MCA In Touch – April 2018

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In this IssueAward Winners Honored at 2018 Annual Convention

It Was Important to Be at the Capitol!

Audit Insurance: Cost-Effective Protection or Expensive Luxury?

The MCA Is Excited to Host the Minnesota Integrative Concussion Summit!

Award Winners Honored at 2018 Annual Convention

MCA’s 2018 Awards Banquet was held on March 16 during the Annual Convention. Twenty-five were honored asMCA recognized those who have made a significant impact on the profession. Whether at the beginning of theircareer or having been in practice for 50 years, we are grateful for the time and commitment of these hard-working,passionate doctors.

Chiropractor of the Year

Dr. Doug Broman

Lifetime Meritorious Achievement Award

Dr. Joseph Sweere

John Allenburg Meritorious Service Award

Dr. Wallace Cole

MCA Outstanding Educator Award

Dr. Jodi Dorpinghaus

Claudius Galen Award

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Dr. Chris Cassirer

Sports Chiropractor of the Year

Dr. Scott Mooring

Young Practitioner Meritorious Service Award

Dr. Dustin JohnsonDr. Frank KochDr. Adam MillsopDr. Michele NortonDr. Jennifer Stuvek-Houselog

50-Year Meritorious Service Award

Dr. Wallace Cole

25-Year Meritorious Service Award

Dr. Roy LewisDr. Kathleen CaseyDr. Matthew CaronDr. Kathryn KnaflaDr. Carla Breunig

Presidential Awards

Dr. Sara CuperusDr. Scott MooringDr. Charles SawyerDr. Beth McVeyDr. Angie GraperDr. Nick Mellum

25-Year Licensure Awards

Dr. Carla BreunigDr. Matthew CaronDr. Kathleen CaseyDr. Michael D. JohnsonDr. Kathryn KnaflaDr. Roy LewisDr. William MettlerDr. Anicia PetersonDr. Michael Svensson

50-Year Licensure Awards

Dr. Wallace Cole

It Was Important to Be at the Capitol!

Charles Sawyer, DCMCA Professional Officer for Legislative Affairs

At this point in the short 2018 session of the Legislature, there is some good news to report — and other things tomention that should be of interest to MCA members.

As we expected at the start of the session, the rights of injured patients and their chiropractic doctors in the no-faultauto insurance system are likely to remain unchanged because no legislation has been introduced that is ofconcern to us. More importantly, based on a presentation during the MCA convention, Drs. Doug Broman and ScottMooring are developing an information package which will be made available to insurers and others interested inknowing more about the current chiropractic community standards of care for the treatment of auto accident injuries.

When it comes to the no-fault system, we will continue to have opportunities to inform the insurance industry aboutthe value of chiropractic care and our efforts to educate members of our own profession regarding best clinicalpractices.

While expanding reimbursement for therapeutic exercise and extremity manipulation in Minnesota’s MedicalAssistance program remains a top MCA legislative priority, we do not anticipate further progress onHF1357/SF1425 in the remaining weeks of the 2018 legislative session. However, as a result of several productivemeetings with the Department of Human Services, the department’s cost estimates for this expansion have beenrevised downward and that could become a critical factor in eventually getting the bill to move out of the HouseHealth and Human Services Financing and Policy in 2019.

Another positive highlight was the good turnout for the MCA Day at the Capitol on March 15. After taking a breakduring the renovation of the state capitol, for the second year in a row we had over 75 doctors and students come toSt. Paul to meet with their House and Senate members to discuss issues of importance to the profession and thepatients we serve.

Thanks for the following doctors and students from Northwestern Health Sciences University who pre-registeredand others who joined us on the morning of the event!

Vinton Albers, DCRebecca Amstutz, DCAlyssa BergstromSteven Biermaier, DCKrista Blomdahl, DCKathleen Bloom, DC

Jenna Goldsmith, DCAngela Graper, DCChris Hanson, DCDoug Harden, DCAnthony Hart, DCChad Henriksen, DC

Roger Marquardt, DCChristopher Massoglia, DCBeth McVey, DCNick Mellum, DCJason Menge, DCGary Miller, DC

Kendra BohannonCarla Breunig, DCDoug Broman, DCRobyn Brostrom Martin, DCMatt Caron, DCMarty Caron, DCSusan Clarke, DCCraig Couillard, DCSara Cuperus, DCJake Dalbec, DCMark Dehen, DCFiona Demel, DCCooper DykstraDustin Emblom, DCTimothy Fargo, DCTammy Fimrite, DCJudy St. Clair, DCScott Stinson, DCJennifer Stuvek, DCJoe Sweere, DC

Claire JessenChristopher Jo, DCDustin Johnson, DCKeith Johnson, DCKristin Johnson, DCArron Kalis, DCKailey KernMadeline Klesk, DCTimothy Klesk, DCJordan Knowlton-Key, DCFrank Koch, DCKarisa Kurszewski, DCBrian Langerude, DCKatherine Leither, DCRassacin LyBrian Malzer, DCJo Theisen, DCEmily ThompsonSeth Tyberg, DCSripathy Umapathi, DC

Adam Millsop, DCMary Beth Minser, DCBrian MorrisJessica MorrisJeffrey Novak, DCEric Oltmanns, DCPaul Osterbauer, DCChristopher Petrie, DCSharon Prahl, DCNicholas Rapp, DCCharles Sawyer, DCJordan Schmidt, DCLydia Schmidt, DCSamantha Shand, DCCailin Shurson, DCAbby Splittstoesser, DCTrevor VelinRobert Waddell, DCKayla Zirpel-Proctor, DC

It’s always important for doctors from across the state to get and stay involved in grass roots advocacy. For many,rescheduling patient appointments and leaving your office to come to St. Paul for MCA Day at the Capitol is a bigsacrifice. But there are other ways to raise awareness about the value of chiropractic care and potentially influencelegislative policy. Email messages and phone calls to Minnesota House and Senate members — in other words,your legislators — can often be critical, as can getting your patients to tell their stories.

If you need help or advice, or just want to pass along information to the MCA’s Legislative Committee, my emailaddress is csawyer@nwhealth.edu or you can call me at (612) 719-1079.

Audit Insurance: Cost-Effective Protection or Expensive Luxury?

Dr. Ray Foxworth. Article submitted by ChiroHealthUSA

When I started out in practice, the biggest risk I faced was a potential malpractice suit. Now, 32 years later, thebiggest threat to my practice is an audit. Often, audits are triggered by patients who are not unhappy with yourclinical care, but your billing or collection practices. Recoupment is BIG business. Don’t believe me? Just look at theresults.

In fiscal year 2016, the DOJ obtained $2.5 billion in settlements and judgments from civil cases involving fraudand false claims against the government in the healthcare industry.Between 2009 and 2016, the DOJ obtained $19.3 billion in civil settlements and judgments for healthcare fraud.In 2014 alone, the Medicare Fraud Strike Force (made up of the DOJ, the FBI, HHS’s Office of InspectorGeneral and individual United States Attorneys’ Offices) brought criminal charges against 353 individuals.Of the 248 individual defendants sentenced in 2014 for healthcare fraud, the average prison sentence wasmore than four years.

Thanks to modern technology, the Office of Inspector General (OIG) can use data analysis, predictive analytics, andmodeling approaches to better analyze and target healthcare fraud and abuse. These algorithms search for knownfraud patterns to calculate ratios of allowed services compared to national averages. Insurance companies use thesame technology in their fraud protection systems. They continually mine data to identify emerging fraudulent

patterns and create new “rules” for those as well. The “intelligence” in the system learns from these new rules andcontinually becomes more sophisticated in identifying even more fraud potential. The best models not only flag thepotential, but provide the reasons for the flag. This makes investigations and assessments by management moreefficient.

It's no secret that audits are on the rise. Ina recent conversation with a friend andconsultant, Dr. Tom Necela, I wanted toknow what this increase in audits wascosting chiropractors across the country.Since 2012, he has worked on over 347audit cases; 67% of those audits were fromcommercial insurance payers, 24% fromMedicare, and 9% from state boards. Dr.Necela stated, “As far as fines orrecoupment goes, we explain to our clientsthat a total victory is unlikely (<5%). It'svery rare that an insurance payer lets thedoc walk away unscathed.”

These numbers are higher than mostdoctors can fund out of their savings. So, much like any other risk we face, if there is a way to “insure” against thistype of loss, it makes sense to do so. In a recent article I read, the average cost of an investigation, possiblerecoupment, and legal defense can easily exceed $200,000. That’s far greater than the average malpractice policycovers. Thanks to Medical Billing Errors and Omissions Liability Insurance (Audit Insurance), we now have a way toprotect our practices.

These audit insurance policies can pay for the defense costs, civil fines, and penalties arising from allegations ofimproper billing, HIPAA, EMTALA, and STARK violations. It is important to check that any coverage you purchaseincludes both governmental and commercial payers, qui tam plaintiffs, and voluntary self-disclosure. It is not a badidea to ask your carrier if additional coverage for legal expenses for disciplinary proceedings by a state licensingboard can be added. If you’re not sure where to get this type of coverage, reaching out to your malpractice carrier isa great place to start.

With today’s unending flow of information, we can’t go a day without seeing headlines, posts, and tweets aboutproviders across the healthcare profession being audited, fined, and some even convicted. We tell ourselves, “Itwon’t happen to me.” The reality is that it easily could. Your license is your livelihood. Your families, employees, andpatients are depending on you. Call your malpractice carrier today — and practice with peace of mind, knowing thatyou have taken the steps to protect your practice in the event of an audit.

Dr. Ray Foxworth is a certified Medical Compliance Specialist and President of ChiroHealthUSA. A practicingChiropractor, he remains “in the trenches” facing challenges with billing, coding, documentation and compliance. Hehas served as president of the Mississippi Chiropractic Association, former Staff Chiropractor at the G.V. SonnyMontgomery VA Medical Center and is a Fellow of the International College of Chiropractic. You can contact Dr.Foxworth at 1-888-719-9990, info@chirohealthusa.com or visit the ChiroHealthUSA website atwww.chirohealthusa.com. Join us for a free webinar that will give you all the details about how a DMPO can helpyou practice with more peace of mind. Go to www.chirohealthusa.com to register today.

The MCA Is Excited to Host the Minnesota Integrative ConcussionSummit!

Date: Saturday, April 28, 8:00am - 5:00pmWhere: MCA Offices, 1000 Westgate Drive, St. Paul, MN 55114Price: $229

This summit will be presented as a large complicated case study. We will take an elite hockey player who wasconcussed in a game and walk through every step, from the on-ice evaluation all the way through to the return-to-play process.

REGISTRATION & INFORMATION

Upcoming Events

April 21Tongue-Tie Evaluation & Chiropractic Influence: A Hands-on Approach

April 28Minnesota Integrative Concussion Summit

April 28-29Review for State of Minnesota Limited X-Ray Operator Examination

On-Demand EducationOn-Demand Webinars

Publication Policy

MCA In Touch is published monthly by the Minnesota Chiropractic Association.

Have news you’d like to share, or an idea for an article? Contact communications@mnchiro.com or MCA executive director Katie

Wallstein at katiew@mnchiro.com.

Articles must meet the following guidelines to be considered for publication:

Of interest to chiropractors in Minnesota, covering topics such new research and emerging trends in chiropractic, insurance

processes, and clinic management.

Not promotional in nature, or advertising specific products or services.

Up to 1,000 words in length.

The author's name/organization name will be credited to the article.

Minnesota Chiropractic Association™1000 Westgate Drive, Suite #252St. Paul, MN 55114Ph: 651-288-3428 • Fax: 651-290-2266

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