New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
Distinguished Speakers Set the Tone for Mercy Center Conference
Paul Shekelle, M.D., M.P.H., and Herve Guillain, M.D., M.P.H., will be the speakers at the upcoming Mercy Center Conference in Burlingame, California January 25-30. The Mercy Center Conference (also known as the Quality Assurance Conference) is comprised of 35 notable chiropractic delegates who will establish comprehensive consensus guidelines for the chiropractic profession.
Dr. Shekelle is the primary investigator of the RAND project studying the effectiveness of chiropractic. An internist, and a member of the University of California at Los Angeles (UCLA)'s faculty, Dr. Shekelle presented his paper on the Consortium for Chiropractic Research (CCR)/RAND consensus project at the California Chiropractic Association (CCA)'s convention June of 1991 in Monterey, California (see October 11, 1991 issue of "DC").
Dr. Herve Guillain oversees various panels for the Agency for Health Care Policy and Research (AHCPR), which is within the U.S. Department of Health and Human Services. He spoke at the first meeting of the AHCPR's Panel on Low Back Pain in November 1991 (please see the January 3, 1992 issue of "DC"). The task of the AHCPR's panel is to "facilitate the development of practice guidelines and measurements of quality care." Dr. Guillain will thus bring to the Mercy Center Conference the perspective of the AHCPR's panel and how the federal government is tackling the guideline-setting process.
Dr. Guillain is currently a doctoral candidate at Johns Hopkins University, Department of Health Policy and Management, in Baltimore, Maryland.
Please be looking for stories in upcoming issues of Dynamic Chiropractic which will have further information on the proceedings and results of the Mercy Center Conference.