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.
ACA Declares "National Legislative Emergency"
A "national legislative emergency" was declared by the board of governors of the American Chiropractic Association to fight what it fears will be exclusion of chiropractic in a sweeping reform of the nation's health care system.
During the presidential campaign, President-elect Clinton promised reform of the nation's health care system within the first 100 days of the new administration (see "Health Reform Promised in First 100 Days" in the Nov. 20, 1992 issue of "DC").
Clinton's victory is judged by the ACA as mandating emergency tactics to prepare the chiropractic profession for what it believes is the strong possibility of speedy and comprehensive change in the nation's health care delivery system.
The ACA announced an immediate nation-wide, grassroots "mobilization campaign" to fight for full and fair inclusion of chiropractic under any national health care reform. The campaign seeks to "organize thousands of DCs and millions of chiropractic patients" into a lobbying effort directed at key members of Congress and the incoming Clinton administration. The ACA will mount a national program to educate both Congress and senior White House officials about the cost effectiveness of chiropractic care.
ACA Board Chairman Dr. Kerwin Winkler stated his concern of a national health care plan going before Congress that could "totally exclude chiropractic or relegate us forever to a second-class status." Dr. Winkler called for a united effort from the profession and avoiding "another Medicare-like fiasco."
ACA President Dr. John Pammer warned that "with one stroke of the pen, everything we've been working years for could be wiped out." He appraised the seriousness of the situation by referring to the mobilization campaign as a "battle for life and death."
The mobilization campaign will be outlined in an upcoming series of ACA mailings to both association members and non-members.