Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 How can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DCOn Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote: ORDCs,It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. "PIP mills" routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that " document" medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye. C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote: Chiropractic Physicians of Oregon Messages In This Digest (5 Messages) 1. "Horrific Auto PIP BIll Indroducted in Florida!" From: vsaboe 2a. HB 119 From: AboWoman@... 2b. Re: HB 119 From: Sunny Kierstyn 2c. Re: HB 119 From: vsaboe 2d. Re: HB 119 From: Schneider View All Topics | Create New Topic Messages 1. "Horrific Auto PIP BIll Indroducted in Florida!" Posted by: "vsaboe" vsaboe@... Sun Jan 29, 2012 12:15 pm (PST) [Attachment(s) from vsaboe included below] Dear colleagues, Attached is an outline of the horrible changes to the current auto PIP law in Florida that this horrific bill would institute. The reality is for all practical purposes we need only read the first bullet, last sentence which reads, "No treatment by DC or LMT allowed. (ll. 533-563!" Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIP whereas Oregon has increased theirs to $15,000. Will we continue business as usual? Will we sit back and wait and be reactionary as in 1989 and SB-1197 which trashed Workers Compensation for us? Or will we as a profession be proactive and preemptive? So what say you??? Vern Saboe DC, FACO ACA Delegate for Oregon 541-231-4528 Cell Attachment(s) from vsaboe 1 of 1 File(s) OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdf Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (1) 2a. HB 119 Posted by: "AboWoman@..." AboWoman@... Sun Jan 29, 2012 12:29 pm (PST) Dear Senator, I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view. Minga Guerrero DC Hood View Chiropractic 270 NE 181st Ave Portland, OR 97230 HB 119 Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem. Minga Guerrero DC abowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2b. Re: HB 119 Posted by: "Sunny Kierstyn" skrndc1@... Sun Jan 29, 2012 12:55 pm (PST) Beautifully reasoned and written, Minga. Thanks for the template! Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 654-0850; Fx; 541- 654-0834 www.drsunnykierstyn.com joseph.abruzzo@...; From: AboWoman@... Date: Sun, 29 Jan 2012 15:28:42 -0500 Subject: HB 119 Dear Senator, I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view. Minga Guerrero DC Hood View Chiropractic 270 NE 181st Ave Portland, OR 97230 HB 119 Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem. Minga Guerrero DC abowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2c. Re: HB 119 Posted by: "vsaboe" vsaboe@... Sun Jan 29, 2012 1:36 pm (PST) You go girl.excellent Minga.excellent..may I post this to the ACA listserve may help as per a template for Florida DCs? Vern Saboe From: [mailto: ] On Behalf Of AboWoman@... Sent: Sunday, January 29, 2012 12:29 PM joseph.abruzzo@...; Subject: HB 119 Dear Senator, I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view. Minga Guerrero DC Hood View Chiropractic 270 NE 181st Ave Portland, OR 97230 HB 119 * Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured in auto accidents * Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical * Removes the number one choice of consumers for drugless, conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention: chiropractic. * By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem. Minga Guerrero DC abowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2d. Re: HB 119 Posted by: " Schneider" portlandchiro1@... wildwill492003 Sun Jan 29, 2012 3:08 pm (PST) I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanks for your efforts to support our good profession. Schneider DC PDX On Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote: > ** > > > Dear Senator, > I am a chiropractic physican of 27 years experience in Portland, OR. I > have served for the Governor's office for over 17 yrs in state regulation. > 6 of those years as a licensing board member and 4 1/2 as president of the > Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to > the National Board of Chiropractic Examiners (the US credentialing/ testing > agency) and 6 years as the Oregon delegate to the Federation of > Chiropractic Licensing Boards (International regulation agency). I was > recently made aware of HB 119, a newly proposed, PIP insurance law that > would limit consumers ability to access non-emergency and non-drug > treatment for musculo-skeletal injurie following an auto accident. I've > listed below, the reasons I believe this is an extremely flawed > idea. Although I'm not a direct constituent, I would respectfully ask that > you consider the points below and vote AGAINST this bill. > thank you for considering my point of view. > Minga Guerrero DC > Hood View Chiropractic > 270 NE 181st Ave > Portland, OR 97230 > > *HB 119* > > > - Does nothing to directly attack fraud > - In these days of high unemployment, will cause the loss of tens of > thousands of jobs (in offices of non-hospital providers) > - Will lower the quality of health care provided to those injured in > auto accidents > - Will result in less care for those with injuries, as all benefits > will be absorbed in just one ER visit with high-dollar diagnostic costs > - Shifts care to the most expensive, most chaotic venue > - Will flood emergency rooms, meaning longer wait time for care for > those who are critical and not critical > - Removes the number one choice of consumers for drugless, > conservative care: chiropractic. > - Removes the least expensive drugless, non-surgical intervention: > chiropractic. > - By removing the number one drugless intervention, will result in > even more injured Floridians with dependencies on pain medication, feeding > the pill mill problem. > > > > Minga Guerrero DC > abowoman@... > > > -- Schneider DC PDX Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) Recent Activity Visit Your Group Meditation andLovingkindnessA Groupto share and learn. 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Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommend that doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever. The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves… In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor….its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself….. Vern Saboe From: [mailto: ] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP law How can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DC On Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote: ORDCs, It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. " PIP mills " routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that " document " medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye. C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of Oregon Messages In This Digest (5 Messages) 1. " Horrific Auto PIP BIll Indroducted in Florida! " From: vsaboe 2a. HB 119 From: AboWoman@... 2b. Re: HB 119 From: Sunny Kierstyn 2c. Re: HB 119 From: vsaboe 2d. Re: HB 119 From: Schneider View All Topics | Create New Topic Messages 1. " Horrific Auto PIP BIll Indroducted in Florida! " Posted by: " vsaboe " vsaboe@... Sun Jan 29, 2012 12:15 pm (PST) [Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill would institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, " No treatment by DC or LMT allowed. (ll. 533-563! " Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 Cell Attachment(s) from vsaboe 1 of 1 File(s) OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to top Reply to sender | Reply to group | Reply via web post Messages in this topic (1) 2a. HB 119 Posted by: " AboWoman@... " AboWoman@... Sun Jan 29, 2012 12:29 pm (PST) Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2b. Re: HB 119 Posted by: " Sunny Kierstyn " skrndc1@... Sun Jan 29, 2012 12:55 pm (PST) Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2c. Re: HB 119 Posted by: " vsaboe " vsaboe@... Sun Jan 29, 2012 1:36 pm (PST) You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for the Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the number one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2d. Re: HB 119 Posted by: " Schneider " portlandchiro1@... wildwill492003 Sun Jan 29, 2012 3:08 pm (PST) I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) Recent ActivityVisit Your Group Meditation andLovingkindnessA Groupto share and learn.Error! Filename not specified. HealthAsthma TriggersHow you canidentify them.Error! Filename not specified.Biz ResourcesY! Small BusinessArticles, tools,forms, and more.Error! Filename not specified.Need to Reply?Click one of the " Reply " links to respond to a specific message in the Daily Digest.Create New Topic | Visit Your Group on the Web Messages | Files | Photos | Links | Database | Polls | Members | Calendar All posts must adhere to OregonDCs rules located on homepage at: /Tell a colleague about OregonDCs! (must be licensed Oregon DC) Change settings via the Web ( ID required) Change settings via email: Switch delivery to Individual | Switch format to Traditional Visit Your Group | Terms of Use | Unsubscribe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 Yes, but I think what Chuck was saying is that PIP mills "document" everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard?Jamey Dyson, DC On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever. The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves… In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor….its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself….. Vern Saboe From: [mailto: ] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP law How can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DC On Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote: ORDCs, It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. "PIP mills" routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that " document" medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye. C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1."Horrific Auto PIP BIll Indroducted in Florida!" From: vsaboe2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1."Horrific Auto PIP BIll Indroducted in Florida!"Posted by: "vsaboe" vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill would institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, "No treatment by DC or LMT allowed. (ll. 533-563!"Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (1)2a.HB 119Posted by: "AboWoman@..." AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: "Sunny Kierstyn" skrndc1@...Sun Jan 29, 2012 12:55 pm (PST)Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: "vsaboe" vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for the Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the number one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider" portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! Filename not specified. HealthAsthma TriggersHow you canidentify them.Error! Filename not specified.Biz ResourcesY! Small BusinessArticles, tools,forms, and more.Error! Filename not specified.Need to Reply?Click one of the "Reply" links to respond to a specific message in the Daily Digest.Create New Topic | Visit Your Group on the WebMessages | Files | Photos | Links | Database | Polls | Members | CalendarAll posts must adhere to OregonDCs rules located on homepage at: /Tell a colleague about OregonDCs! (must be licensed Oregon DC)Change settings via the Web ( ID required) Change settings via email: Switch delivery to Individual | Switch format to Traditional Visit Your Group | Terms of Use | Unsubscribe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2012 Report Share Posted January 30, 2012 It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern Saboe From: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon DCsSubject: Re: Re: FL PIP law Yes, but I think what Chuck was saying is that PIP mills " document " everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard? Jamey Dyson, DC On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever. The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves… In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor….its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself….. Vern Saboe From: [mailto: ] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP law How can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DC On Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote: ORDCs, It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. " PIP mills " routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that " document " medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye. C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1. " Horrific Auto PIP BIll Indroducted in Florida! " From: vsaboe2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1. " Horrific Auto PIP BIll Indroducted in Florida! " Posted by: " vsaboe " vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill would institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, " No treatment by DC or LMT allowed. (ll. 533-563! " Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (1)2a.HB 119Posted by: " AboWoman@... " AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: " Sunny Kierstyn " skrndc1@...Sun Jan 29, 2012 12:55 pm (PST)Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: " vsaboe " vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for the Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the number one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider " portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! Filename not specified. HealthAsthma TriggersHow you canidentify them.Error! Filename not specified.Biz ResourcesY! Small BusinessArticles, tools,forms, and more.Error! Filename not specified.Need to Reply?Click one of the " Reply " links to respond to a specific message in the Daily Digest.Create New Topic | Visit Your Group on the WebMessages | Files | Photos | Links | Database | Polls | Members | CalendarAll posts must adhere to OregonDCs rules located on homepage at: /Tell a colleague about OregonDCs! (must be licensed Oregon DC)Change settings via the Web ( ID required) Change settings via email: Switch delivery to Individual | Switch format to Traditional Visit Your Group | Terms of Use | Unsubscribe Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 This is just a quick reflexive idea: What about after a process that is similar to Work Comp: After say 24 vists the patient must be referred to another DC to evaluate the efficacy of continued care and for recommendation on referral etc. That DC sees the patient, gathers their opinions on their recovery, goes over the notes the progress, does an exam and decides what the appropriate manner of continued care would be. I hate to say it, but I can see why the Work Comp restrictions are in place. These PIP mills wouldn’t have the leeway under that system to “use and abuseâ€. Nonetheless, if there were a way we could get some sort of regulation process together and keep it “in house†and self police, we may be able to somehow reduce the egregious and fraudulent practice of overtreatment. Wouldn’t take long before these PIP mills were gone. ph Medlin D.C. From: vsaboe Sent: Monday, January 30, 2012 7:31 PM 'Jamey Dyson' Cc: 'Chuck Simpson, DC' ; 'Oregon DCs' Subject: RE: Re: FL PIP law It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern Saboe From: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon D CsSubject: Re: Re: FL PIP law Yes, but I think what Chuck was saying is that PIP mills "document" everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard? Jamey Dyson, DC < div> On Jan 30, 2012, at 5:56 PM, vsaboe wrote: Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management†as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever. The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves…< o> In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons†problems, possible solutions, and actions steps kind of a dispute resolution flavor 230;.its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself….. Vern Saboe From: [mailto:@.com] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP law How can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DC On Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote: ORDCs, It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. "PIP mills" routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that & quo t; document" medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye. C Simpson Sent from my iPad On Jan 30, 2012, at 10:17 AM, " " < > wrote: Chiropractic Physicians of Oregon Messages In This Digest (5 Messages) 1. "Horrific Auto PIP BIll Indroducted in Florida!" From: vsaboe< /p> 2a. HB 119 From: AboWoman@... 2b. Re: HB 119 From: Sunny Kierstyn 2c. Re: HB 119 From: vsaboe 2d. Re: HB 119 From: Schneider View All Topics | Create New Topic Messages 1. "Horrific Auto PIP BIll Indroducted in Florida!" Posted by: "vsaboe" vsaboe@... Sun Jan 29, 2012 12:15 pm (PST) [Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill w ould institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, "No treatment by DC or LMT allowed. (ll. 533-563!"Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 Cell Attachment(s) from vsaboe 1 of 1 File(s) OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdf Back to top Reply to sender | Reply to group & nbsp;| Reply via web post Messages in this topic (1) 2a. HB 119 Posted by: "AboWoman@..." AboWoman@... Sun Jan 29, 2012 12:29 pm (PST) Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance l aw that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2b. Re: HB 119 Posted by: "Sunny Kierstyn" skrndc1@...< h4 style="background:white;background-attachment:initial;border-width:initial;border-color:initial;">Sun Jan 29, 2012 12:55 pm (PST) Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federa tion of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feedin g the pill mill problem.Minga Guerrero DCabowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2c. Re: HB 119 Posted by: "vsaboe" ; vsaboe@... Sun Jan 29, 2012 1:36 pm (PST) You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2d. Re: HB 119 Posted by: " Schneider" portlandchiro1@... wildwill492003 Sun Jan 29, 2012 3:08 pm (PST) I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDX Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) RECENT ACTIVITY Visit Your Group Meditation and Lovingkindness A Group to share and learn. Error! Filename not specified. Health Asthma Triggers How you can identify them. Error! Filename not specified. Biz Resources Y! Small Business Articles, tools, forms, and more./ b> Error! Filename not specified. Need to Reply? Click one of the "Reply" links to respond to a specific message in the Daily Digest. Create New Topic | Visit Your Group on the Web Messages | Files | Photos | Links | Database | Polls | Members | Calendar All posts must adhere to OregonDCs rules located on homepage at: /Tell a colleague about OregonDCs! (must be licensed Oregon DC) Change settings via the Web ( ID required) Change settings via email: Switch delivery to Individual | Switch format to Traditional Visit Your Group | Terms of Use | Unsubscribe < /div> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012  Perhaps if these clinics were listed here and known to all, it may give them pause to reassess their intentions. I would like to know who they are just to know not to refer patients to them. Rodney G. , DCTillamook Natural Health Center309 Laurel Ave.Tillamook, OR 97141503-842-6532 HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@... Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) 2d. Re: HB 119 Posted by: " Schneider" portlandchiro1@... wildwill492003 Sun Jan 29, 2012 3:08 pm (PST) I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDX Back to top Reply to sender | Reply to group | Reply via web post Messages in this topic (4) RECENT ACTIVITY Visit Your Group Meditation and Lovingkindness A Group to share and learn. 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Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 Well now your touching upon a very good idea Joe. The evidence based outcome assessments are not being done properly or not at all by many of these PIP mills additionally in some each consumer/patient gets one of everything as per provider and modalities with a per visit average of $300-$400 and of course they run through the $15,000 PIP in 3-4 months with the consumer still hurting but the money is now gone… In 2002 I put together an algorithm of a proposed “Single Blinded Oregon External PIP Review System.â€Â It was subsequent to all of this and just after the State Farm Foltz Case relative to the CMR paper review fiasco and subsequent suit I worked on with Dan Gatti and that which was featured on “NBC Dateline, Paper Chase I & II.â€Â The system I put together was an external review or “paper/file review†process wherein a requesting party usually the auto PIP insurer would request a file review to determine the necessity of ongoing care or care that had already been given. The request would be sent to either the State Association who would control the system or the Oregon Board of Chiropractic Examiners who would control the file review system. The controlling body would then select a chiropractic physician at random from the computer data base with the computer being set up to do so. Any DC who is currently willing to accept Auto PIP cases would be required to be part of the “stateside pool†of reviewers and we would have training session for reviewers. All the medical records are sent to the reviewer with the patient and the treating doctor blinded to who the reviewer is only the doctor/reviewer’s SS# or lic. # would appear as a referent of who performed the review so if there were some form of complaint the OBCE could in fact perform an investigation (which isn’t going to happen). The reviewer must review the file within 5-7 business days weekends don’t count and return their report via fax or email to the requesting party. We would keep the report very simple and to the point it would be a one page check the box type deal answering the basic questions the insurer always asks…e.g. based on a medical probability could the MVA in question have caused the injuries reported? Has treatment to date been clinically necessary? Is further curative treatment indicated? How long would that treatment be expected to continue? Was the time loss authorized by the treating doctor necessary? Etc. Doctors would be paid well for these reviews which could be performed during non-patient hours. If the treating doctor and patient disagree with the review they can request a secondary review the findings of which are binding however, the insurers also pay for these reviews. Though binding the consumer can still have their day in court and challenge both reviews however, the defense would describe in great lay detail to jurors the unbiased nature of these reviews which determined this or that and as such would have much more weight in court or arbitration.   By blinding the treating doctor and patient to the reviewer it would take the “monkey off the back†of colleagues who can opine what they really truly believe is right in any particular case without fear of making a colleague they know personally mad at them and as such with to duck-out around the corner when they see that colleague at the annual state convention. Alternatively there is no incentive for the reviewer to favor the insurer who has requested the exam in hopes of gaining more business as they have no idea when they might be selected again by the centralized computer. We could consider a pilot program (State Farm is interested) selecting one particular auto PIP insurer or two or three making it completely optional for them to use our system and if it works well then move forward with administrative rule or legislation installing the system for good. If anyone is interested in the concept and I’m not saying its perfect just my draft start and would love your input, send me a self addressed stamped envelope and I’ll send you a copy of my algorithm of this proposed system…again I’m not saying its perfect but it’s a start…and dear colleagues we had better “start†doing something to address the issue of abuse if we which to avoid being the next Florida…. Hey it could work…lol… Cheers, Vern Saboe PS the SASE isn’t because I’m cheap it’s because of time….. From: ph Medlin [mailto:spinetree@...] Sent: Tuesday, January 31, 2012 8:53 AM'Jamey Dyson'; vsaboeCc: 'Chuck Simpson, DC'; 'Oregon DCs'Subject: Re: Re: FL PIP law This is just a quick reflexive idea: What about after a process that is similar to Work Comp: After say 24 vists the patient must be referred to another DC to evaluate the efficacy of continued care and for recommendation on referral etc. That DC sees the patient, gathers their opinions on their recovery, goes over the notes the progress, does an exam and decides what the appropriate manner of continued care would be. I hate to say it, but I can see why the Work Comp restrictions are in place. These PIP mills wouldn’t have the leeway under that system to “use and abuseâ€. Nonetheless, if there were a way we could get some sort of regulation process together and keep it “in house†and self police, we may be able to somehow reduce the egregious and fraudulent practice of overtreatment. Wouldn’t take long before these PIP mills were gone. ph Medlin D.C. From: vsaboe Sent: Monday, January 30, 2012 7:31 PM'Jamey Dyson' Cc: 'Chuck Simpson, DC' ; 'Oregon DCs' Subject: RE: Re: FL PIP law It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern SaboeFrom: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon D CsSubject: Re: Re: FL PIP lawYes, but I think what Chuck was saying is that PIP mills " document " everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard?Jamey Dyson, DC < div> On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management†as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever.The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves…< o>In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons†problems, possible solutions, and actions steps kind of a dispute resolution flavor 230;.its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself…..Vern SaboeFrom: [mailto:@.com] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP lawHow can we, as a profession, deal with the PIP mills in Oregon? Jamey Dyson, DCOn Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote:ORDCs,It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. " PIP mills " routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that & quo t; document " medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye.C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1. " Horrific Auto PIP BIll Indroducted in Florida! " From: vsaboe< /p>2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1. " Horrific Auto PIP BIll Indroducted in Florida! " Posted by: " vsaboe " vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill w ould institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, " No treatment by DC or LMT allowed. (ll. 533-563! " Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group & nbsp;| Reply via web post Messages in this topic (1)2a.HB 119Posted by: " AboWoman@... " AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance l aw that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: " Sunny Kierstyn " skrndc1@...< h4 style= " background:white;background-attachment:initial;border-width:initial;border-color:initial; " >Sun Jan 29, 2012 12:55 pm (PST) Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federa tion of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feedin g the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: " vsaboe " ; vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider " portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! 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Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 Wow Joe & Verne - that's sounds pretty awesome to me! If it can be done in a way that also educates the treating doctor as to how to improve his/her documentation and/or treatment, then we could really raise the bar for chiropractic care in Oregon.Brilliant ideas!Jamey Dyson, DCOn Jan 31, 2012, at 10:07 AM, vsaboe wrote:Well now your touching upon a very good idea Joe. The evidence based outcome assessments are not being done properly or not at all by many of these PIP mills additionally in some each consumer/patient gets one of everything as per provider and modalities with a per visit average of $300-$400 and of course they run through the $15,000 PIP in 3-4 months with the consumer still hurting but the money is now gone… In 2002 I put together an algorithm of a proposed “Single Blinded Oregon External PIP Review System.” It was subsequent to all of this and just after the State Farm Foltz Case relative to the CMR paper review fiasco and subsequent suit I worked on with Dan Gatti and that which was featured on “NBC Dateline, Paper Chase I & II.” The system I put together was an external review or “paper/file review” process wherein a requesting party usually the auto PIP insurer would request a file review to determine the necessity of ongoing care or care that had already been given. The request would be sent to either the State Association who would control the system or the Oregon Board of Chiropractic Examiners who would control the file review system. The controlling body would then select a chiropractic physician at random from the computer data base with the computer being set up to do so. Any DC who is currently willing to accept Auto PIP cases would be required to be part of the “stateside pool” of reviewers and we would have training session for reviewers. All the medical records are sent to the reviewer with the patient and the treating doctor blinded to who the reviewer is only the doctor/reviewer’s SS# or lic. # would appear as a referent of who performed the review so if there were some form of complaint the OBCE could in fact perform an investigation (which isn’t going to happen). The reviewer must review the file within 5-7 business days weekends don’t count and return their report via fax or email to the requesting party. We would keep the report very simple and to the point it would be a one page check the box type deal answering the basic questions the insurer always asks…e.g. based on a medical probability could the MVA in question have caused the injuries reported? Has treatment to date been clinically necessary? Is further curative treatment indicated? How long would that treatment be expected to continue? Was the time loss authorized by the treating doctor necessary? Etc. Doctors would be paid well for these reviews which could be performed during non-patient hours. If the treating doctor and patient disagree with the review they can request a secondary review the findings of which are binding however, the insurers also pay for these reviews. Though binding the consumer can still have their day in court and challenge both reviews however, the defense would describe in great lay detail to jurors the unbiased nature of these reviews which determined this or that and as such would have much more weight in court or arbitration. By blinding the treating doctor and patient to the reviewer it would take the “monkey off the back” of colleagues who can opine what they really truly believe is right in any particular case without fear of making a colleague they know personally mad at them and as such with to duck-out around the corner when they see that colleague at the annual state convention. Alternatively there is no incentive for the reviewer to favor the insurer who has requested the exam in hopes of gaining more business as they have no idea when they might be selected again by the centralized computer. We could consider a pilot program (State Farm is interested) selecting one particular auto PIP insurer or two or three making it completely optional for them to use our system and if it works well then move forward with administrative rule or legislation installing the system for good. If anyone is interested in the concept and I’m not saying its perfect just my draft start and would love your input, send me a self addressed stamped envelope and I’ll send you a copy of my algorithm of this proposed system…again I’m not saying its perfect but it’s a start…and dear colleagues we had better “start” doing something to address the issue of abuse if we which to avoid being the next Florida…. Hey it could work…lol… Cheers, Vern Saboe PS the SASE isn’t because I’m cheap it’s because of time….. From: ph Medlin [mailto:spinetree@...] Sent: Tuesday, January 31, 2012 8:53 AM'Jamey Dyson'; vsaboeCc: 'Chuck Simpson, DC'; 'Oregon DCs'Subject: Re: Re: FL PIP law This is just a quick reflexive idea: What about after a process that is similar to Work Comp: After say 24 vists the patient must be referred to another DC to evaluate the efficacy of continued care and for recommendation on referral etc. That DC sees the patient, gathers their opinions on their recovery, goes over the notes the progress, does an exam and decides what the appropriate manner of continued care would be. I hate to say it, but I can see why the Work Comp restrictions are in place. These PIP mills wouldn’t have the leeway under that system to “use and abuse”. Nonetheless, if there were a way we could get some sort of regulation process together and keep it “in house” and self police, we may be able to somehow reduce the egregious and fraudulent practice of overtreatment. Wouldn’t take long before these PIP mills were gone. ph Medlin D.C. From: vsaboeSent: Monday, January 30, 2012 7:31 PM'Jamey Dyson'Cc: 'Chuck Simpson, DC' ; 'Oregon DCs'Subject: RE: Re: FL PIP law It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern SaboeFrom: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon D CsSubject: Re: Re: FL PIP lawYes, but I think what Chuck was saying is that PIP mills "document" everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard?Jamey Dyson, DC< div>On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever.The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves…< o>In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor 230;.its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself…..Vern SaboeFrom: [mailto:@.com] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP lawHow can we, as a profession, deal with the PIP mills in Oregon?Jamey Dyson, DCOn Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote:ORDCs,It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. "PIP mills" routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that & quo t; document" medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye.C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1."Horrific Auto PIP BIll Indroducted in Florida!" From: vsaboe< /p>2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1."Horrific Auto PIP BIll Indroducted in Florida!"Posted by: "vsaboe" vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill w ould institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, "No treatment by DC or LMT allowed. (ll. 533-563!"Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group & nbsp;| Reply via web post Messages in this topic (1)2a.HB 119Posted by: "AboWoman@..." AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance l aw that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: "Sunny Kierstyn" skrndc1@...< h4 style="background:white;background-attachment:initial;border-width:initial;border-color:initial;">Sun Jan 29, 2012 12:55 pm (PST)Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federa tion of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feedin g the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: "vsaboe" ; vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider" portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! Filename not specified. HealthAsthma TriggersHow you canidentify them.Error! Filename not specified.Biz ResourcesY! Small BusinessArticles, tools,forms, and more.Error! Filename not specified.Need to Reply?Click one of the "Reply" links to respond to a specific message in the Daily Digest.Create New Topic | Visit Your Group on the WebMessages | Files | Photos | Links | Database | Polls | Members | CalendarAll posts must adhere to OregonDCs rules located on homepage at: /Tell a colleague about OregonDCs! (must be licensed Oregon DC)Change settings via the Web ( ID required) Change settings via email: Switch delivery to Individual | Switch format to Traditional Visit Your Group | Terms of Use | Unsubscribe< /div> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 The system will force the issue of proper charting and the utilization of evidence based outcome assessments…not more hiding behind the “evil IME doctors”……Vern From: Jamey Dyson [mailto:drjdyson1@...] Sent: Tuesday, January 31, 2012 12:29 PMvsaboeCc: 'ph Medlin'; 'Chuck Simpson, DC'; 'Oregon DCs'Subject: Re: Re: FL PIP law Wow Joe & Verne - that's sounds pretty awesome to me! If it can be done in a way that also educates the treating doctor as to how to improve his/her documentation and/or treatment, then we could really raise the bar for chiropractic care in Oregon. Brilliant ideas! Jamey Dyson, DC On Jan 31, 2012, at 10:07 AM, vsaboe wrote:Well now your touching upon a very good idea Joe. The evidence based outcome assessments are not being done properly or not at all by many of these PIP mills additionally in some each consumer/patient gets one of everything as per provider and modalities with a per visit average of $300-$400 and of course they run through the $15,000 PIP in 3-4 months with the consumer still hurting but the money is now gone… In 2002 I put together an algorithm of a proposed “Single Blinded Oregon External PIP Review System.” It was subsequent to all of this and just after the State Farm Foltz Case relative to the CMR paper review fiasco and subsequent suit I worked on with Dan Gatti and that which was featured on “NBC Dateline, Paper Chase I & II.” The system I put together was an external review or “paper/file review” process wherein a requesting party usually the auto PIP insurer would request a file review to determine the necessity of ongoing care or care that had already been given. The request would be sent to either the State Association who would control the system or the Oregon Board of Chiropractic Examiners who would control the file review system. The controlling body would then select a chiropractic physician at random from the computer data base with the computer being set up to do so. Any DC who is currently willing to accept Auto PIP cases would be required to be part of the “stateside pool” of reviewers and we would have training session for reviewers. All the medical records are sent to the reviewer with the patient and the treating doctor blinded to who the reviewer is only the doctor/reviewer’s SS# or lic. # would appear as a referent of who performed the review so if there were some form of complaint the OBCE could in fact perform an investigation (which isn’t going to happen). The reviewer must review the file within 5-7 business days weekends don’t count and return their report via fax or email to the requesting party. We would keep the report very simple and to the point it would be a one page check the box type deal answering the basic questions the insurer always asks…e.g. based on a medical probability could the MVA in question have caused the injuries reported? Has treatment to date been clinically necessary? Is further curative treatment indicated? How long would that treatment be expected to continue? Was the time loss authorized by the treating doctor necessary? Etc. Doctors would be paid well for these reviews which could be performed during non-patient hours. If the treating doctor and patient disagree with the review they can request a secondary review the findings of which are binding however, the insurers also pay for these reviews. Though binding the consumer can still have their day in court and challenge both reviews however, the defense would describe in great lay detail to jurors the unbiased nature of these reviews which determined this or that and as such would have much more weight in court or arbitration. By blinding the treating doctor and patient to the reviewer it would take the “monkey off the back” of colleagues who can opine what they really truly believe is right in any particular case without fear of making a colleague they know personally mad at them and as such with to duck-out around the corner when they see that colleague at the annual state convention. Alternatively there is no incentive for the reviewer to favor the insurer who has requested the exam in hopes of gaining more business as they have no idea when they might be selected again by the centralized computer. We could consider a pilot program (State Farm is interested) selecting one particular auto PIP insurer or two or three making it completely optional for them to use our system and if it works well then move forward with administrative rule or legislation installing the system for good. If anyone is interested in the concept and I’m not saying its perfect just my draft start and would love your input, send me a self addressed stamped envelope and I’ll send you a copy of my algorithm of this proposed system…again I’m not saying its perfect but it’s a start…and dear colleagues we had better “start” doing something to address the issue of abuse if we which to avoid being the next Florida…. Hey it could work…lol… Cheers, Vern Saboe PS the SASE isn’t because I’m cheap it’s because of time….. From: ph Medlin [mailto:spinetree@...] Sent: Tuesday, January 31, 2012 8:53 AM'Jamey Dyson'; vsaboeCc: 'Chuck Simpson, DC'; 'Oregon DCs'Subject: Re: Re: FL PIP law This is just a quick reflexive idea: What about after a process that is similar to Work Comp: After say 24 vists the patient must be referred to another DC to evaluate the efficacy of continued care and for recommendation on referral etc. That DC sees the patient, gathers their opinions on their recovery, goes over the notes the progress, does an exam and decides what the appropriate manner of continued care would be. I hate to say it, but I can see why the Work Comp restrictions are in place. These PIP mills wouldn’t have the leeway under that system to “use and abuse”. Nonetheless, if there were a way we could get some sort of regulation process together and keep it “in house” and self police, we may be able to somehow reduce the egregious and fraudulent practice of overtreatment. Wouldn’t take long before these PIP mills were gone. ph Medlin D.C. From: vsaboeSent: Monday, January 30, 2012 7:31 PM'Jamey Dyson'Cc: 'Chuck Simpson, DC' ; 'Oregon DCs'Subject: RE: Re: FL PIP law It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern SaboeFrom: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon D CsSubject: Re: Re: FL PIP lawYes, but I think what Chuck was saying is that PIP mills " document " everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard?Jamey Dyson, DC< div>On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever.The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves…< o>In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor 230;.its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself…..Vern SaboeFrom: [mailto:@.com] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP lawHow can we, as a profession, deal with the PIP mills in Oregon?Jamey Dyson, DCOn Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote:ORDCs,It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. " PIP mills " routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that & quo t; document " medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye.C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1. " Horrific Auto PIP BIll Indroducted in Florida! " From: vsaboe< /p>2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1. " Horrific Auto PIP BIll Indroducted in Florida! " Posted by: " vsaboe " vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill w ould institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, " No treatment by DC or LMT allowed. (ll. 533-563! " Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group & nbsp;| Reply via web post Messages in this topic (1)2a.HB 119Posted by: " AboWoman@... " AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance l aw that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: " Sunny Kierstyn " skrndc1@...< h4 style= " background:white;background-attachment:initial;border-width:initial;border-color:initial; " >Sun Jan 29, 2012 12:55 pm (PST)Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federa tion of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feedin g the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: " vsaboe " ; vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider " portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! 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Guest guest Posted January 31, 2012 Report Share Posted January 31, 2012 Jamey, Joe, Vern,The "Got Documentation" seminar I went to last weekend addressed this issue. I'm glad I went, and it wasn't even too boring. I'm also looking forward to Vern's Evidence Based Outcomes class at the OCA convention next weekend.I've become increasingly aware my documentation skills are in need of brushing up.Apparently it is not just my problem.AnnetteOn Jan 31, 2012, at 12:28 PM, Jamey Dyson wrote: Wow Joe & Verne - that's sounds pretty awesome to me! If it can be done in a way that also educates the treating doctor as to how to improve his/her documentation and/or treatment, then we could really raise the bar for chiropractic care in Oregon.Brilliant ideas!Jamey Dyson, DCOn Jan 31, 2012, at 10:07 AM, vsaboe wrote:Well now your touching upon a very good idea Joe. The evidence based outcome assessments are not being done properly or not at all by many of these PIP mills additionally in some each consumer/patient gets one of everything as per provider and modalities with a per visit average of $300-$400 and of course they run through the $15,000 PIP in 3-4 months with the consumer still hurting but the money is now gone… In 2002 I put together an algorithm of a proposed “Single Blinded Oregon External PIP Review System.” It was subsequent to all of this and just after the State Farm Foltz Case relative to the CMR paper review fiasco and subsequent suit I worked on with Dan Gatti and that which was featured on “NBC Dateline, Paper Chase I & II.” The system I put together was an external review or “paper/file review” process wherein a requesting party usually the auto PIP insurer would request a file review to determine the necessity of ongoing care or care that had already been given. The request would be sent to either the State Association who would control the system or the Oregon Board of Chiropractic Examiners who would control the file review system. The controlling body would then select a chiropractic physician at random from the computer data base with the computer being set up to do so. Any DC who is currently willing to accept Auto PIP cases would be required to be part of the “stateside pool” of reviewers and we would have training session for reviewers. All the medical records are sent to the reviewer with the patient and the treating doctor blinded to who the reviewer is only the doctor/reviewer’s SS# or lic. # would appear as a referent of who performed the review so if there were some form of complaint the OBCE could in fact perform an investigation (which isn’t going to happen). The reviewer must review the file within 5-7 business days weekends don’t count and return their report via fax or email to the requesting party. We would keep the report very simple and to the point it would be a one page check the box type deal answering the basic questions the insurer always asks…e.g. based on a medical probability could the MVA in question have caused the injuries reported? Has treatment to date been clinically necessary? Is further curative treatment indicated? How long would that treatment be expected to continue? Was the time loss authorized by the treating doctor necessary? Etc. Doctors would be paid well for these reviews which could be performed during non-patient hours. If the treating doctor and patient disagree with the review they can request a secondary review the findings of which are binding however, the insurers also pay for these reviews. Though binding the consumer can still have their day in court and challenge both reviews however, the defense would describe in great lay detail to jurors the unbiased nature of these reviews which determined this or that and as such would have much more weight in court or arbitration. By blinding the treating doctor and patient to the reviewer it would take the “monkey off the back” of colleagues who can opine what they really truly believe is right in any particular case without fear of making a colleague they know personally mad at them and as such with to duck-out around the corner when they see that colleague at the annual state convention. Alternatively there is no incentive for the reviewer to favor the insurer who has requested the exam in hopes of gaining more business as they have no idea when they might be selected again by the centralized computer. We could consider a pilot program (State Farm is interested) selecting one particular auto PIP insurer or two or three making it completely optional for them to use our system and if it works well then move forward with administrative rule or legislation installing the system for good. If anyone is interested in the concept and I’m not saying its perfect just my draft start and would love your input, send me a self addressed stamped envelope and I’ll send you a copy of my algorithm of this proposed system…again I’m not saying its perfect but it’s a start…and dear colleagues we had better “start” doing something to address the issue of abuse if we which to avoid being the next Florida…. Hey it could work…lol… Cheers, Vern Saboe PS the SASE isn’t because I’m cheap it’s because of time….. From: ph Medlin [mailto:spinetree@...] Sent: Tuesday, January 31, 2012 8:53 AM'Jamey Dyson'; vsaboeCc: 'Chuck Simpson, DC'; 'Oregon DCs'Subject: Re: Re: FL PIP law This is just a quick reflexive idea: What about after a process that is similar to Work Comp: After say 24 vists the patient must be referred to another DC to evaluate the efficacy of continued care and for recommendation on referral etc. That DC sees the patient, gathers their opinions on their recovery, goes over the notes the progress, does an exam and decides what the appropriate manner of continued care would be. I hate to say it, but I can see why the Work Comp restrictions are in place. These PIP mills wouldn’t have the leeway under that system to “use and abuse”. Nonetheless, if there were a way we could get some sort of regulation process together and keep it “in house” and self police, we may be able to somehow reduce the egregious and fraudulent practice of overtreatment. Wouldn’t take long before these PIP mills were gone. ph Medlin D.C. From: vsaboeSent: Monday, January 30, 2012 7:31 PM'Jamey Dyson'Cc: 'Chuck Simpson, DC' ; 'Oregon DCs'Subject: RE: Re: FL PIP law It’s only a start as per what I suggested…we then as a profession need to determine based on the best available evidence and by professional consensus what interventions are redundant or duplicative and determine which if given on the same visit should not be reimburse. Also when should active curative rehab begin and end and what outcome assessments to use and when evidence is lacking make the call by consensus etc., etc.…….Vern SaboeFrom: Jamey Dyson [mailto:drjdyson1@...] Sent: Monday, January 30, 2012 6:27 PMvsaboeCc: Chuck Simpson, DC; Oregon D CsSubject: Re: Re: FL PIP lawYes, but I think what Chuck was saying is that PIP mills "document" everything they are supposed to document so that on paper their treatment looks medically necessary. They use computer generated notes and reports that say all the right things. When you look at their billing practices, however, you see them billing for everything under the sun in order to get that $15K asap. Their billing is on the extreme high end of norm per visit charges for chiropractors. I was asking what can we do about that issue? How do we weed out the PIP clinics who are doing legit work vs. those doing unethical work? How do we clean up our own profession in this regard?Jamey Dyson, DC< div>On Jan 30, 2012, at 5:56 PM, vsaboe wrote:Well Jamey at the very least doctors must start performing the “Evidence Based Outcomes Management” as required in our administrative rules. Our guidelines only recommendthat doctors re-assess their patients if they have treated them daily for two weeks, or have treated them three times per week for six weeks, or have authorized 30 days of time loss, or the patient has show no improvement whatsoever.The evidence based outcome assessments then must document or show that a doctor’s curative treatment is, has been, or continues to be clinically necessary and to reveal when that patient is at maximum chiropractic/medical improvement (MMI) and end care. This would be at least a first step in the right direction in hopes of not ending up with the Florida situation. With that said I believe that with the legislative relationships the OCA has built at the State Capital over the last 10 years combined with the coalition of other healthcare providers we have built we could stop any such legislation. However, as your lobbyist and colleague I would rather not absolutely depend on that which is reactionary I would hope we as a profession would be proactive and pre-emptive and address the issue head on ourselves…< o>In addition the OCA years ago put together an insurance outreach program with a notebook of information for claims representative about chiropractic our education, or clinical skill sets, how we treat and why as well as the evidence that support or interventions. I Drs. Ron Grice and Palmer gave some of this talks to the insurers claims representatives… I would also like to see an annual roundtable symposium with insurers, doctors, representatives from the insurance division, legislators, during these informational symposiums we talk about the latest research on auto crash injuries, treatment, etc. whatever and then a roundtable discussion about things that are “red buttons” problems, possible solutions, and actions steps kind of a dispute resolution flavor 230;.its amazing how if you get in the room with an individual(s) you have demonized all of a sudden you realize they are human after all…and not so different that youself…..Vern SaboeFrom: [mailto:@.com] On Behalf Of Jamey DysonSent: Monday, January 30, 2012 5:24 PMChuck Simpson, DCCc: No Reply; Oregon DCsSubject: Re: Re: FL PIP lawHow can we, as a profession, deal with the PIP mills in Oregon?Jamey Dyson, DCOn Jan 30, 2012, at 2:07 PM, Chuck Simpson, DC wrote:ORDCs,It's deja vu, all over again. We have some DCs in our midst who may make PIP a thing of the past. "PIP mills" routinely treat patients to the max, multiple modalities, 1 hour massages, adjusting spine and extremities at each visit from day 1 to day 60. With computerized chart notes that & quo t; document" medical necessity. It's creepy. The profession is just a sting and a press release with a perp walk away from kissing the ability to treat injured auto accident victims goodbye.C SimpsonSent from my iPadOn Jan 30, 2012, at 10:17 AM, " " < > wrote:Chiropractic Physicians of OregonMessages In This Digest (5 Messages)1."Horrific Auto PIP BIll Indroducted in Florida!" From: vsaboe< /p>2a.HB 119 From: AboWoman@...2b.Re: HB 119 From: Sunny Kierstyn2c.Re: HB 119 From: vsaboe2d.Re: HB 119 From: SchneiderView All Topics | Create New TopicMessages1."Horrific Auto PIP BIll Indroducted in Florida!"Posted by: "vsaboe" vsaboe@...Sun Jan 29, 2012 12:15 pm (PST)[Attachment(s) from vsaboe included below] Dear colleagues,Attached is an outline of the horrible changes to the current auto PIP lawin Florida that this horrific bill w ould institute. The reality is for allpractical purposes we need only read the first bullet, last sentence whichreads, "No treatment by DC or LMT allowed. (ll. 533-563!"Is Oregon next? Keep in mind that Florida only has a minimum $10,000 PIPwhereas Oregon has increased theirs to $15,000. Will we continue businessas usual? Will we sit back and wait and be reactionary as in 1989 andSB-1197 which trashed Workers Compensation for us? Or will we as aprofession be proactive and preemptive? So what say you???Vern Saboe DC, FACOACA Delegate for Oregon541-231-4528 CellAttachment(s) from vsaboe1 of 1 File(s)OCA Auto PIP Alert Horrific Florida Bill Introduced 2012.pdfBack to topReply to sender | Reply to group & nbsp;| Reply via web post Messages in this topic (1)2a.HB 119Posted by: "AboWoman@..." AboWoman@...Sun Jan 29, 2012 12:29 pm (PST)Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federation of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance l aw that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feeding the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2b.Re: HB 119Posted by: "Sunny Kierstyn" skrndc1@...< h4 style="background:white;background-attachment:initial;border-width:initial;border-color:initial;">Sun Jan 29, 2012 12:55 pm (PST)Beautifully reasoned and written, Minga. Thanks for the template! SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.comjoseph.abruzzo@...; From: AboWoman@...Date: Sun, 29 Jan 2012 15:28:42 -0500Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I have served for the Governor's office for over 17 yrs in state regulation. 6 of those years as a licensing board member and 4 1/2 as president of the Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to the National Board of Chiropractic Examiners (the US credentialing/ testing agency) and 6 years as the Oregon delegate to the Federa tion of Chiropractic Licensing Boards (International regulation agency). I was recently made aware of HB 119, a newly proposed, PIP insurance law that would limit consumers ability to access non-emergency and non-drug treatment for musculo-skeletal injurie following an auto accident. I've listed below, the reasons I believe this is an extremely flawed idea. Although I'm not a direct constituent, I would respectfully ask that you consider the points below and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119Does nothing to directly attack fraud In these days of high unemployment, will cause the loss of tens of thousands of jobs (in offices of non-hospital providers) Will lower the quality of health care provided to those injured in auto accidents Will result in less care for those with injuries, as all benefits will be absorbed in just one ER visit with high-dollar diagnostic costs Shifts care to the most expensive, most chaotic venue Will flood emergency rooms, meaning longer wait time for care for those who are critical and not critical Removes the number one choice of consumers for drugless, conservative care: chiropractic. Removes the least expensive drugless, non-surgical intervention: chiropractic. By removing the number one drugless intervention, will result in even more injured Floridians with dependencies on pain medication, feedin g the pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2c.Re: HB 119Posted by: "vsaboe" ; vsaboe@...Sun Jan 29, 2012 1:36 pm (PST)You go girl.excellent Minga.excellent..may I post this to the ACA listservemay help as per a template for Florida DCs? Vern SaboeFrom: [mailto: ] On BehalfOf AboWoman@...Sent: Sunday, January 29, 2012 12:29 PMjoseph.abruzzo@...; Subject: HB 119Dear Senator,I am a chiropractic physican of 27 years experience in Portland, OR. I haveserved for th e Governor's office for over 17 yrs in state regulation. 6 ofthose years as a licensing board member and 4 1/2 as president of the OregonBoard of Chiropractic Examiners. I served as the Oregon delegate to theNational Board of Chiropractic Examiners (the US credentialing/ testingagency) and 6 years as the Oregon delegate to the Federation of ChiropracticLicensing Boards (International regulation agency). I was recently madeaware of HB 119, a newly proposed, PIP insurance law that would limitconsumers ability to access non-emergency and non-drug treatment formusculo-skeletal injurie following an auto accident. I've listed below, thereasons I believe this is an extremely flawed idea. Although I'm not adirect constituent, I would respectfully ask that you consider the pointsbelow and vote AGAINST this bill. thank you for considering my point of view.Minga Guerrero DCHood View Chiropractic270 NE 181st AvePortland, OR 97230HB 119* Does nothing to directly attack fraud * In these days of high unemployment, will cause the loss of tens ofthousands of jobs (in offices of non-hospital providers) * Will lower the quality of health care provided to those injured inauto accidents * Will result in less care for those with injuries, as all benefitswill be absorbed in just one ER visit with high-dollar diagnostic costs * Shifts care to the most expensive, most chaotic venue * Will flood emergency rooms, meaning longer wait time for care forthose who are critical and not critical * Removes the n umber one choice of consumers for drugless,conservative care: chiropractic. * Removes the least expensive drugless, non-surgical intervention:chiropractic. * By removing the number one drugless intervention, will result ineven more injured Floridians with dependencies on pain medication, feedingthe pill mill problem.Minga Guerrero DCabowoman@...Back to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)2d.Re: HB 119Posted by: " Schneider" portlandchiro1@... wildwill492003Sun Jan 29, 2012 3:08 pm (PST)I echo Sunny's thoughts. A masterpiece of reasoning and truth!! Thanksfor your efforts to support our good profession. Schneider DCPDXOn Sun, Jan 29, 2012 at 12:28 PM, <AboWoman@...> wrote:> **>>> Dear Senator,> I am a chiropractic physican of 27 years experience in Portland, OR. I> have served for the Governor's office for over 17 yrs in state regulation.> 6 of those years as a licensing board member and 4 1/2 as president of the> Oregon Board of Chiropractic Examiners. I served as the Oregon delegate to> the National Board of Chiropractic Examiners (the US credentialing/ testing> agency) and 6 years as the Oregon delegate to the Federation of> Chiropractic Licensing Boards (International regulation agency). I was> recently made aware of HB 119, a newly proposed, PIP insurance law that> would limit consumers ability to access non-emergency and non-drug> treatment for musculo-skeletal injurie following an auto accident. I've> listed below, the reasons I believe this is an extremely flawed> idea. Although I'm not a direct constituent, I would respectfully ask that> you consider the points below and vote AGAINST this bill.> thank you for considering my point of view.> Minga Guerrero DC> Hood View Chiropractic> 270 NE 181st Ave> Portland, OR 97230>> *HB 119*>>> - Does nothing to directly attack fraud> - In these days of high unemployment, will cause the loss of tens of< br>> thousands of jobs (in offices of non-hospital providers)> - Will lower the quality of health care provided to those injured in> auto accidents> - Will result in less care for those with injuries, as all benefits> will be absorbed in just one ER visit with high-dollar diagnostic costs> - Shifts care to the most expensive, most chaotic venue> - Will flood emergency rooms, meaning longer wait time for care for> those who are critical and not critical> - Removes the number one choice of consumers for drugless,> conservative care: chiropractic.> - Removes the least expensive drugless, non-surgical intervention:> chiropractic.> - By removing the number one drugless intervention, will result in> even more injured Floridians with dependencies on pain medication, feeding> the pill mill problem.>>>> Minga Guerrero DC> abowoman@...>> >-- Schneider DCPDXBack to topReply to sender | Reply to group | Reply via web post Messages in this topic (4)RECENT ACTIVITYVisit Your GroupMeditation andLovingkindnessA Groupto share and learn.Error! 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