The National Association of Chiropractic Attorneys (NACA) held its annual meeting November 12-14, 1993 in San Francisco, California. Attorneys representing 36 state associations, two chiropractic colleges, the ICA, and the ACA reported on activities, new judicial decisions, legislative enactments, and other events occurring during the past year affecting chiropractic.
Topics of intense discussion included workers' compensation and health care reform.
Just about every state association attorney reported that their state legislatures have enacted health care reform laws similar to what is being considered in Congress. It was reported that many states are defining primary care physicians in the health care reform plans to include chiropractors, but many more states are not clear on the primary role chiropractors will play.
After a presentation on the details of President Clinton's health care reform bill submitted to Congress, Attorney Robert Hirtle (Connecticut) volunteered to prepare a written analysis of the bill for distribution to NACA members. Attorney Hirtle's analysis will assist NACA members in explaining the president's plan to their associations. With this information, chiropractors from around the country will be better prepared to discuss chiropractic inclusion in the plan with their congressional representatives.
Lobbying Committee
Appointed at the meeting was a grassroots lobbying committee. Chaired by Shawn Steel (California), the committee includes Des Taylor (Texas), Arly Richau (North Dakota), and John DeCamp (Nebraska). It was Attorney DeCamp who represented NACA at the ACA grassroots lobbying conference on congressional health care reform November 20th in Dallas.
NACA recognizes that many congressional representatives served in state legislatures, and have been lobbied by NACA members on behalf of their associations. Many NACA members have maintained close ties with these legislators after their elections to Congress. It is this resource that the NACA grassroots lobbying committee hopes to make available to the ACA and ICA in its lobbying efforts.
Council on Chiropractic Guidelines
In support of the efforts by the Congress of Chiropractic State Associations (COCSA) to establish a process for revising and updating the Mercy Guidelines, a NACA committee consisting of Mike Schroeder (Calif.), Kevin Snell (Minn.), John Schreppler (Delaware), chaired by Paul Watson Lambert, will prepare incorporation documents for the Council on Chiropractic Guidelines and Practice Parameters. The council was the structure recommended by the Guidelines Development Planning Conference organized by COCSA at the October 23-24 meeting in St. Louis, Missouri. NACA will send a representative to sit on the board of directors of the Council on Chiropractic Guidelines and Practice Parameters, but after preparing the initial incorporation documents, NACA will no longer provide legal assistance in the process. NACA urges the council to retain independent counsel to advise it; NACA's director will provide input, but no legal advice.
Record Keeping: A Problem Area
NACA recognizes that poor record keeping is one of the most serious problems facing chiropractic. The NACA will be urging chiropractic colleges to emphasize even more the record keeping practices currently taught. NACA will also be urging each state chiropractic licensing board to require at least five hours of continuing education per license renewal period dealing with proper record keeping requirements. The association has appointed a record keeping committee to develop a compendium of state laws and regulations addressing record keeping, and will prepare a manual on record keeping requirements to be made available to all DCs. The committee, consisting of Michael Schroeder, Philip Buckwalter, Shawn Steel (all from Calif.), Mark Carroll (Florida), Jim Hogan (New York), Robert Sherman (Ohio), and chaired by NACA President Paul Watson Lambert (Florida), will survey each of the NACA members for development of laws and regulations requiring proper record keeping.
Assignments and Liens
Discussion of the problems chiropractors have across the country in having insurance assignments and liens honored, concluded with appointing a third-party assignments and liens committee. The committee will be preparing a compendium on state laws and judicial decisions addressing enforceability of third-party assignments and liens. The committee, chaired by Shawn Steel (Calif.), is comprised of Aubrey Villines (Georgia), Mark Carroll (Florida), David Morrison (Arizona), Phillip Stowers (West Virginia), Mike Kelly (South Carolina), Brian Niederhauser (Indiana), Des Taylor (Texas), Robert Sherman (Ohio), and William Shields (Virginia). The compendium will be made available to chiropractors and lawyers to help enforce assignments and liens.
Mid-year Meeting
The NACA mid-year meeting will be held June 25, 1994. NACA members will discuss the progress on developing the record keeping manual, the third-party assessments and liens compendium, health care reform progress, and more at this June meeting. For further information about sending your state association attorney to the next NACA meeting, contact:
Paul Watson Lambert, NACA president
2851 Remington Green Circle
Suite C
Tallahassee, Florida 32308-3749
Tele. (904) 385-9393
Fax (904) 385-8045
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
