Some time ago, a few of the carriers who write automobile medical payments policies slipped a small change into their policies, which was largely unnoticed until they started to refuse payments for certain services. Specifically, they changed the language in the policies so that they would make payments for services rendered only to "licensed medical providers."
Many chiropractic offices use the talents of staff for a multitude of tasks associated with the delivery of chiropractic care. These staff members are typically unlicensed, and work under the license of the DC. They take x-rays, do ultrasound, muscle stimulation, massage, etc. The carriers specifically targeted massage therapy for their denial of payments, and based it on the new language in their policies (because it is typically delivered by unlicensed personnel).
The complaints from the field at first trickled in, then flooded into the CCA. Team CCA went into action. CCA legal counsel Ellen Berkowitz discovered in her research that not all of the policies issued by the carriers who were denying these payments contained the language barring payments for services rendered by unlicensed individuals. She also noted in her letters to those carriers that there are many other types of service rendered to injured patients by unlicensed individuals, as noted above.
CCA received a letter from the biggest carrier involved assuring us that they will remove that language from their policies, and that they will stop denying payments for medically necessary services on the basis of who is doing it, so long as proper protocols are met, i.e., that there is supervision of these services by licensed providers.
This act by the CCA reinstated payments for services which total in the millions of dollars every year, and put that money back into your practice. This is but one of many victories the CCA has won for our profession, and the conflicts will most certainly continue: every time you treat a workers' compensation or personal injury patient; every time you bill any insurance company for your services; every time you testify in court or at deposition; every time your interests are served in the California legislature; and every time you open your doors to your offices you need to recognize that without the efforts of the volunteers and superb staff of CCA, none of this would be there for you and your patients.
CCA's membership is growing again, and so is the spirit that has driven her for the past 70 years. We must prevail so that our patients and their families and friends can receive the unlimited benefits of chiropractic care, and we can continue to advance and thrive in the health care marketplace.
Support your team CCA. Remember, your CCA does it all for you and your patients.
Bob Dubin, DC
Petaluma, California
Vice President, Communications
California Chiropractic Association
