Chiropractic Physician Sues Insurance Giant and Gets Verdict on Behalf of Patient
MISSOURI: Dr. Anthony W. Calandro, a Crestwood, MO, chiropractic physician, was “fed up” with insurance company tactics. So, on behalf of his patient, he a Mr. Mitch Jacobs, attorney-at-law with over fifteen years of trial experience, filed a lawsuit against Safeco Automobile Insurance Co.
The suit claims Safeco cheated the patient out of benefits, which had been rightfully bought. Safeco allegedly uses a common tactic called “consultant review” where a so-called “doctor” reviews a file without ever seeing the injured patient, thereby rendering a bogus cut in benefits, thus cheating patients out of the benefits which they paid for to cover their health care costs.
The trial lasted over two hours, and two days later the verdict was in favor of Dr. Calandro. The judgment award was for over $4000, which included the amount denied, interest, and all attorney and court costs.
Dr. Calandro recommends that other doctors and patients faced with this tactic stand up for their rights and prove that, when paying high premiums for benefits, they should be rightfully reimbursed accordingly, to insure good health care.
Lawmakers Vote to Limit Physical Therapy and Chiropractic Care
CALIFORNIA: In the final day of the state legislature’s regular session, California legislators voted to make revisions to their state’s worker’s compensation insurance system, with the intent of reducing premiums and overall costs associated with the system.
Along with provisions regarding prescription drugs, fee schedules and fraud-related fine caps, the legislature also approved provisions that will limit chiropractic and physical therapy treatment for injured employees to no more than 24 treatments per claim. In addition, the legislature also voted to stop the state’s vocational rehabilitation program in favor of educational grants for retraining injured employees.
If signed into the law, the new worker’s compensation provisions will also establish medical guidelines for governing how injuries are treated and allow for an administrative review of previous worker’s compensation cases to prevent future over-treatment.
While these cost-saving measures may help ease the pains of the states’s worker’s compensation program for the worker with an injury resulting from an ergonomics-related issue, it may also cut into the effectiveness and viability of some of the more popular current forms of injury treatment, including chiropractic care and physical therapy.
With the highest premiums in the US, California’s worker’s compensation system has come under fire by insurance providers, businesses and lawmakers. The state’s governor, Grey Davis, has vowed to sign the recently approved workers compensation reform package into law.
Sacramento Bee: Insurance Journal
Chance Parker, Grandson of Dr. Jim Parker,
Dies at Age 38
TEXAS: Michael Chance Parker (age 38), affectionately known as Chance, grandson of the founder of Parker College, Dr. James W. Parker, and son of seminar leader and Past-President of Parker College, Dr. W. Karl Parker, passed away at his home in Burleson, TX, July 31, 2003.
Parker discovered he had renal cell carcinoma when his right kidney failed in 1997. About a year later, he discovered it had metastasized to the bones in his right arm, followed by his left arm, his neck, sacrum and pelvis and, later, to his adrenal and lungs. He was originally given a death sentence of about six months from the onset of the disease, but with the help of natural health care, chiropractic and prayer, he remarkably survived an additional six years.
Parker was well known and loved by many in the profession, as he was a staff member of the Parker Seminars and Share International for many years, moving up the ranks until he was promoted to be president of the forty-year-old Parker Products company.
He is survived by over twenty-five members of the Parker family including seven chiropractors, his father, brothers and uncles.
“Chance really had a knack of making friends with everyone,” his father, Dr. Karl Parker said of him. “His positive uplifting attitude was never dampened by his condition and the pain he was suffering, even up to the very end. He was a model for many others in loving life, family and friends, regardless of life’s circumstances.”
Parker passed away peacefully with his father, mother, wife, children and numerous friends at his side. A memorial was held at his church, Crestmont Baptist in Burleson, which was filled with family and friends. His life’s pride and joy were his wife, Diane, and two children, Jordan (10) and Cole (8). Parker requested no flowers and that any gifts be sent to a fund he established to help with his children’s education. Send to Diane Parker at 2360 Charles Ave, Burleson, TX, 76028.
Medicare Announces Plan to Accept HIPAA Non-Compliant Electronic Transactions After the Compliance Deadline
WASHINGTON: The Centers for Medicare & Medicaid Services (CMS) has announced that it will soften up on its October 16, 2003, deadline with a contingency plan designed to accept noncompliant electronic transactions submitted after that deadline has passed. This will ensure continued processing of claims from thousands of providers who are unable to meet the deadline and would have had their Medicare claims rejected were it not for this late-hour reprieve.
“Implementing this contingency plan moves us toward the dual goals of achieving HIPAA compliance, while not disrupting providers’ cash flow and operations,” CMS Administrator Tom Scully states, ”so that beneficiaries can continue to get the health care services they need.”
CMS came to this decision after reviewing statistics showing unacceptably low numbers of compliant claims being submitted.
“Non-doctors” Excluded from $540 Million Dollar CIGNA Settlement
FLORIDA: A federal judge gave preliminary approval, in early September, to an agreement requiring Cigna Corp. to spend $540 million to settle claims that the insurance company chronically skimped on payments to the nation’s 700,000 doctors.
Cigna joins Aetna in settling racketeering lawsuits against managed care industry leaders. Both companies have agreed to pay refunds to doctors and change procedures for reviewing and processing doctors’ claims for services.Cigna agreed to spend $400 million on internal changes, at least $70 million to doctors on claims up to 12 years old, $55 million on attorneys’ fees and $15 million to create a health care foundation.
Doctors expect to see $300 million in savings, mostly on overhead for handling claims and appeals.
Chiropractors, podiatrists, optometrists, therapists, mental health counselors and others were excluded from the agreement and will not be able to recover money for claims that were improperly denied or services for which they were shortchanged, lawyers on the case said.
“We’re pursuing separate litigation,” said Alan H. Rolnick, a Miami attorney who is among several attorneys seeking to gain a court victory or a settlement for health-care providers not covered by the pact reached with physicians. Those lawyers told Moreno they hope to negotiate with Cigna, but neither side would suggest a date for a status conference.
The lawsuit upon which the “non-doctors” are building is a case which was filed early this year by Allen Knecht, a Portland, OR, chiropractor. The suit was transferred to Moreno because he has been designated to handle all similar class actions.
Rolnick said his team does not know the number of health professionals who would fit into the class, and that lawyers are “trying to determine that now.” When Moreno proposed negotiations between the two sides, Cigna lawyers said they didn’t anticipate any immediately because they are trying to put final touches on the physicians’ settlement.
Quackpot Barrett Crushed in Federal Court—Again…
CALIFORNIA: Some people never learn. Stephen Barrett (quackwatch.com) seems to be one of those.
Despite loss after loss, and humiliation on top of humiliation, self styled “quackbuster,” Stephen Barrett trudges on to the next embarrassment.
Like a bug in the fast lane, Barrett is doomed to be wiped off the windshield of the North American Health Freedom Movement time after time, it appears.
This time, Barrett, apparently stung from defeats in other arenas, and perhaps trying to reclaim some dignity from a world becoming accustomed to laughing at his anti-health antics, sued the attorney he’s come to associate with his steady downfall in the politics of health care, Carlos Negrete.
It’s not clear what the subject of Barrett’s suit against Negrete in Federal Court in San Diego was all about. Barrett submits volumes of whiney material in his court actions, none of which, seems to be acquainted with reality. But, what is known is that Barrett used, as his own attorney, one Morse Mehrban, listed as the general counsel of the National Council Against Health Fraud (NCAHF). It was Mehrban who was quoted in the LA Law Journal as saying, “I consider suicide daily.”
Negrete flattened them both—without breaking a sweat. Another victory for GOOD, in the battle against EVIL.
Of course, Barrett also sued, in the same lawsuit, world-renowned health-humanitarian Hulda Regehr Clark PhD, ND. Barrett can’t seem to talk, or write, these days, without bringing up Clark’s name in some way. So, it’s not surprising he put Clark’s name in the lawsuit. He describes her as an “Unlicensed Naturopath, Hulda Clark,” in his writing. His hatred and resentment of her accomplishments, compared to his, are obvious. He lost to Clark, too.…
Barrett had to allegedly “retire” from the medical profession, giving up his license in 1993, when he was in his mid-50’s. He admits that he didn’t have enough medical practice income in 1993 to even pay the required malpractice insurance premiums. Barrett, who claims to be a retired psychiatrist, was forced to admit in court documents (forced by Negrete) that he only had nine patients all year, each year, for several years, before he supposedly “retired.” Psychiatrists get their patients from referrals from other MD’s. Doctors in the LeHigh Valley of Pennsylvania just weren’t sending him any business. Anybody wonder why?
And now Barrett is failing as a “quackbuster.”
By the way—Barrett lost in an anti-SLAPP motion, which means he gets to pay Negrete, and Clark’s, attorney fees.…
Tim Bolen—Consumer Advocate website
FLORIDA: The Florida Office of Insurance Regulation (OIR) is moving ahead with developing guidelines designed to tighten personal injury protection (PIP) rules in the state, and the National Association of Independent Insurers (NAII) expressed confidence that the reforms will help combat fraud in that state.
“The industry, the department and medical representatives are working to formulate a list of excluded tests that everyone can agree on,” said James S. Taylor, southeastern regional manager for the NAII.
The State Board of Medicine held a workshop recently to discuss excluded diagnostic procedures, with insurance industry and medical associations in attendance. Insurers agreed that a number of tests should no longer be covered by PIP, including procedures on a list created by New Jersey in its auto reform efforts. Such tests include diagnostic spinal ultrasound, nerve conduction velocity tests, reflexology and digital range of motion studies.
After receiving input from medical associations and the Board of Chiropractic Medicine, the State Board of Medicine found that the groups see no medical necessity or value for many common PIP diagnostic tests.
In other action, the Office of Insurance Regulation has developed a revised PIP sworn disclosure form that requires a signature from patients stating that they have actually received the medical services being claimed.
”Although the details are still being developed, we are confident that these methods will help reduce the problem of PIP fraud in Florida,” Taylor noted.
Pass on the information to warn other D.C.’s about events that are really happening to chiropractors. When you see a “ yellow page” article in your local, regional, or national newspaper about chiropractic or a fellow chiropractor, fax, e-mail or mail it to us at TAC. For further information, fax: 1-305-716-9212 or see page 4 for our mailing address.