Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
The Hidden Hip in LBP: Critical Screening Tests
In 1998, Harvey used this test on 117 elite athletes and found excellent interrater reliability to differentially assess iliopsoas, quadriceps or TFL/ITB tightness.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.