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D:\wrdfiles\agendas\agenda 1004 web.wpdNew York State Chiropractic AssociationBoard of Directors and House of Delegates Meeting Fort William Henry Hotel & Convention Center A. Budget
B. Accountant’s Report
D. Legal Expenses
E. NYCPAC Contribution Report (Oliver)
F. Controller’s Report to the District Treasurer’s, Re: District Bank Accounts
VI. Chiropractic Education Foundation of New York (CEFNY) VII. Chiropractic Health Services and Research Forum of New York (CHSRFNY) A• Insurance Equality Update (Lanzafame)
State Insurance/Health Departmentsa.
Draft Proposed Insurance Equality Regulation (Mazzullo/Lanzafame).
A.11751 An Act to amend the Insurance Law in relation to doctors of chiropractic.
Insurance Equality Issues (Kranz)
The Honorable James L. Seward, Senator, Chair, NYS Senate Insurance Committee. The Health Insurance Market in New York State. Strategies for Affordable Coverage.
February 2004 (Selected Portions) Novak D. New York State Mandated Health Insurance Benefits. NovaRest Consulting,May 2003.
Malanga S. Medicare Monkey Business. Steven Malanga on how Albany is makingNew Yrok’s costly health care system costlier. The New York Sun; May 21, 2004.
Malanga S. Albany’s Medical Monkey Business. City Journal 2004 (Spring); 14(2).
iii. Durr E. Report takes Legislature to task for mandating health insurance benefits. The Capital District Business Review 2003 (Jun 2).
iv. Alesse M. Study Concludes: Policy holders pay over $1,000 per employee for mandates. Alliance Alert. Employer Alliance for Affordable Health Care 2003 (Fall).
Franczyk AM. Small business gets big break on Insurance. Buffalo Business First2003 (Jun 9).
vi. Doran E. Small Businesses Struggle to Cope with Soaring Health Insurance Costs.
Small Businesses Oppose Adding Proposed New Mandates. GE Industry News, BOARD OF DIRECTORS AND HOUSE OF DELEGATES AGENDA vii. Who Wants to Be a Millionaire. Distributed by: The Mental Health Association in New York State, Citizen Action of New York and the Public Employees Federation. 2003.
Jensen GA, Morrisey MA. Employer-sponsored Health Insurance and Mandated BenefitLaws. The Milbank Quarterly 1999; 77(4):1-34.
National Conference of State Legislatures. State Health Care Cost Containment Ideas. Prepared by the NCSLs Standing Committee on Health. July 2003.
National Conference of State Legislatures. State Health Care Policy: First Quarter of2004. Lower-Cost Policies, p. 4.
Other Initiatives (Kranz)
National Association of Insurance Commissionersa.
B• Legislation (Mazzullo)
State – See NYSCA Legislative Briefing Booka.
New York Chiropractic Legislative Task Force Meeting Agenda May 27, 2004 PT Direct Access – A4582 (P Mar 10_04) /S2073-b (NM) (Kranz)
Chiropractic Equity Bill – A787(NM) /S424 (NM) (Littlejohn)
Governor’s WC Program Bill – S6841 (NM)/A10975 (NM) (Kranz/Lanzafame/Mazzullo)
Freedom Policies – S.6332(P Jun 21_04)/A10251(NM) (Kranz/Lanzafame)
Articles 49 PHL/IL – Clinical Peer Revieweri.
Any Willing Provider (Lanzafame)
Corporate Multidisciplinary Practice (Lanzafame)
Health Savings Accounts (HSAs) (Kranz/Lanzafame)
Association Health Plans (Kranz/Lanzafame)
C• State Law and Regional Regulatory Issues
Education Department – Law and Regulation Issuesa.
SED approval as Mandatory CE sponsor (Kranz)
Chiropractic Plus – Is this Legal? (Wolfson)
Proposed Rule Making – Managed Care Organizations, ID No. HLT-13-04-00017-P
NYS DOH HMO and IPA Provider Contract Guidelines NYS DOH HMO and IPA Contract Standard Clauses iii. NYS DOH HMO and IPA Provider Contract Statement and Certificationiv. NYS Rule Making ID No. HLT-13-04-00017-Pv.
NYS DOH HMO and IPA Revised Provider Contract Guidelines vi. Draft NYSCA response to Proposed Rule-making Chiropractors’ Medical Record Access Review Committee BOARD OF DIRECTORS AND HOUSE OF DELEGATES AGENDA Letter to Howard G. Baumgartner, MS, DOH Coordinator Insurance Department – Law and Regulation Issues (Kranz)
Proposed revision to proposed Amendment of § 68.1(b) of Part 68 and Appendix 17C(Regulation 83) of Title 11 NYCRRi.
NYSCA Notes (Kranz/Lanzafame)
Council Update (Penna)
Letter from Donald Littlejohn, DC to MVP Healthcare (Littlejohn)
Workers’ Compensation Board – Law and Regulation Issuesa.
Payment of Interest for Delinquent Healthcare Claims, NYS Attorney General’s Office
First Health Letter to William Egan, Director, Bureau of Medical Management and Brenda
A. Rigas, Confidential Aide to the Chair, New York State Workers’ Compensation Board.
Law Judge fee determination and Notice of Decision (Littlejohn)
Business Council of New York State, Inc Issuesi.
Issue 4 – Scheduled Comp Payments: A Wage Replacement, Not a Supplement Issue 3 – Objective Medical Guidelines: A Fair Assessment for Everyone Involved.
iii. Issue 2 –Durational Limits: Ample Benefits and Sufficient Time to Retrainiv. Issue 1 – Workers’ Compensation Costs: When Does Your Business Say “Enough is Access to patient records online (DeSantis)
Forward to the 2004 WC Fee Schedule; the Council’s response and the NYSCA critique.
Congress of Chiropractic State Associations (Kranz)
National Association of Chiropractic Attorneys (Lanzafame)
Informed Consent (Rogers/Lanzafame)
D• Federal Law and National Regulatory Issues
Trigon Lawsuit (Wolfson/Lupinacci)
Request for Amicus (Wolfson)
Harter, Secrest & Emery/Lanzafame note (Lanzafame)
ACA issues and items (Wolfson)
ACA Clinical Documentation Manual (Pownall, Penna, Tesoriero, Silber)
New Requirements for Chiropractic Billing of Active/Corrective Treatment andMaintenance Therapy BOARD OF DIRECTORS AND HOUSE OF DELEGATES AGENDA Empire Medicare Services – The Medicare News Brief (Sept 2004) Upstate Health Now – “Dear Doctor” material, Calendar Year (CY) 2005 MedicareParticipation Announcement and Agreement, Fact Sheet and fee schedule by CD-ROM.
Upstate Health Now – Chiropractic Update regarding code 98941 (Chiropracticmanipulative treatment (CMT); spinal, three to four regions.
Coverage of Chiropractic – Kotlar – Target Coding, Inc.(Lanzafame)
Health Insurance Portability and Accountability Act (HIPAA) of 1996a.
Security Standards (Lanzafame/Kranz)
E• NYSCA Website Update (Richards)
F• NYSCA District CE Policy (Pownall/Kranz)
G• Council on Chiropractic Guidelines & Practice Parameters Eugene A. Lewis, DC, MPH/John J. Triano, DC, PhD H• Long Range Planning (Kranz/Lupinacci/Penna/Pownall)
Integrating Chiropractic into the Mainstream of Healthcarea.
Issues – Issue 1 (Kranz/Lupinacci)
Suggestions of an Ad Hoc Committee Meeting of Districts 3, 6 & 7 (and 9), May 23,
a• Conduct Surveys & Studies
Gerald Stevens, DC – University at Buffalo (Kranz)
Revised UB Affiliation Agreement (Lanzafame/Kranz)
b• Create an Evidence-based Practice Parameters and Best Practices Boot Camp for Doctors – A Center of Excellence.
! Extra Professional, Graduate Level Degrees and the Language of Science.
Bridges to Excellence and the National Committee for Quality Assurance.
2004 Standards & Guidelines for Physician Practice Connections
iii• Best Practice: Basics and Beyond. Texas University at San Antonio, Health Science Center. (Kranz)
iv• Martha S. Gerrity, MD, PhD. Evidence-based Medicine Workshops for the Practicing Clinician. Society for General Internal Medicine, Washington, DC
National Institutes of Health. AHRQ Small Grant Program for ConferenceSupport. October 2, 2000.
vi• National Institutes of Health. AHRQ Small Research Grant Program. January to Carriers, HMOs, MCOs, self-insureds, health benefit managers andemployers d• Deal with Fraud & Abusee• Policy Statements World Federation of Chiropractic Task Force on Professional Identity (Quatro)
BOARD OF DIRECTORS AND HOUSE OF DELEGATES AGENDA National Committee for Quality Assurance (NCQA) – Certification Programsa.
Sarnat RL, Winterstein J. Clinical and cost outcomes of an integrative Medicine IPA. JMPT 2004 (Jun); 27(5): 226-347.
Letter from Delilah Anderson, DC; Alvine Graun, DC et al. to James Zechman, CEO,Richard Sarnat, MD Chief Medical Director and Mayer Eisenstein, MD, Medical Director,Alternative Medicine Integration, 473 Central Avenue St. 2, Highland Park, IL 60035,August 13, 2004.
NY State Fair Booth Expenses (Sportelli)
American Board of Forensic Professionals Update (Tesoriero)
K• New York City Marathon Medical Volunteer Application (Ippolito)
A. Dues DispensationsB. Conventions, Regional A. New York Alliance Against Insurance Fraud B. Complaint – MVP Health Plan Website (Littlejohn)
C. ABC/CPT Codes – Integrative Medicine Networks D. District 4 merger with Westchester (District 8) or Queens (District 3) E. Non-Approval of Application for Participation in ASH Networks F. New York Chiropractors Unity Conference (Bernstein)
G. CCE Commission on Accreditation (COA) Academy of Site Team Visitors (Academy)
PRAIRIE SHOULDER, ELBOW & HAND CENTER 1. It is the patient’s responsibility to get pre-certification from your insurance company for your surgical procedure. At this time, if you will need Physical Therapy, please verify the number of visits allowed. 2. Make an appointment for your preoperative history & physical with your personal physician. This needs to be completed within 30