West Virginia Chiropractic Society Resists Attacks

One month before the West Virginia legislature was to address insurance equality for chiropractors, individuals inside the State Workers' Compensation Fund attempted to derail the equality legislation. In a surprise news story on December 17, 1989, the Charleston, West Virginia Sunday Gazette-Mail carried as its lead headline, "Fees Charged by Chiropractors 3-1/2 Times More." The article referred to an April 1989 study completed by a Dr. Judith Greenwood, Ph.D., which purported to show that chiropractors charge three and one-half times more than medical doctors or osteopathic physicians while treating compensation claimants.

Outraged by such a malicious and misleading news story, the West Virginia Chiropractic Society headed by its president, Dr. Joseph Martin, convened a special board of directors meeting that

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Workers' Compensation Fund a Freedom of Information Request demanding that the state agency provide within ten days, all documents, studies and other materials used to formulate Greenwood's opinion. Since the so-called study found that the average chiropractic claim was $7,500, the board knew the figures must be inaccurate, since the average amounts asserted in the fund by society members did not equal the amount asserted in the article. However, when the state complied with the Freedom of Information Request, Greenwood's study was conspicuously absent.

This was not the first time the West Virginia Workers'

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chiropractors charged excessive amounts. In response to that initial attack, the society performed its own study based on the data released by Dr. Greenwood. The independent study found that Greenwood had failed to correlate the type of injury with the cost of treatment, and had compared the cost of one-time emergency room visits with chiropractic care rendered over a span of several weeks. The society had also prevailed in an earlier suit against the Workers' Compensation Fund when it established a fee schedule without following required administrative procedures. That decision went to the West Virginia Supreme Court of Appeals, which ordered that the fee schedule be abolished and that any further fee schedules be developed according to law. While no one understands the Fund's or Greenwood's predisposition against chiropractors, the society knew it was time to put Greenwood under oath and ask her some long-awaited questions.

On December (Can't Read) The West Virginia Chiropractic Society sued Emily A. Spieler, the commissioner of the fund (and the wife of a medical doctor) to obtain Greenwood's study. Since the law allowed the society to seek an expedited hearing, the issue was set to be heard by the court in just a few days. At the hearing, the society was afforded the right to cross-examine Greenwood regarding her findings and to determine ---------------- of methodology of any such "study." Greenwood testified under oath that no such study had existed. She further testified that the data was compiled by examining the first 200 closed claims for each provider group, and that there was no correlation between the type of injury and the treatment rendered in the claims which were reviewed. Greenwood used this same flawed methodology in her other studies. Later, through informal meetings with the fund, it became clear that even the individuals who had helped generate the misleading data were unsure of the parameters employed to produce her results.

Knowing that the misleading article diminished the likelihood of success for the chiropractic equality law, the West Virginia Chiropractic Community united for the most dramatic legislative effort the society had ever witnessed. By the second week of the session, state legislators had received thousands of letters in support of the bill from chiropractic patients. Many legislators formerly opposed to chiropractic legislation changed their opinions due to the dramatic support shown by patients throughout the state. Chiropractic lobbyist Nelson Robinson, Jr., found many legislators willing to listen to chiropractic concerns as a result of the letter writing campaign.

The bill passed the state senate, 31 to 3, with such overwhelming support that it astonished everyone working with the legislation. However, the road through the house of delegates was not successful. After passing both the Insurance and Judiciary Committees of the House, the equality legislation reached the floor only two days before the end of the legislative session. While the last informal vote tally showed that the legislation was supported by more than 70 of the 100 delegates, the support of 80 delegated was necessary to advance the bill by suspending the constitutional rules requiring that the bill be read on three successive days. As a result, the bill failed on the last day of the session.

The society has also been active in litigation against State Farm Insurance Company's paper IME reviews and is planning litigation against a major West Virginia hospital for failing to provide chiropractors access to its MRI facility. However, with only 80 members in the society, and 135 practicing chiropractors in the state, it is difficult to marshal the necessary resources to defend all the attacks against the profession. But in spite of its size, the society is resolved to fight for the freedom of consumers to choose chiropractic care, and to maintain its status as a primary care provider in West Virginia. The experience in West Virginia clearly shows that in a state where there is only one organization representing all chiropractors, a unified effort can produce results that surprises even experienced political observers.