It is rare for an insurance department to render an opinion on a newspaper article. But when Kathy Chittom, executive director of the Chiropractic Association of Louisiana, asked their insurance commissioner about the article on prepay insurance plans,1 Lester J. Dunlap, assistant commissioner, responded with this letter:
| James H. "Jim" Brown Commissioner of Insurance State of Louisiana P.O. Box 94214 Ms. Kathy Chittom, Executive Director Dear Kathy: This is in reply to your September 16, 1996 letter in which you request a departmental opinion regarding the legality of pre-paid chiropractic services plans. You also provided a copy of an article "Insurance Commissioners Rule Patient Prepay Plans Illegal" by Mr. Michael Schroeder, which appeared in the August 15, 1996 edition of Dynamic Chiropractic. As you know the Department previously issued Louisiana Insurance Directive #133 on September 22, 1995 (copy enclosed) as notice to all concerned that pre-paid health care plans which involve the assumption of insurance risk are illegal unless the provider is licensed as an insurer or health maintenance organization. Our department directive is based upon the National Association of Insurance Commissioners' Bulletin mentioned in Mr. Schroeder's article. As a matter of fact, Mr. Schroeder's article provides a superb explanation of why certain pre-paid plans are considered the business of insurance and subject to state insurance licensure requirements. In your letter you presented two scenarios and asked whether either represents the "business of insurance." Scenario 1 The doctor projects extended treatment plan of "x" number of visits, and the patient can arrange/contract to pre-pay in cash for that course of treatment. This is probably not insurance if the doctor diagnosis a condition requiring treatment. This appears synonymous to the case of an orthodontist who requires full or partial pre-payment for treatment of misalignment of the teeth over an extended time period. Scenario 2 For a flat up-front payment (annual), patient is entitled to unlimited chiropractic care on an as-needed basis. Pre-payment covers everything except P.I. and workers' compensation cases. This case appears to definitely represent insurance, because over the terms of the agreement, the doctor may or may not be required to provide treatment. To a limited degree, the doctor is acting as a health maintenance organization. In summary, the best advice I can give you is to suggest that a chiropractor intending to offer pre-paid plans, follow Mr. Schroeder's advice in avoiding activities which would constitute the unauthorized and illegal business of insurance. I do not believe I have seen a better outline and explanation relative to this issue. Sincerely yours, Lester J. Dunlap |
Reference
1. Schroeder, M. Insurance commissioners rule patient prepay plans illegal. Dynamic Chiropr, August 15, 1996, 14(17):1,26.
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
