Chiropractors In Anti-Fraud Campaign

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

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

Ms. Jackson, who formerly worked for an insurer, explained that in 1999 the ACA, based in Arlington, Va., put a group together composed 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 announcement last month praising the International Association of Special Investigation Units and the National Insurance Crime Bureau "for their work to uncover fraud within the ranks of the chiropractic profession."

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

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

Dr. Ronald L. Halstead, a medical consultant who owns Practice Systems in Scottsdale, Ariz., was indicted by a federal grand jury in West Virginia last September, accused of conspiring with three chiropractors to commit mail and healthcare fraud to collect charges that exceeded Medicare limits for chiropractic treatment.

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

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

ACA President Daryl Wills, in letters to both the NICB and IASIU, said his group since its inception "has strongly opposed fraudulent activity in healthcare through its own Code of Ethics and Policies on Public Health."

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

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

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

"Even so, ACA recognizes the financial crisis currently plaguing the insurance industry and the subsequent increase in premiums that hurt patients. As a provider organization, we believe we have a responsibility to do everything we can to help stabilize or decrease healthcare premiums for patients by policing our own ranks against fraud," he said.

"With the combined efforts of organizations like the ACA, IASIU and NICB, we are hopeful that this small percentage of doctors of chiropractic [care] involved in fraudulent activities will continue to decrease, benefiting not only patients but also fair and principled healthcare providers nationwide."

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

Mr. Jackson said ACA is also working with the National Association of Independent Insurers to eliminate fraud by chiropractors.

When chiropractors become involved in such activity, "it creates a black eye for the profession, and we don't need it," she said.

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Chiropractors In Anti-Fraud Campaign

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