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Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
September, 2011, Vol. 11, Issue 09
Massage Therapy Insurer Pleads Guilty to Fraud
By Kathryn Feather, Senior Associate Editor
Bret T. Van Leeuwen, 52, the former president and founder of Stratus Insurance Services, Inc., pled guilty in June to one count of insurance fraud in the second degree. He agreed to pay up to $995,000 in civil penalties.
Three associations listed as victims in Van Leeuwen's plea include the now defunct IMA Group, the Hands-On Trade Association and the International Association of Reike Professionals. Massage Today readers might remember that Van Leeuwen and Stratus Insurance were linked in the financial demise of the International Massage Association and had accused owner and founder Will Green of owing Stratus "close to seven figures" and offered that as the reason Stratus dropped coverage of the IMA. However, Green claimed that Stratus had failed to properly acquire policies in several of the years since 2004, and alluded to an FBI investigation in a letter to IMA members in July of 2010. As reported in Massage Today in August of 2010, Van Leeuwen strongly denied Green's claims.
The Hands-On Trade Association (HOTA) became aware there was a problem with Stratus and Van Leeuwen in May 2010, when the case became public. Directed by Judi Calvert, co-founder of Massage Magazine, the HOTA formally terminated their relationship with Stratus and Bret Van Leeuwen in January 2011. According to Calvert, "it took time to transition to our new risk purchasing group, the Wellness and Beauty Association Risk Purchasing Group."
"Numerous issues with the company led us to start seeking a new risk purchasing group in May of 2010," said Calvert. "We are still in the process of determining the consequences. As owner of HOTA, I have given years of service to this wonderful industry, and it's important that our members know they can continue to trust us as their benefits provider. Our focus remains on serving our membership and the industry." As part of this new Wellness and Beauty Association Risk Purchasing Group, the HOTA is now with Western States Insurance.
Investigation Background And Timeline
In his Statement of Offense filed with the U.S. District Court for the District of Columbia on June 20, 2011, Van Leeuwen acknowledged he was the founder, president and majority owner of Stratus Insurance Services, which focused on specialty insurance programs provided to associations and purchasing groups. The three associations offered their members insurance coverage through a non-profit entity known as the Health and Beauty Risk Purchasing Group (HBRPG), which Will Green of the IMA was also involved in starting.
Van Leeuwen's partner in providing these policies was Rodney R. Ayer, former president of Phoenix Underwriting Managers Inc. According to prosecutors, Ayer pleaded guilty in July 2010 to one count of insurance fraud in connection with fraudulent statements in a 2006 application to operate as a captive insurance company in Washington, D.C. Ayer agreed to pay $500,000 in penalties and set aside an additional $495,000 in an escrow account to cover any outstanding claims for the policy periods covered by the criminal charges, which cover September 2004 through May 2006.
Mark Maxson, Senior Vice President at Willis Re, and an insurance industry expert, said the escrow fund might not be sufficient if major claims are filed for that time frame, "in this case, $500,000 to cover all claims for a portfolio of exposure--particularly when the portfolio consists of 15,000 policies. Even one policy limits claim would wipe out the fund and leave all the other insureds unportected."
"We became aware of the Ayer case in July 2010 through Massage Today," said Calvert. "Prior to that, we didn't know that we were named in the Ayer case."
Van Leeuwen admitted that he and Ayer intended to insure the members of the HBRPG which included the IMA and the HOTA, as well as the approximately 27,000 members of the Federal Employee Professional Liability Insurance Program, with insurance carriers known as "cells" which would be established through multi-national insurance carrier, Hannover Rueckverisherung AG (Hannover Re). Van Leeuwen and Ayer planned to co-own the cells, which would be associated with Hannover Re, and supervise the administration of the HBRPG, as well as the Federal group. Based on their knowledge of the claims histories for both groups, Ayer and Van Leeuwen expected substantial underwriting profits from owning and operating these programs. However, both men did not reveal their ownership of the cells to the associations participating in the HBRPG.
Van Leeuwen and Ayer did pay the claims associated with these programs and they did retain the underwriting profits associated with these groups. However, there was just one problem with this arrangement; Hannover Re backed out of its coverage of the programs in December 2005. Despite Ayer and Van Leeuwen being unable to obtain approval from Hannover Re to operate the cells, the men led the associations and insurance regulatory agencies to believe that Hannover Re had approved the cells to insure the Federal program and the HBRPG.
According to court records, while continuing to pay claims and receiving substantial premium payments from members of both groups based on representations that Hannover Re was insuring those programs, Van Leeuwen and Ayer filed an application with the District of Columbia's Department of Insurance, Securities and Banking in April 2006, seeking approval for a District of Columbia Certificate of Authority allowing Defense Shield Insurance Co. Inc. (DISC) to operate as a captive. The DISC was intended to succeed the cell Ayer and Van Leeuwen led the associations to believe was being handled by Hannover Re.
Chris Van Leeuwen, brother of Bret Van Leeuwen and current President of Stratus, said the company does continue to provide massage therapy insurance. He said the guilty plea does not impact any of the coverage it currently provides to massage therapists and there was no lapse in coverage for those programs under the Beauty, Health and Trade Alliance Purchasing Group. Stratus Insurance covers approximately ten different groups through the Beauty, Health and Trade Alliance Purchasing Group.
Rodney Ayer has not yet been sentenced. Bret Van Leeuwen is scheduled to be formally sentenced on September 26, 2011. He faces a maximum sentence of 24 months in prison, a fine of $10,000, a three-year term of supervised release and a $250 special assessment for the Crime Victim's Assistance Fund, in addition to his civil penalties of almost $1 million.
In the meantime, the organizations involved are left to pick up the pieces and try to move on. "We're focusing on the future," said Calvert. "We feel that our decision to go with another risk purchasing group best serves our members needs."
It remains unclear what the status of coverage is for those insured through any of these groups in the years 2006-2010.
However, it looks as though this case isn't over just yet. Bill Miller from the U.S. Attorney's Office would only say that "we typically do not comment on cases that are still active. Because the case is pending and remains under investigation, the U.S. Attorney's Office is unable to comment at this time beyond relying on the public record of what is said or submitted in court."
Massage Today will continue to monitor this case as the U.S. Attorney's Office investigation continues.
Editor's Note: As this issue of Massage Today was going to press, MPA Media received a letter from attorneys representing a massage therapy insurer that has had a relationship with Stratus Insurance, but which was not mentioned or included in the 2004-06 insurance fraud case. On August 2, 2011, Eric Hearn, a lawyer representing The Doyle Group, owners of Massage Magazine and Massage Magazine Insurance Plus (MMIP), stated that "Doyle has terminated its contractual relationship with Stratus." The letter warned of legal action should this story "implicate Doyle in the affairs that culminated in Bret Van Leeuwen's current legal issues." At the time the letter was sent, Massage Today had made no contact with The Doyle Group. Massage Today then contacted The Doyle Group to ask when and why the relationship with Stratus Insurance Services was officially terminated but received no response.
A publicly available May 16, 2010 record (approximately two months before Ayer's guilty plea) of the MMIP website contains this language: "MMIP is offered in conjunction with Stratus Insurance Services, Inc. American Fork, Utah. Coverage under the MMIP program is underwritten by certain underwriters at Lloyds, London, an A rated carrier." A screenshot of the same website taken on July 25, 2011, has language stating that "MMIP is offered in conjunction with the Beauty, Health, and Trade Alliance Purchasing Group, domiciled in IL and Stratus Insurance Services". Upon receipt of Hearn's August 2 letter, a review of the MMIP webpage showed that the reference to Stratus was removed, consistent with the attorney's letter stating that contractual relations with Stratus had been terminated. The Lloyds of London reference remained.
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