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04/29/2011

OSCA News Update - IMMEDIATE ATTENTION REQUESTED-


The OSCA has been very busy and we want to keep you aware of the major issues taking place: 

       1)   ASHN taking over management of Aetna on July 1, 2011

       2)   Talks of privatizing Workers Compensation

       3)    UHC / Optum  Lawsuit

The chiropractic profession has always had its challenges in the world of healthcare but it seems the healthcare environment has taken an interesting turn.  Many of you reading this update are not happy with the current environment.  Rest assured the OSCA is not either. We are taking all of the above very seriously and are up to the challenge of changing the environment for the better of the profession.

Below you will see the latest updates on each issue and what you can expect to see from the OSCA in the coming days.  Please read this information completely and be sure to share with your colleagues all we are doing. 

1)  ASHN’s Management of Aetna

 

  • The OSCA has been in communication with Dr. Lloyd Friesen, Vice   President of Public Affairs with ASHN, in an effort to convey the concerns of our members.  These talks have been of little value at this point as we are not convinced they care, but none the less we will continue to communicate in an effort to gain more information for our membersThe OSCA met with our lobbyist on 4/13/11 to discuss two possible repressive activities of all MCO’s; Restriction of Trade and Discrimination. To face the current and future issues with MCO’s we feel the Ohio Department of Insurance needs to be involved. Our lobbyists are making contact with all interested parties in this issue.

 

  • The OSCA met with Anti-Trust attorneys on 4/13/11 to ensure any advice or actions we take to help our members is not in violation of Anti-Trust laws.  We look to remain in constant communication with our attorneys on this issue.

 

  • We have a scheduled meeting with the Ohio Department of Insurance on the 12th of April and plan to discuss anti-discrimination language and the ORC 3923.23. We are seeking current opinions as this was brought up to the ODI in 2004 – 2005. If we find this code needs to be modified we will address this with our lobby group. We will update you further on this issue after the meeting.

 

  • The OSCA has been in contact with a national expert on Federal Insurance laws to find out how these policies hold up to Federal ERISA laws.  In those conversations a protocol of appeal was conveyed that will help us expose the noncompliance of the MCO.  Just yesterday, March 29th, we had training with a select group of chiropractors and billing staff to train on this appeal process.  This line of thinking was also confirmed with the attorneys we contacted as they encouraged us to expose these non-compliant acts as often as possible.

It is important that we take these issues on from as many angles as possible to ensure success. The OSCA is quickly and actively moving on this issue.
 

2) Talks of Privatizing Workers Compensation

 

Governor Kasich has made it very clear in his communications that    he wants to tackle the state run workers compensation system.  He has talked a number of times about the possibility of privatizing the bureau.  This is a major concern as this could evolve into similar dealings we have seen in the major medical environment. 

 

  • The OSCA has been preparing for this with our lobbyist and by communicating with key legislators at the State House.  We have been building strong relationships and creating strong lines of communication. It was believe that we would not see any language from the State House until early fall.  However, we feel there is a possibility a bill  will get introduced within the next 3-4 weeks while the house and senate are busy concentrating on the budget. 

 

  • We are working closely with our lobbyist to make sure we communicate the clinical benefits and cost effectiveness of our care. We believe we will have unlikely allies on this issue as many are opposed to this happening. 

 

  • We will keep you up to date on the happenings here but please keep your eyes & ears open as we may be needing your involvement in contacting your local Legislator. 
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3)  UHC / Optum Lawsuit 

 

  • On April 21st the ACA joined the OSCA in a class action against UHC. This amendment extends the lawsuit to include the repressive actions of Optum (formally ACN).  This is an exciting step in this case.  Over the last month the Congress of Chiropractic State Associations (COCSA), other doctors, state associations, and provider groups have entered the lawsuit.

 

  • We still believe this will be a landmark case as the ripple effects will transcend UHC.  We will keep you informed on the progression of this case as well.

 

We have shared a lot of material and encourage you to give us a call at 614-229-5290 should you have questions on any of these items.  The bottom line is that the OSCA is fighting for you. We are very active and WILL fight for the rights of chiropractors and their patients. These issues will require a lot of resources which we can afford through our membership. If you are not a member and these issues will affect your practice NOW is the time to join. We appreciate your support and belief in the OSCA.

Keep believing and never stop fighting for that belief!


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