resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
May, 2001, Vol. 01, Issue 05
Washington State Massage Therapists Win Again
Regence BlueShield Agrees to $30 Million Settlement
By Editorial Staff
In 1995, Washington state showed its progressiveness in health care matters with the passage of an "alternative provider" statute (House Bill 1034), which required insurers to cover services provided by all of the state's licensed categories of health care providers, including: massage therapists; chiropractors; medical doctors; acupuncturists; naturopaths; physicians' assistants; registered nurses; and podiatrists.
Not surprisingly, days before the Jan.1, 1996 enactment of the bill, a dozen of the state's largest health insurers challenged the law in the courts. The outcome of the legal maneuvering was that in the spring of 1997, a federal judge in Tacoma declared that the bill conflicted with federal (ERISA) law barring state regulation of employer benefit plans.
During this litigious period, Regence BlueShield determined that the statute applied only to managed care plans, or those plans in which patients were required to go through a primary care physician for a referral to receive specialized treatment. Regence reportedly only allowed "managed care" patients to choose a naturopath as their primary care provider; this left most Regence subscribers, specifically those on the "indemnity" plans, out in the cold. Regence's strategy excluded alternative providers on approximately two-thirds of its plans, while offering limited coverage to the remaining one-third.
In June 1998, however, the U.S. Ninth Circuit Court of Appeals in San Francisco overruled the Tacoma decision and reinstated the law. The court ruled that federal law did not prevent a state from expanding health coverage to its residents. The court recognized that HB 1034 met the traditional tests for insurance matters and therefore fell within the state's jurisdiction.1
The Seattle law firm of Sirianni & Youtz was granted permission by the Ninth Circuit Court to present arguments in support of the state's position, and to uphold the laws on behalf of the Washington Association of Naturopathic Physicians and the Washington State Chiropractic Association in urging that the law be held valid and enforceable. Regence continued its policy of excluding and limiting alternative care.
Represented by Sirianni & Youtz, Dale Snow became the lead plaintiff in a class-action lawsuit in federal court against Regence. Claiming that Regence ignored the "every category" law, the suit charged Regence to reimburse its subscribers for the out-of-pocket expenses they incurred when receiving treatment from alternative providers.
This action was brought under ERISA, a federal law that governs health plans issued to employees by private employers. Snow and other Regence subscribers (now members of the class-action lawsuit) alleged that Regence failed to comply with the "every category of provider" law with respect to health plans governed by ERISA.
On February 22, 1999, the U.S. Supreme Court declined to hear an appeal by the insurance industry, rejecting their attempts to have the law overturned. The justices also let stand the decision of the Ninth Circuit Court.2
During that same year, Regence moved to dismiss the Snow et al. lawsuit as frivolous. Judge William Dwyer denied the motion, certified the lawsuit as a class action suit, and asked the Washington Supreme Court to decide whether the every category law required Regence to provide access to alternative providers on all its health care plans. Sirianni & Youtz argued before the Washington Supreme Court that the law requires Regence to provide coverage on all its plans.
The next attack on House Bill 1034 was issued in November of 1999 when Regence BlueShield accused the state's insurance commissioner, Deborah Senn, of interpreting the law too broadly. In their suit, Regence argued that the law should apply only to managed care plans in which a patient's health coverage is managed by a "gatekeeper," and that it should not apply to traditional insurance plans.3
The court unanimously rejected Regence's claims.The court decreed that the insurance commissioner's interpretation of the statute was "consistent with the legislature's intent" and pertained to managed care plans and all health care insurance plans offered by health care insurers. The court added that "every health plan offered by Regence (with the exception of basic health model plans)" is subject to the regulations contained within the alternative provider law.
In a unanimous January 2000 decision, the Washington State Supreme Court ruled in favor of Dale Snow et al. The court said that the every category law applied to managed and nonmanaged care plans alike.
Sirianni & Youtz then filed another class-action suit, Steven Holman v. Regence BlueShield, to pick up non-ERISA policies (for example, policies governed by state law, such as individual policies). A state court judge certified the case as a class action, and ruled that Regence must allow access to every category of provider on its state-law-governed policies. With this order, the federal and state actions were brought into alignment on the issue.
Effective March 1, 2000, Regence changed its policies and allowed its subscribers access to massage therapists and other alternative care providers as the Washington State Supreme Court ordered, but denied that it had any obligation to reimburse the class-action litigants for care received before March 1, 2000.
In July, Federal District Court Judge Marsha Pechman ruled in favor of the class members, finding Regence liable for past benefits wrongfully withheld from their subscribers since 1996 for care the subscribers received from massage therapists, chiropractors, naturopaths, acupuncturists and nutritionists. The amount of damages, and the method by which the class-action litigants will be reimbursed, had yet to be determined by the court.
In November, the parties agreed to mediate the damage issue before Judge George Finkle, a retired judge who provides professional mediation services. The parties could not agree on a lump sum of money Regence should pay, but they did agree on a process to determine that amount. An agreement was reached whereby the state and federal class-action suits were combined. An arbitrator, assisted by a PhD health economist, set the amount of damages Regence must pay. The class-action litigants and Regence presented evidence and testimony before the arbitrator and health economist in a contested arbitration trial.
On February 9, 2001, arbitrator Thomas Brewer awarded $30,400,000 to the combined state and federal class-action litigants for out-of-pocket expenses incurred by Regence subscribers for alternative care between January 1996 and February 2000.
In March, Sirianni & Youtz and Regence's attorneys asked the federal and state courts to approve and confirm the $30,400,000 award and approve a claims process.
Sirianni & Youtz has brought these and other class-action lawsuits designed to enforce the requirements of the "every category" law, and to recover damages for those people who have had to pay out-of-pocket for their alternative providers.
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