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?
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).
#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.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
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.
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.
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:
"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.
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.
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.
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.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
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.
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.
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?
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.
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).
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
April 17, 2012
The CAMTC Money Grab
By Donald M. Petersen Jr., BS, HCD(hc), FICC(h)
It is a sad time for the massage therapy profession. A disturbing trend has continued, despite my hopes that the people involved would recognize how unhealthy it is for massage. I'm referring to the decision by the California Massage Therapy Council (CAMTC) board to vote themselves unnecessary travel money so they can attend a convention later this week, all expenses paid.
This money was originally approved for attending a convention as "roving ambassadors" with no real duties or responsibilities. After news of this decision was publicized last week by Massage Today, CAMTC CEO Ahmos Netanel submitted a list of duties board members will now be expected to perform.1
The decision was made on a board conference call on Tuesday, April 10, 2012. Kathryn Feather, Massage Today's Senior Associate Editor, was on the call. While it was not unanimous, the majority of those voting in favor of the measure were the ones who would receive the money.
For the record, this is who voted for and against a motion to take money for unnecessary travel:
Actions Reveal Intent
The vote was to reimburse board members to attend the American Massage Conference (AMC) in San Diego. This was in addition to already receiving free registration and free Gala tickets ($115 total value). This was the second time in the last 6 months that this board has voted to spend money on themselves for a convention.
What was strange is that attached to the board's meeting agenda was a worksheet listing those board members who had already decided to attend the AMC and how much they had already spent for their airfare and hotel registration.
A per diem allowance of $213 ($71 per day) was also included in the worksheet along with mileage reimbursement for those who would be traveling by car. In short, these board members had already decided to go and were making an effort to see if they could get free money from the CAMTC.
Note that these board members are attending in addition to the 6 staff members who will already be present. As a means of comparison, the ABMP, which is the global educational sponsor for the event, will only have four staff members there. And they have to coordinate seminars and speakers, as well as maintain their exhibit booth. The CAMTC will have a total of 14 staff and board members.
Efforts were made to contact these board members, but only four of those who voted for the motion responded; one through the CEO, two via e-mail and another declined to comment as he is not attending the convention. They appeared to be in hiding over their decision.
When Ahmos Netanal, the CAMTC CEO was contacted, he waited to respond until after the first article deadline. His ultimate response can only be described as one of panic. In fact, this is the most confused, poorly rationalized response I have seen in 30 years of journalism. When he finally responded to direct questions regarding the board's actions a few days later, his initial response had to be rescinded as his answers did not have the board's approval.
In an effort to justify the board's decision, the response included statements which were obviously untrue. Here are just a few examples:2,3
In September 2010, the board adopted an expense reimbursement policy that allows for reimbursement for costs related to "Council service" and "Council business." There was specific conversation during the April 10 board meeting that made it clear that the attending board members did not have any particular duties.
Neither the 2010 nor an earlier 2009 policy mentions a cap on how many board members can go or even when they arrive and depart.
Some of the board members are arriving on Thursday, April 19th, when the only event is the golf tournament. The exhibit hall, where the CAMTC has a booth, does not open until 1 p.m. Friday. Had all 20 board members decided to participate in the money grab, the total cost to the CAMTC could have been more than $20,000 for this single event.
Keep in mind that this is the second event where the board has decided to pay themselves. The first was in October 2011, the board okayed reimbursements for travel to the FSMTB convention in Southern California. With several massage events in California every year, it's not a stretch to imagine tens of thousands of dollars going to such expenses, the equivalent of hundreds of certificate fees per year.
Following the Money
The question that quickly comes to mind is: Why approve so many people for travel to an event already being covered by six staffers?
Ahmos Netanal introduced the resolution for reimbursement. As CEO, he currently earns more than $259,000 under a very lucrative contract that we understand is up for review later this year. While I have a hard time justifying over a quarter of a million dollars a year for this position, I have to assume it had something to do with the need to build the CAMTC from the ground up.
But now that they have been up and running since August 2009, the CEO compensation package should be reduced to the $85,000 per year that the chiropractic Board and other similar professional boards pay their executives.
For example, the same position with the California Board of Chiropractic Examiners pays $6,694 to $7,239 per month. The annual difference between these two positions is $173,112, equal to approximately 1,100 more certificate fees per year.
According to Board records (April 2011), "Mr. Netanel's base salary (was decreased) from $16,666.66 per month to $15,833 per month and add an additional $330 per month to his existing benefits allowance (from $3,000 per month to $3,333 per month). In addition, provide Mr. Netanel with $1,666 per month toward dependent benefits, and $833 per month (for 12 months only) toward his home office expenses. Total annual compensation package would increase from $236,000 to $259,980."
One would think that if the CAMTC is so drunk with money that, at the very least, they would reduce the amount they charge therapists for registration. I would actually prefer to see them just make better use of the money.
With three years under their belt, one would think that the board would decrease Netanal's compensation instead of increasing it by $2,000 per month. Given the recent reimbursement decision one has to wonder what their motive is. Is the liberal travel reimbursement for unnecessary travel part of a quid pro quo? It is not hard to see that if each of them collects a few thousand dollars a year, that they would be more than willing to let him have his quarter million. It will be easy to see if this is correct, just watch and see what the board does when the contract renewal comes up. If they don't severely reduce the compensation package, then their votes were bought and paid for.
The End of the CAMTC
The CAMTC is a nonprofit corporation operating under strict laws. It is also unique in that it is not directly under the state of California like most professional boards, at least not right now. The CAMTC is an experiment to see if the profession can manage itself without heavy-handed oversight by the state. The experiment may come to a close at the end of 2014 when the CAMTC is set to sunset unless it is renewed.
The current self dealing by the board and overpayment of Netanal puts the future of the CAMTC in jeopardy. With their current actions now public, it is not unreasonable to think that enemies of the massage therapy profession will be contacting their state legislators asking them to take action against the board. And our legislative friends may be embarrassed and hard-pressed to defend us particularly when the board comes up for renewal.
So why risk the future of the CAMTC by overpaying Netanal and allowing the board to take money to go places they were scheduled to go anyway?
What You Can Do
This issue is not something I ever expected to see in massage therapy. It seems counter to our culture. Having exposed this type of behavior in the chiropractic profession,4 I can tell you it is incredibly embarrassing for the profession and damaging to its reputation. It has a lasting impact that is not easily forgotten.
While you can't vote to elect or replace the board members, you do have a voice. You can encourage the board members to stop lining their pockets with travel money and reduce the CEO compensation to a level that will not anger the California legislature when it votes on the fate of the CAMTC in the next two years.
We have established a web page (www.massagetoday.com/moneygrab) where you can write an e-mail and, with one click, send it to the board members and Mr. Netanal. The hope is that they will see the importance of doing the right thing and make the necessary changes.
Please understand that I still have faith in this board. I know some of the people on it and believe that those who voted for the motion have been mislead in their decision to take money from the certificate holders. And while it may appear that we are "attacking" the CAMTC board or have some sort of axe to grind, the truth is that Massage Today has strongly supported the organization since its inception, most notably in the bruising fight over AB1822.
If they will make the changes necessary, the CAMTC can live on to do great things for our profession. If not, they will sunset in two years, ending the money grab. Rest assured that the legislature will receive an analysis from our enemies that will compare how this Board operates verses how they would be required to operate under State oversight. It is easy to see the legislators alienated by self dealing and by a CEO compensation package that is more than two and half times their pay.
Less than six months ago, Massage Today recognized the CAMTC for their investigation into human trafficking.5 How sad that this same board could themselves come under investigation for self dealing. Last year MT named the CAMTC Board the "2011 Heroes of the Profession." How heroic will they be if their desire for a few thousand dollars a year is one of the reasons the California legislature decides that we can no longer oversee our own certification. With millions of dollar at stake, the future of the CAMTC will get plenty of attention.
Please, take a few moments and make your voice heard. This is not just a California issue. This will impact the entire profession nationally: www.massagetoday.com/moneygrab.
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