This material was contributed directly by GCO member Doctor Vern Saboe, Jr, DC DACAN FICC DABFP FACO, OCA/CHIROPAC lobbyist, and is not edited by GoodChiropractic.Org. We have contacted CHIROPAC to secure a digital link to an automatically refreshing page which will replace this text in a future generation.
The CHIROPAC newsletter is updated approximately Monthly.
ChiroPAC Newsletter for November, 2014
Governor’s Race: The race is tighter than we would like with the latest polls showing the Governor with a 7% – 9% lead over his opponent. If we wish to finally achieve proper interpretation of the federal non-discrimination provisions in the PPACA, which is Section 2706(a) we need John back in the big seat. I and Dr. Dan Beeson OCA Board member have met personally with the Governor twice on a very specific strategy as per forcing proper enforcement of non-discrimination here in Oregon on the state level.
Class action: I continue to funnel examples of clear violation of the non-discrimination provisions in the federal law to the law firm back east which specializes in class action law suits. Point being if we must go this route we will attempt to force the insurers to stop violating the non-discrimination provisions via this method. Insurance Commissioner’s Network Adequacy Advisory Committee: I continue to serve on this committee which the commissioner appointed me to. Key to the draft bill we are writing is inserting the exact language in federal law (Section 2706). This is very key because the federal government gives states the ability to entirely enforce the PPACA including this non-discrimination provision and enforcement will be easier if that language is in Oregon State law. The 14 commercial health insurers who also serve on this committee made it abundantly clear they did not want this language inserted into Oregon law for rather obvious reasons. However, we were way ahead of the insurers anticipated view I personally contacted the Governor explaining how important having this non-discrimination language inserted into Oregon law that would apply to the commercial health insurers was to us. The Governor agree to meet personally with Laura Cali the commissioner and explain to her the significance and need for the non-discrimination language to be included in the draft bill we are working on. That conversation with the Governor has been paying off, the insurers have kept attempting to have the non-discrimination language removed but thankfully the Oregon Insurance Commissioner isn’t budging.
Low Back Pain Prioritized List Reorganization Task Force: We have been shouting from the roof tops over the last 24 months ever since the adopted State of Oregon Low Back Pain Management Guidelines were established in 2012, that Medicaid patients cannot see a chiropractor. Low back pain and related conditions are below the prioritized line of covered services for patients on the Oregon Health Plan meaning the poor or Medicaid population. Though this class of patients have no trouble have their visits paid for to see a medical doctor who only prescribes pain medications including opioid narcotics, they can’t come to us for the very treatment the State’s guidelines recommend, spinal manipulation. I have been appointed to this task force which has a lot of big players including OHSU’s Richard Deyo, MD, author of the new book “Watch Your Back” and who has written extensively about the excesses in medical management of back pain. The goal is to place certain low back pain condition above the line so that evidence-based and evidence informed treatment interventions are covered services not the least of which will be spinal adjustments/manipulations. The number of Oregonians and Americans in general that are qualifying for the Oregon Health Plan are growing hugely due to the health care reforms and this population remains a huge untapped potential patient base for the chiropractic profession. As you Oregon Delegate to the American Chiropractic Association (ACA) and member of the ACA Legislative Committee and Governor’s Advisory Council we have been discussing this reality on the national level.
Patient-Centered Primary Care Medical Homes (PCPCMH): Have the potential of being a huge key to the future of the chiropractic profession across our nation and especially here in Oregon. This is one method by which chiropractic physicians can be integrated into the mainstream of health care and work in very rewarding multi-disciplinary clinical environment. The whole health care system is moving in chiropractic’s direction a focus away from episodic care and fee for service to a focus on population health, health promotion and wellness and new capitated payment systems. For decades we have spoken of chiropractic’s philosophy and clinical goal of taking our patients to higher levels of wellness, optimum health or a state of homeostasis so they are less likely to fall prey to illness and injury in the first place. We get paid for “wellness care” instructing our patients to “eat well,” “move well,” and “think well,” and as a result keep them healthy and out of our offices for acute care. In a capitated payment system you would be paid flat fee per month for each patient in your patient base and receive bonuses for certain services that our preventative and for documented outcomes e.g., keeping their blood pressure down, their blood sugar down, reducing trips to the ER and hospitalizations etc. It is exciting to see where the whole system is headed, though for you in the trenches dealing with the insurer carriers inappropriate baloney it doesn’t much seem like we are progressing but just the reverse. Think of the current wacky actions by the insurers and health plans as “growing pains” as I said it’s going to be a bumpy ride for a while so stay financially lean, keep your debt to a minimum pay cash for everything you can until this current ride and growing pains are gone and we break through to the other side!
Auto PIP Insurance: I continue to network with other professions and specifically with the Oregon Trial Lawyers Association to ensure we defeat any negative legislation that might attack Oregon’s wonderful PIP laws. However, we in the profession must address obvious abuses by the time honored few in our profession. The Oregon Board of Chiropractic Examiners will re-visit our “Oregon Practice and Utilization Guidelines” with the goal of continuing to improve the quality of chiropractic management for all Oregonians. Personally I can tell you there are two areas of rather blatant abuse wherein we need further guidance for our doctors and to showcase to the auto insurance carriers we are willing and able to address these issues. Rehabilitative in-clinic services and massage therapy are two areas of abuse that continue and run the risk of tanking us all. We must address these issues and come up with evidence-informed guidelines and field consensus for example, who should receive in-clinic rehabilitative services and who should not? When should rehabilitative services begin and when should they end? What forms of rehabilitative and adjunctive passive modalities are appropriate in the acute, subacute and chronic phases of injury healing and which are not appropriate or redundant? These are the types of “hot button” issues this committee which I’ve been appointed to will address. If for no other reason if the auto PIP insurers attempt to restrict chiropractic services that reality that we as a profession the OCA, the OBCE and UWS are address the very concerns they have will help me tremendously in Salem when I testify against any such negative legislation.
Well that’s if for this newsletter I could give you much more but like to keep these to a single page even if it means 8 pt. font! Doctor THANK YOU for your continued $$$ contributions to our ChiroPAC you are helping to make a difference.
Blessings, Vern Saboe
Contribute to the Fund [Developer – should go to the Oregon Fund Anchor]