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First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
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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