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Maine's Managed Care Legislation

Dear Editor:

The Maine Chiropractic Assoc. has worked to pass three separate pieces of managed care legislation. The first bill was passed by our legislature in 1994, and fortunately we had strong enough legislative support to override a veto of our governor at that time. The first bill mandated that any HMO doing business in Maine had to cover chiropractic care. Our next legislative bill passed in 1995, and that set up a trial two year period for direct access to chiropractic care in HMO managed care plans. It stated that if a chiropractor is a network provider then patients of that HMO can have direct access to that chiropractor for up to 36 visits a year. We recently passed legislation that continues our direct access coverage indefinitely (see "Maine Bill Guarantees Direct Access to Chiropractic under Managed Care" on this issue's front page).

Maine's approach to dealing with the problem of access to chiropractic treatment under managed care plans is not a complete solution to the problem, but it certainly has helped. We are pleased that managed care patients at least now have the opportunity to choose chiropractic care without concern of subjecting themselves to possible medical bias.

John Royce
Executive Director
Legislative Agent
Maine Chiropractic Assoc., Inc.
Box 7120, Albee Rd.
Augusta, Maine 04330
Fax: 207-623-8394

Dear Editor:

Last week the assistant medical director of a local HMO self-referred to our office for chiropractic care. She stated that she was very pleased with the fact that she did not have to get her primary care provider to refer her to our office. Another benefit of the situation is the legislative requirement to communicate to the primary care providers when patients self-refer to our offices. This has been a valuable tool for chiropractors to educate our medical colleagues on the types of conditions patients are presenting to us, the quality of the physical exams and the findings, and diagnoses and the treatment recommendations. Follow-up communications are also required by one HMO so that the PCP is aware of the progress that the patient is or is not making under chiropractic care.

It is my feeling that we have an obligation as a profession to educate our medical colleagues. This will reduce misunderstanding, distrust and increase knowledge of our profession. This is probably the best system that we can utilize until we can work side by side in hospital and clinical settings.

Robert Lynch Jr., DC
South Portland, Maine

Editor's Note:

The ACA's legal counsel did a real reach when he tried to connect certification with membership. If your statistics are accurate relative to numbers of CCSPs versus CCSPs who are members, I wonder how many other diplomates or those certified are not ACA members? To carry the though further, how many board certified MDs are not AMA members? If ACA is going to require membership to be certified or to become a diplomate, then all those received before the ACA deadline should be grandfathered and retain their status in spite of their nonmembership. We who were certified prior to this edict were not given informed consent that our CCSP would require ACA membership at any time.

Dennis Lokmer, DC
De Pere, Wisconsin

Dear Editor:

I'm a registered investment advisor serving chiropractors nationwide and utilize Charles Schwab & Co. for my client's security purchases and accounts. My wife and I have been under chiropractic care for 11 years and our children since each of them were born. We understand chiropractic and we have the greatest respect for chiropractors.

In all our dealings with Charles Schwab & Co. we have never found any discrimination against the chiropractic profession. When I read the letter to the editor from Imogene Protz, DC, in the April 21, 1997 edition, (regarding Dr. Protz's complaint on the e.Schwab ads that "e.chiropractor" had been taken out), I immediately contacted Charles Schwab & Co. to research this situation. The vice president of marketing confirmed this is a misunderstanding and the commercial has not been changed.

According to our research, we found no evidence of any discrimination against the chiropractic profession. We continue to have faith in Charles Schwab & Co.'s integrity and professional service they provide to my clients and myself.

Carl F. Petersen, MIM
Registered Investment Advisor

In regards to "Stephenson's Principles Revisited" (4-7-97 issue), how does the author deem himself worthy of changing the very core principles of chiropractic? With health care changing every day it is foolish to think that by changing our principles to the latest scientific theory that we will be better servants of chiropractic. It seems as if the author is concerned about his patient's feeling good, but not concerned about removing interferences in the nervous system to allow the body to be restored to health and vitality. If he really agrees with Joseph Keating Jr., PhD, about being skeptical about the subluxation, then both of them should seriously question their own thinking and not the principles on which chiropractic was founded. A better title for his book would be "Principles of Skepticism."

Phillip Pavkov, DC
Sterling, Ohio