injuries, restore proper spinal balance and alignment, recommend rehabilitation and conditioning exercises and provide nutrition counseling so athletics can return back to their sport at an optimum level."

We evaluate patients with Down syndrome who sometimes have problems with the atlantodental ligament, which may predispose them to instability in the upper part of the neck. In those cases, they might be restricted from participating in certain sports that might cause problems, such as equestrian, diving and gymnastics," he explained.

Injuries are all too common in active athletes. From acute impact injuries to wear and tear from overuse, Wren and Dr. Josh Glass of Georgia Sports Chiropractic in Atlanta have treated them all, from the legs through the neck. "Joint adjustments, extremity adjustments and manipulation help these injuries, as does massage." Glass said injuries are generally related to the sport. "What part of the body you’re using or gets hit is where you have the injury" he said. Because he treats many runners and triathletes, he sees a lot of low back and leg problems, while Wren, who sees more team sports athletes, has noticed a lot of shoulder lower back, knee and neck injuries, as well as rotator cuff impingements. Joint adjustments, extremity adjustments and manipulation help these injuries, as does massage," Wren said. "I’ve found athletes prefer to have their injuries treated without drugs or surgically" Both doctors also counsel patients on preventing injuries, as well. “Building up your core strength is a good injury prevention tool because it strengthens the smaller muscles connecting to the spine and pelvis," Glass said. Core strengthening exercises he recommends may include pilates, strengthening classes and work on the physioball. Wren said strength, agility and speed conditioning work can help improve performance and help prevent injuries, as well. “When we’re dealing with professional arena football players, we suggest a routine in their weight room to build strength in their upper and lower bodies. For high school athletes, we suggest working with their trainer not only in the weight room for strength, but also performing stretching and theraband exercises to improve agility and running to improve speed," he explained. Having a physical before beginning a sports program is also a good idea to identify and avoid potential problems.

SEPTEMBER 2010

Other activities recommended beyond regular conditioning and physicals include properly warming up before an event and cooling down after it. "Stretching after the event is equally important. You need to do the appropriate warm up and preparation for the sport you’re competing in. "Try doing the activity you’ll be performing at an easier, slower rate to lengthen the muscles you’ll be using during the activity," Glass suggested. “Stretching alter the event is equally important. You’ll need to stretch the opposing muscle groups to the ones you were using during the activity. If you’ve been injured, icing can help muscles recover. Place ice on the hurt area, but not directly on the skin, for 20 to 30 minutes and repeat as necessary. Heat is palliative, but it doesn’t promote healing like ice does," he continued. Common sense measures such as proper rest and nutrition are also vital to achieve peak performance. "Demands on an athlete’s body are different. Their caloric intake is higher than average, especially in contact sports. They need substantial amounts of carbohydrates, fats and proteins in their diets. Some athletes take whey protein supplements and use energy bars to boost the amount of protein they are ingesting," Wren said. "Some athletes think drinking high carb, sugary energy drinks will help improve performance, but that’s a mistake. It just provides them with empty calories," he continued. "Properly balanced nutrition is especially important in adolescent athletes." "And using the proper equipment is vital. Some contact injuries can be prevented with the right athletic equipment and safety gear," Wren said. Despite conditioning and prevention measures, athletes will inevitably be hurt from time to time. And they are responsible for ensuring they seek the proper treatment. "Athletes need to report any injuries to the coach or trainer, and they should discontinue participation in the sport until they’ve been treated, rehabilitated and adequately healed," Wren advised.

ISCA REPORT

2010 FALL CONFERENCE October 22-24, 2010 | Hilton Indianapolis North 8181 N. Shadeland Avenue Indianapolis, IN

EARLY BIRD REGISTRATION ENDS OCTOBER 1ST! FRIDAY, OCTOBER, 22 (5:30PM – 9:30PM): 101, Adv. Pain Mngt. Tech.,Osteoporosis & Vertebral Aug, Min. Invasive Spine Surgery SPEAKER: CDI - Dr. Kent Remley • Advanced Imaging 101 • Interventional Pain Management 101 • Advanced Pain Management Techniques • Osteoporosis and Vertebral Augmentation • Minimally Invasive Spine Surgery SATURDAY, OCTOBER 23 PART 1 (8AM–12PM) & PART 2 (2PM-6PM): Neurology & The Vertebral Subluxation Complex SPEAKER: Dr. Lisa Bloom DC, DACS, DIBCN SATURDAY, OCTOBER 23 SESSION 1 (8AM–12PM) (2 Hrs Risk Management) & SESSION 2 (2PM-6PM): Chiro., Acupuncture, & Nutrition (2 Hrs Risk Management) SPEAKERS: Dr. Larry Jaggers DC, Lac & Dr. Tommy Thompson DC, Lac

SUNDAY, OCT. 24 (8AM – 12PM): Chiro., Acupuncture, & Nutrition SPEAKERS: Dr. Larry Jaggers DC, Lac & Dr. Tommy Thompson DC, Lac SUNDAY, OCT. 24 (8AM – 12PM): Legal Compliance for Your Professional Practice and Association (4 Hrs Risk Management) SPEAKER: David Jose, ESQ. • Antitrust • Regulatory and Enforcement Investigations • Payor Audits and Appeals • Employment Laws and Personnel Practices The presenters will include David E. Jose and Randall R. Fearnow, along with other colleagues from the Indianapolisbased law firm of Krieg DeVault LLP.

THE ISCA & CATS CAREERS ARE PLEASED TO OFFER ADVANCED EDUCATION FOR CHIROPRACTIC ASSISTANTS

LIMITED MEDICAL RADIOGRAPHY PROGRAM & CHIROPRACTIC TECHNOLOGY CERTIFICATION PROGRAM

Upon successful completion of our comprehensive four educational sessions, Chiropractic Assistants have met the prerequisites and introductory classroom training components of the Limited Medical X-Ray License and Chiropractic Technology Certification programs. The following sessions are offered on October 24, 2010 in conjunction with the ISCA Fall Conference from 7AM to 6:30PM. CHIROPRACTIC TECHNOLOGY CERTIFICATION SESSIONS & LIMITED MEDICAL X-RAY PREREQUISITES Session 1: Medical Billing Specialists and Medical Office Assistant 3 hrs, 7-10AM $200 registration fee* on or before Oct. 1, 2010 / $250 after Oct. 2, 2010 Session 2: Chiropractic Technology 3 hrs, 10AM-1PM $200 registration fee* on or before Oct. 1, 2010 / $250 after Oct. 2, 2010 Successful completion of the above listed programs enables you to attend to the Limited Medical Radiology Program. Register online: www.indianastatechiros.org/fallconference

LIMITED MEDICAL RADIOLOGY PROGRAM Session 3: Mandatory Office Manager Orientation 1 hr, 1-2PM (This session will be offered via teleconference prior to the ISCA Conference if the Chiropractor or Office Manager is not attending the conference.) No cost to registrants. Session 4: X-Ray Program 3 hrs, 2:30–6:30PM $1,000 registration fee* due on or before Oct. 1, 2010 / $1,750 after Oct. 2, 2010 In addition to all of the above listed classes, Chiropractic Assistants will need to complete online course work (included in registration fees), laboratory rotations (done in employing D.C.’s office), CPR certification, and pass ARRT Limited Medical Radiography Exam (core and spine and/or extremities). Register online: www.indianastatechiros.org/fallconference ---------------------------------------------------------------------------------------------Take advantage of this special members only offer and save up to $4,000! This is an exclusive ISCA Member Benefit and is available to ISCA Members only. *Required course books and state required fees not included in the registration fees listed above and must be purchased through CATS Careers. Course registration fees will not be refunded, but may be transferred to another employee to attend.

Questions? Contact Stephanie Higgins at 317.673.4245 ext 135, 800.572.8002 toll-free or email shiggins@LMVconsulting.com

RETURN TO: ISCA 200CONFERENCE: S. MERIDIAN ST, SUITE 350 INDIANAPOLIS, IN 46225 22-24, OR BY FAX: 317.673.4210 ISCA FALL OCTOBER 2010 HILTON INDIANAPOLIS NORTH - 8181 NORTH SHADELAND AVE. INDPLS, IN 46250

CDI – DR. KENT REMLEY Fri. 5:30-9:30 DR. LISA BLOOM DC, DACS, DIBCN: Part 1 Sat. 8-12 DR. LISA BLOOM DC, DACS, DIBCN Part 2 Sat. 2-6

DR. LARRY JAGGERS DC, LAC & DR. TOMMY THOMPSON DC, LAC – Session 1 Sat. 8-12 2 HRS Risk Management

DR. LARRY JAGGERS DC, LAC & DR. TOMMY THOMPSON DC, LAC – Session 3 Sun. 8-12

DR. LARRY JAGGERS DC, LAC & DR. TOMMY THOMPSON DC, LAC – Session 2 Sat. 2-6 2 HRS Risk Management

DAVID JOSE, ESQ Sun. 8 -12 4 HRS Risk Management

Please indicate if you will attend the luncheon and After Hours, to assure we provide sufficient meals for all attendees. Additional lunches and After Hours tickets may be purchased for guests at $30.00 each. Attendance to lectures is by badge only, including spouses. I will attend the Saturday Luncheon & Membership Meeting YES____ NO____ (1 included with purchase of 8 or 12 hour package) I will attend ISCA After Hours YES____ NO____ (1 included with purchase of 8 or 12 hour package)

12 Hour Package

REGISTRATION TYPE

8 Hour Package

After Oct. 1 -------

Adv. -------

After Oct. 1 -------

$400

$230

3. Member (in good standing).... $400 4. Member (in arrears)................. $515

$450 $565

5. Non-Member............................. $535

$585

Adv. 1. Platinum.......... complimentary -------2. Gold & Silver.............................. $350

CA RATE: CA $109 (up to 8 hrs) GUEST RATE: Guest*/Student $75 LUNCH RATE: Lunch Ticket $30

4 Hour Package Adv. -------

After Oct. 1 -------

$280

$145

$195

$270

$320

$165

$215

$310

$360

$210

$260

$330

$380

$230

$280

(1 included with 8 or 12 hr packages)

AFTER HOURS: Additional After Hours Ticket $30

(1 included with 8 or 12 hr packages) * = non DC Guest

* = Members shall only be eligible for all membership benefits, including Fall Conference registration prices, if they are in “good standing.” The ISCA’s By Laws state the following, “a member shall not be in ‘good standing’ when his or her dues are more than two (2) quarters in arrears. ‘Good standing’ will be determined at the time registration is received in the ISCA office.

Platinum members of the ISCA may attend the Fall Conference free of charge but registration is still required.

CONTACT NAME ADDRESS

CLINIC NAME CITY

E-MAIL

PHONE (

)

STATE FAX (

ZIP )

PACKAGES

REGISTRATION TYPE 12 HR, (Example: Platinum, Member) (Example: CA, etc)

REGISTRANT NAME

Amount

$ ____________________________________________________________________________________________________________________ $ ____________________________________________________________________________________________________________________ $ ____________________________________________________________________________________________________________________ PAYMENT INFORMATION

Amex

Visa

Mastercard

Check (Make Payable to ISCA)

TOTAL $ _________

Cardholder:______________________________________________ Card #:__________________________________________________ Exp.______________

3 digit security #:_________________ Signature:__________________________________________________

Questions? Call 1.317.673.4245, or e-mail info@indianastatechiros.org / Refunds at 90% until Oct. 1. No refunds after Oct. 1.

RETURN TO: ISCA 200 S. MERIDIAN ST, SUITE 350 INDIANAPOLIS, IN 46225 OR BY FAX: 317.673.4210

INDIANA STATE CHIROPRACTIC ASSOCIATION

2010 GOLF OUTING

SEPTEMBER 17, 2010-1:00PM SHOTGUN START Hickory Stick Golf Course 4422 Hickory Stick Blvd. Greenwood, IN 46143

Sign up as a team or sign up individually and we’ll pair you up on a team. • Rain or Shine • 4-person scramble format • Team check-in - 11:00AM-12:45PM • Shotgun start - 1:00 PM • Dinner and prizes immediately after play $105 - Members/$130 - Nonmembers Fee covers green fees, cart, lunch, dinner, and drinks.

Advance Purchase Raffle/Contest Package

Buy a Raffle/Contest Package before the event and save $40

The package includes: • 2 mulligans for each member of your team • An armstretch of raffle tickets for each member of your team • 1 entry per team for the “skins game” $100 advance purchase $140 day of the event Limit: One per team

WHEN: Friday, September 17, 2010 / 1:00PM - Shotgun Start / Rain or Shine WHERE: Hickory Stick Golf Course 4422 Hickory Stick Blvd Greenwood, IN • Dinner and prizes immediately after play • Cost per golfer (per person): $105 Members/ $130 Non-Members (includes green fees, cart, lunch, dinner & drinks) • 4-person scramble format • Team check-in and lunch: 11:00AM 12:45PM

Company _________________________________________________________ Contact Name _____________________________________________________ Company Address __________________________________________________ City_____________________________ St. __________ Zip ________________ Phone _____________________________ Fax ___________________________ Email address: _____________________________________________________

T-SHIRT SPONSOR PAR 3 SPONSORS

Your team: 1. ________________________________________________________________ 2. ________________________________________________________________ 3. ________________________________________________________________ 4. _______________________________________________________________ Quantity

Amount

HOLE SPONSORS

Dinner Only @ $35 ea.

COX CHIROPRACTIC MEDICINE DR THOMAS CARRICO ISCA INSURANCE COMMITTEE DYER HEALTH & WELLNESS CENTER EAST WASHINGTON CHIROPRACTIC KRAUSE CHIROPRACTIC

Raffle/Contest Package @ $100 per team, One Per Team Golf Prize Donation: Sponsorship Type: Need a “sponsor’s” golf cart? __ yes __no Total Enclosed

__ MasterCard __ Visa __ Amex __Discover Card No. ____________________________________________ CID No. ________ 3-digit # next to signature line on back of card Exp. Date ____________________________________________

Individuals or teams welcome. Do all golfers want to play on same team?

Cancellations before Sept. 3, 2010 will receive 90% refund. No refunds after Sept. 3.

For more information or sponsorship opportunities contact: Stephanie Higgins - Director of Events 317.673.4245 ext. 135 shiggins@LMVconsulting.com

Yes ____

Cardholder’s Name ____________________________________ Signature:____________________________________________

LONGEST DRIVE SPONSOR

NEWBURGH CHIROPRACTIC

Golf & Dinner @ $105 ea. Nonmembers @ $130 ea,

Payment Options __ Check Enclosed

INDIANA MRI LANE ENTERPRISES PROSCAN IMAGING WHITE CONSTRUCTION

No ____

INDIANA STATE CHIROPRACTIC ASSOCIATION CLASSIFIEDS PRACTICES FOR SALE 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) Southside Indianapolis. Established 14 years. Located in professional building with Dentist, MDs and MRI facility. High growth community near St Francis Hospital. Gorgeous, open floor plan with rehab area, part time PT and fulltime LMT. 1000 visits monthly. 17 hr work week. Contact drmchiro@aol.com Posted 10/22/09 (M) Perfect opportunity for a new practitioner or someone looking for a satellite office. Established practice located in Peru Indiana (215 W. Main). 1 Exam room, 2 tables, and waiting room furniture included. Willing to negotiate. Contact Dr. Smelser at 765-4727610. Posted 10/17/09 (M) Practice which pays for itself and a doctor's paycheck! Collections about ÂźM per year. Small town practice. Doctors semi-retired. With down payment and contract, owner carries paper for associate doctor ready to own and grow. Contact tabascoi812@ hotmail.com Posted 09/17/09 (M) ASSOCIATES AVAILABLE Independent Contractor Available: New Independent Contractor looking to rent space in greater Indianapolis area from established doctor who has extra room. Why not make money on the extra space you are not using and help a new doctor get established? Contact Shelley Coughlin at 317-453-7005 or coughlindc@gmail.com. Posted 2/9/10 (M) Seeking full time associate position in successful Indiana practice. I am currently a student at Logan College of Chiropractic and plan to graduate in April, 2010. I am conscientious, reliable, and self motivated ATC (certified athletic trainer) seeking an

SEPTEMBER 2010

associate position that provides growth and learning opportunities. Main Techniques are Cox and Diversified, and also trained in Thompson & Graston. Please feel free to contact me with any questions or to request a copy of my resume. lizaschuck@hotmail. com Posted 1/29/10 (M) Seeking full time associate position. Current student at Palmer in Florida, will graduate in March. Looking to join practice in Louisville/ Southern IN area. Hard worker, dedicated, and passionate about chiropractic. Techniques used: Diversified, Gonstead, Thompson, Motion Palpation, Activator, Flexion Distraction, Graston. Contact Kyle Bowling (502) 594-8326, kylebowling@ gmail.com Posted 1/21/10 (M) Seeking part-time or full-time associate position. Very good rapport with patients and comfortable with fast-paced office. Mainly diversified technique, but comfortable with others. Adam Davis, DC (812) 767-0394 or dradamdavis@yahoo. com Posted 9/29/09 (M) ASSOCIATES WANTED 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 â&#x20AC;&#x201C; distraction techniques. Salary and profit share of clinic are offered. Emailed resume to Dr. Daniel Coffman at chirodan@comcast.net. Posted 9/1/10 (M) Associate wanted to take over practice of Doctor ready to retire. Call 877-897-9968. Posted 3/1/10 (M) Rapidly expanding Lake County practice in Crown Point, Indiana, is looking for full time position to be filled. Enthusiastic doctor is a must. Must be proficient in Cox Distraction, Palmer Diversified, and Thompson techniques. Salary and profit share of clinic are offered. E-mail resume to: chirodan@ comcast.net Posted 2/24/10 (M)

do. Contact us at spinedoc@drseland.com Posted 1/14/10 (M) EQUIPMENT FOR SALE Titan Table Automatic flexion-Distraction table with cervical, thoracic and pelvic drops. Very good condition. Black with automatic shut off timer and smooth running motor. Asking $2000.00. Contact me at 765-342-2000 or allaboutchirocare@ gmail.com Posted 2/3/10 (M) Bennett HFQ300 w/anatomical programming, dark room accessories, and AFP mini med red 90 automatic film processor w/stand and tanks. If interested, please call office for details Case Chiropractic, Greencastle, 765-630-8191. Posted 1/14/10 (M) CA WANTED Front 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: pj@smartviewimaging.com. Posted 8/6/2010 (M) POST A CLASSIFIED AD ISCA 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.

Energetic and busy Fishers practice looking for a DC who is passionate about subluxation based chiropractic care. Family wellness is our specialty. Join our team of professionals who feel called to do what we

ISCA REPORT

ISCA Report

200 S. Meridian St. Suite 350 Indianapolis, IN 46225 317.673.4245 www.IndianaStateChiros.org