Chiropractors In Anti-Fraud Campaign

NU Online News Service, Nov. 4, 11:26 a.m.,EST--In what its leadership said underlines its efforts toroot out fraud, a chiropractors group announced recently that itwas praising an investigator whose activities led to chargesagainst three chiropractors.

As Patricia Jackson, vice president for professional developmentand research at The American Chiropractic Association explained:"We're backing the insurance companies in an effort to root outfraud. It's going to help make things better between the twoprofessions."

Ms. Jackson, who formerly worked for an insurer, explained thatin 1999 the ACA, based in Arlington, Va., put a group togethercomposed of property-casualty and workers' compensation insurers"to problem-solve issues between the two groups."

As part of this effort, the ACA came out with an announcementlast month praising the International Association of SpecialInvestigation Units and the National Insurance Crime Bureau "fortheir work to uncover fraud within the ranks of the chiropracticprofession."

The group singled out the work of NICB Special Agent Lewis D."Dennie" Huggins, who received the "2002 Investigator of the YearAward" from IASIU.

ACA credited Mr. Huggins with uncovering the "Halstead scaminvolving millions in bogus chiropractic claims."

Dr. Ronald L. Halstead, a medical consultant who owns PracticeSystems in Scottsdale, Ariz., was indicted by a federal grand juryin West Virginia last September, accused of conspiring with threechiropractors to commit mail and healthcare fraud to collectcharges that exceeded Medicare limits for chiropractictreatment.

"It's a great day when an organization recognizes the work ofanother to fight fraud within their own ranks," said JudyFitzgerald, a senior vice president with NICB in Washington.

She said the individuals involved are only a small percentage ofthe chiropractic community, and praised the ACA for recognizing"there could be a problem, and they are not providing any safeharbor for individuals."

ACA President Daryl Wills, in letters to both the NICB andIASIU, said his group since its inception "has strongly opposedfraudulent activity in healthcare through its own Code of Ethicsand Policies on Public Health."

He added that "to further strengthen its position, ACA passed ananti-fraud resolution in late 2000 as part of our ongoing work withthe insurance industry to improve the impact of reimbursement andmedical review policies on the chiropractic profession."

Dr. Wills letter said that while ACA realizes doctors ofchiropractic care who commit fraud "make up a minute fraction ofthe tens of thousands of ethical doctors of chiropractic [care] whopractice on a daily basis, we have made it clear that those who usequestionable practices will find no safe harbor within the bordersof the ACA."

"We are pleased to report that recent studies conducted by theHealth Insurance Association of America show the incidence ofchiropractic fraud constitutes a very small percentage ofhealthcare fraud in general," Dr. Wills continued.

"Even so, ACA recognizes the financial crisis currently plaguingthe insurance industry and the subsequent increase in premiums thathurt patients. As a provider organization, we believe we have aresponsibility to do everything we can to help stabilize ordecrease healthcare premiums for patients by policing our own ranksagainst fraud," he said.

"With the combined efforts of organizations like the ACA, IASIUand NICB, we are hopeful that this small percentage of doctors ofchiropractic [care] involved in fraudulent activities will continueto decrease, benefiting not only patients but also fair andprincipled healthcare providers nationwide."

Ms. Jackson said that none of the doctors indicted in the"Halstead scam" were members of the ACA, which counts itself thelargest chiropractic organization in the world. ACA represents"mainstream chiropractors and not fringe groups," she said.

Mr. Jackson said ACA is also working with the NationalAssociation of Independent Insurers to eliminate fraud bychiropractors.

When chiropractors become involved in such activity, "it createsa black eye for the profession, and we don't need it," shesaid.