- On August 9th, 2019, Council President Joseph Baudille and Immediate Past President Dr. John LaMonica presented testimony before the Joint Senate Task Force on Opioids, Addiction and Overdose Prevention to advocate for Chiropractic as an alternative to prescribing opioids for pain treatment.
- Council representatives will be meeting in Albany with Senate Health and Insurance Committee staff to discuss our proposed non-discrimination legislation.
- The Council submitted a joint letter with the NYSCA to the Workers' Compensation Board to thank them for increasing chiropractic reimbursement under the WCB Medical Fee Schedule. Please note we will continue to work on having our fees increased to equal our education.
- The Council is attending all IME Advisory Committee Meetings and will be providing comments to the Committee for suggestions on how to improve the IME system. We especially want to thank Dr. Donna DeRosa for all the effort she has made in attending the hearings and putting together these comments.
- The Council continues to monitor all ongoing WCB and Department of Financial Services (DFS) regulatory activities to amend Medical Fee Schedules and provide comments to the agencies as necessary. On August 15th, 2019 the Council has a conference call with DFS staff to discuss the No-Fault fee schedule.
- Council representatives traveled to Albany on March 26 to meet with state legislators and share our concerns about the recent Workers' Comp and No-Fault Fee Schedules changes, meeting with members of the Assembly and Senate Insurance Committees.
- Senator Neil Breslin, Chair of the Senate Insurance Committee, is considering sending a draft letter we prepared to the Department of Financial Services on behalf of the Senate Insurance Committee seeking further information on the implementation of the No-Fault Fee Schedule and Ground Rules asking why the fee increase is being delayed, but the practice limitations are being immediately imposed.
- Council President Joe Baudille met with Senator Diane Savino on April 4 to discuss the No-Fault and Workers' Compensation Fee Schedules and our efforts in combating opioid addiction.
- The Council's Legislative Committee is evaluating Workers' Comp reforms that passed in the State Budget to determine its impact on Chiropractic and the delivery of healthcare services.
- We are making final preparations for our first "Opioid Community Connect" town hall meeting in Guilderland on May 7th, 2019.
- Planning is underway for our upcoming joint Lobby Day with NYSCA on May 14th, 2019.
- In the remaining months of the legislative session, we will continue advocating for our priorities, including the Scope bill (A.4405 Lentol), MD/DC Partnership bill (A.6525 - O'Donnell/A.6377 - People Stokes)), IME Reform bill (A.5827 Titus), and other priority bills.
- With the State Budget behind us, we are seeking out sponsors for the Opioid Alternative Treatment bill, and Patient Non-Discrimination Act. Both drafts are being reviewed by Senate Health Committee Chairman Gustavo Rivera.
- Council leadership, along with NYSCA leadership, met with the Workers' Compensation Board on February 21st, 2019 to discuss a number of issues, including the new WCB Fee Schedule and the IME Advisory Committee process.
- The Council and NYSCA are also working together on comments to submit regarding the Department of Financial Services' proposed regulations to update the No-Fault Fee Schedule.
- We are engaging in discussions with potential legislative sponsors for our opioid alternatives bill proposal. The Council also has an upcoming call on March 22nd, 2019 with the Department of Health to discuss the issue of opioids.
- Senator Gustavo Rivera, Chairman of the Senate Health Committee, is reviewing our draft Patient Non-Discrimination Act with an eyes towards possible support/introduction.
- The Council will be participating in the Stand up for Recovery Day in Albany, hosted by Friends of Recovery NY, on March 20th, 2019.
- We are continuing to monitor the state budget process and ongoing bill introductions for issues of interest to the chiropractic profession.
- We are attending important political events in Albany to support elected officials who are friends of the chiropractic profession.
- We have continued our meetings with Senators and Assembly members on the Labor Committees to discuss the Workers' Compensation Board's proposed Chiropractic Fee Schedule. We have discussed with Senator Diane Savino (D-SI), the likely incoming chair of the Senate Labor Committee, her reaching out to the Workers' Comp. Board on behalf of the profession to urge parity in reimbursement rates.
- Council President Dr. Joe Baudille and Council lobbyist Perry Ochacher attended a November 28 fundraising event where they met with Senator Gustavo Rivera, the incoming chair of the Senate Health Committee, and Senator Andrea Stewart-Cousins, the new Senate Majority Leader.
- Council representatives met with legislative staff for Senator Terrence Murphy on December 4 to discuss the formal introduction of our proposed “Patient Health Care Non-Discrimination Act”. With the change of political control in the State Senate, we will need to seek out new sponsors to introduce our legislation.
- In addition to our work with other provider organizations in drafting legislation to require consideration of alternatives to opioids, we have discussed with Senator Savino the possibility of a Senate hearing on nonpharmacological healthcare options as a solution to the opioid epidemic, and as an alternative to prescription medications. She is interested in possibly sponsoring this as a Senate Labor Committee hearing in 2019.
- We are preparing for the opening of the 2019-20 New York State Legislative Session, beginning with the Governor's annual State of the State address in early January, when we will advocate for our legislative priorities, including the Scope Bill, DC/MD Partnership Bill, Health Care Non-Discrimination Act, and our Nonpharmacological Alternatives to Opioids Bill.
- The Council submitted a letter to the Chair of the Workers’ Compensation Board on October 24 raising concerns regarding the proposed Medical Fee Schedule. There are possible practice limitations contained in the Fee Schedule's Physical Medicine Ground Rules, and we questioned the methodology regarding the calculation of Relative Value Units (RVUs) for chiropractic practice, which we believe reflects an anti-chiropractic bias. Additionally, we also submitted a joint letter with NYSCA on October 31 detailing our concerns over the significant pay disparity chiropractors would face under the proposed Medical Fee Schedule reflected in the Conversion Factor.
- In advance of the 2019-20 legislative session, Council representatives will be meeting with legislative staff for Senator Terrence Murphy on December 4 to discuss sponsorship for our proposed “Patient Health Care Non-Discrimination Act”.
- We are presently working alongside other health care providers on finalizing draft legislation to require the consideration of nonpharmacological treatment such as chiropractic, physical therapy, and others who are skilled in drug-free pain management before an opioid may be prescribed in New York. This bill proposal, which amends New York’s recently-enacted Opioid Stewardship Act, will be introduced in the upcoming the 2019-20 legislative session.
- Democrats have won full control of the State Senate and it appears that Sen. Terrence Murphy has been defeated in a tight race by his challenger, Peter Harckham.
Welcome to the Council’s 29th Annual Convention! Below is our annual legislative and regulatory update.
Council Demands DFS Investigation of Possibly Discriminatory Insurance Industry Practices
Over the past year many DC’s have received letters from insurance carriers questioning trends in office practice procedures, and asking you to complete surveys regarding maintenance care and x-rays. We are concerned as to whether these inquires may possibly violate New York State Insurance Equality Laws, which were enacted precisely to protect the chiropractic profession from these types of abuses. So as a first step, the Council provided guidance to members who chose to respond to the carrier letters and as a second step, Council President Dr. Joseph Baudille wrote to the Department of Financial Services (DFS - previously the Insurance Department) requesting a meeting and review of these potentially discriminatory practices. The Council will not sit idly by if this practice is inappropriately targeting chiropractic, and we await a response from DFS.
Council Readies “Patient Health Care Non-Discrimination Act” for Introduction
The Council strongly believes that all New Yorkers should have freedom to seek the treatment and provider of their choice with respect to their healthcare, if treatment of a given health condition is within a licensed health care provider’s scope of practice. Unfortunately, this has not always been possible in New York for a number of reasons. To reverse this historical bias against chiropractic and other non-allopathic health care professions, the Council researched and drafted a "Patient Health Care Non-Discrimination Act Blueprint”, which will be a top legislative priority in 2019.
The bill, which will be based on the blueprint, is the product of many months of research and development, and will be based on current “best practices”– laws enacted and legislation pending from across the nation–and will be aimed at strengthening existing federal and state laws by prohibiting discrimination against all non-allopathic health care providers, thus allowing New Yorkers equal access to a wide array of beneficial, licensed health care services. We are presently engaged with NYSCA and other licensed health care professions which have expressed an interest in advancing this important legislation, and we are working with our Senate sponsors on its formal introduction in the 2019 legislative session.
Council Working to Improve Workers’ Compensation Practice
We continue to work with the Workers’ Compensation Board (WCB) to try and improve practice conditions in a number of areas. Over the past year, we met with Clarissa M. Rodriguez, the new WCB Chair and her top staff, to discuss various matters of concern. We discussed the Medical Treatment Guidelines (MTG), following up on materials we submitted to WCB detailing how some carriers are not operating in compliance with MTG rules, leading to unjustified treatment denials. We also discussed continuing fee disparity in chiropractic reimbursement and IME reform. Regarding IME reform, if you recall the Council successfully lobbied for the creation of the Governor’s Advisory Committee on the Utilization of Independent Medical Examiners, as part of the 2017 state budget. We are now working to ensure adequate chiropractic representation on this important Advisory Committee, which is tasked with improving the deeply flawed IME process at WCB.
Regarding fees, WCB has proposed revisions to the Chiropractic fee schedule. There is both good and bad news in the proposed fee schedule. Working with NYSCA, the Council submitted joint comments to WCB regarding its proposed changes. The Board’s amended proposal was published on October 3rd, and the Council is currently analyzing this second round of revisions, and will comment on them accordingly. WCB will likely adopt its new fee schedule sometime in November. In the meantime, we will be meeting with key members of the Senate and Assembly Labor Committees to share our reaction and express our concerns with the proposed changes to the WCB Chiropractic Fee Schedule.
Council Takes Leading, Public Role in Promoting Chiropractic as an Alternative to Opioids
As New York and the nation continue to reel from the opioid crisis, the Council has played a very public role in advocating how chiropractic can be part of the solution. On February 12th, Council Legislative Committee Chairman Dr. John LaMonica submitted testimony before the Senate and Assembly Joint Health Budget Committee on chiropractic as a natural, non-addictive alternative for the treatment of pain. Council President Dr. Joseph Baudille testified twice before the Senate Joint Task Force on Heroin and Opioid Addiction, emphasizing how chiropractic can help alleviate the crisis by managing pain without the use of addictive drugs. We will continue to raise awareness on how chiropractic can be a natural solution to help combat the opioid crisis in New York.
In 2018 the Council also carefully monitored state legislation related to the opioid crisis. We successfully amended one bill, A.9834-A, introduced by Assemblywoman Linda Rosenthal (D-Manhattan), which mandated coverage for alternative non-opioid treatment options by the medical assistance program and insurers, to specifically include chiropractic care. And we are presently working on draft legislation that would require the consideration of health care providers such as chiropractic, physical therapy and others who are skilled in drug-free pain management, before an opioid may be prescribed in New York. We will introduce this bill during the 2019 legislative session.
Lobby Day and a Whole Lot More
We held our annual Albany Lobby Day on April 24th, where almost 100 Doctors of Chiropractic attended over 80 meetings with legislators from across the state. On Lobby Day 2018 we advocated for the Chiropractic Scope of Practice Modernization Act (A.8541/S.7427), the MD/DC Partnership bills (A.5807, A.1943/S.4291, S.4125), and we also initiated discussions about our forthcoming Patient Health Care Non-Discrimination Act.
The Council is also presently monitoring over 200 bills pending in the state legislature that potentially impact chiropractic. For many of these bills, we met with various legislators and staff during the year, advocating for the Council’s positions, and drafting related memos and amendments. If you would like a full list of these bills, please ask Legislation Committee Chairman Dr. John LaMonica, or Council lobbyist Perry Ochacher. Additionally, we continue to host and attend important political events with key legislators to promote the Council and its legislative agenda.
If you have further questions or need any additional information, Council lobbyist Perry Ochacher can be reached at (914) 319-9173, or by email at email@example.com.
Please continue to support the New York Chiropractic Council and the ChiroPurpose-PAC.
- Joining a coalition of over a dozen leading health care provider associations, the Council signed a letter urging the Governor to include language in the 2019-20 Executive Budget proposal allowing health care providers and physicians to jointly own health care practices (the Partnership Bill). This modernization would improve patient care, reduce health care costs, and move the state to an integrated health care model, and has been a priority for the profession for the past several years.
- We submitted joint comments to the Workers’ Compensation Board on August 6 regarding its proposed changes to the Workers’ Compensation Board Fee Schedule. While the WCB continues to analyze our (and other) comments, we will begin an outreach campaign with certain key members of the Senate and Assembly Labor Committees to share our reaction to and concerns with the proposed changes.
- The Council continues to engage in preliminary conversations with the State Senate to secure legislative sponsorship for its “Patient Health Care Non-Discrimination Act”, with an eye towards formal bill introduction this fall.
- We are working on a draft of an alternative provider to opioid prescription bill, similar to legislation that passed in several other states, that would require the consideration of health care providers such as chiropractic, physical therapy and others drug-free health care providers who are skilled in pain management, before an opioid may be prescribed.
- The Council will shortly submit a letter to the New York State Department of Financial Services, requesting a review of potentially discriminatory methods of utilization review by insurance carriers regarding trends in office practice procedures, including maintenance care and x-rays, that may be illegally targeting chiropractic.
- We will carefully monitor both the September primaries and November general elections for political changes in Albany, and their implications for the chiropractic profession.
Below please find highlights on some of our priority summer issues:
● Working with NYSCA, we submitted joint comments to the Workers’ Compensation Board on August 6 regarding its proposed changes to the Workers’ Compensation Board Fee Schedule. We will follow-up with a meeting and possibly other political action.
● The Council is engaging in preliminary conversations with the State Senate to secure legislative sponsorship for its “Patient Health Care Non-Discrimination Act”, with an eye towards formal bill introduction later this year.
● We continue to monitor political and legislative developments in the fight against opioid addiction, and continue to prioritize advocating for Chiropractic as a solution to the crisis.
● It has come to our attention that some Council members have received letters from insurance carriers regarding trends in office practice procedures, including maintenance care and x-rays. We are providing information to Council members who choose to respond to these letters, and are working on an appropriate response to the situation, which may involve meeting with the Department of Financial Services (previously the Insurance Department).
The NYS legislature adjourned at the end of June, and state legislators have returned to their home districts to campaign for reelection in November. Here are some of our accomplishments from the past legislative session:
- With formal comments due August 6, we are analyzing proposed changes in the Workers’ Compensation Board Chiropractic fee schedule, and will submit our comments to WCB on behalf of the Council.
- The Council researched and drafted a “Patient Health Care Non-Discrimination Act” legislative blueprint, and we are now reaching out to secure legislative sponsorship and a formal bill draft.
- The Council has made a sustained priority of advocating for Chiropractic as a solution to the opioid crisis, with Dr. John LaMonica submitting testimony to the Senate and Assembly Joint Health Budget Committee and Dr. Joseph Baudille testifying twice before the Senate Joint Task Force on Heroin and Opioid Addiction.
- The Council held a successful joint Lobby Day in April with NYSCA, with almost 100 Doctor of Chiropractic attending over 80 meetings with legislators from across the state.
- The Council worked with 13 other allied health care associations in support of our coalition MD partnership bill (S.4123/A.1943), which unfortunately did not advance.
We also advocated on a number of other important bills, including:
- S.6666 Amedore/A.2023-A Bronson - Relates to authorizing the care and treatment of injured employees by duly licensed or certified acupuncturists under the workers' compensation program. We carefully tracked this bill, which will soon be sent to the governor for final action.
- S.9072 Ortt/A.11228 Abinanti - Authorizes summer camps to hire certain licensed professionals to provide services. The Council successfully amended this bill to include chiropractic.
- S.6141-D Golden/A.8123-B Golden - Relates to the admission of unvaccinated students where parents submit a form stating that such vaccinations are contrary to their religious beliefs. The Council supported this bill.
- A.5913 Ortiz/S.4297 LaValle - Regulates the practice of naturopathic medicine. The Council lobbied against this bill, which died in the legislature.
- A.5807 O’Donnell/S.4291 Funke - Permits Doctor of Chiropractic to form limited liability companies. This is one of our priority bills, which unfortunately was held in committee at the request of Assembly Higher Ed Chairwoman Debra Glick, despite our lobbying efforts.
- A.8387-C Pretlow/S.8812-A Akshar - Relates to extending the authority of the WCB to resolve medical bill disputes. The Council expressed concerns with this bill, which was held back from committee consideration at our request.
- A.9834-A Rosenthal - Requires the coverage of alternative treatment options by the medical assistance program and private insurers. The Council amended this bill to include Chiropractic; however, the bill was held back in committee.
The action in the state legislature is heating up in its final month, as elected officials look towards their reelection in November. Here is what we’ve been up to over the past few weeks:
- The Council signed a support letter along with 13 other allied health care associations for our coalition partnership bill (S.4123/A.1943).
- Our Political Action Committee, ChiroPurpose-PAC, held a successful fundraiser this past month for Senator Terrence Murphy, the only state legislator who is a Doctor of Chiropractic!
- We have also been advocating on a number of other important bills, including:
S.6141-D Golden/A.8123-B Golden - Relates to the admission of unvaccinated students where parents submit a form stating that such vaccinations are contrary to their religious beliefs. The Council supports this bill, which has moved in the Senate.
S.1858-B Bonacic/A.3088-B Abinanti - Authorizes summer camps to hire certain licensed professionals to provide services. The Council successfully amended this bill to include chiropractic.
A.5913 Ortiz/S.4297 LaValle - Regulates the practice of naturopathic medicine. The Council expressed concerns with this bill, which was held back in the Assembly.
A.5807 O’Donnell - Permits Doctor of Chiropractic to form limited liability companies. This is one of the Council’s priority bills, which unfortunately was held in committee this week at the request of Chairwoman Debra Glick.
S.8387-B Pretlow - Relates to extending the authority of the board to resolve medical bill disputes. The Council expressed concerns with this bill, which was held back in committee at our request. We are currently analyzing new amendments to this bill.
A.9834-A Rosenthal - Requires the coverage of alternative treatment options by the medical assistance program and private insurers. The Council successfully amended this bill to include Chiropractic; however, the bill was held back in committee.
We had a successful lobby day this past month, with almost 100 Doctors of Chiropractic in Albany, advocating for our legislative priorities and showing support for their profession. Below is an update on Lobby Day 2018, along with some of the other items we spent time working on in April.
Lobby Day was a success and a strong show of support for chiropractic. Almost 100 Doctors of Chiropractic attended over 80 meetings with legislators from across the state, advocating for the MD/DC Partnership Bill, Scope Modernization, and our new "non-discrimination" draft "concept" bill, which is designed to end discrimination against non-allopathic health care providers in New York, and is inspired by federal health care non-discrimination laws, which unfortunately are not being enforced in the states.
Council President Scott Schwager sent to the Workers' Comp Board a strong letter requesting the immediate removal of a WCB Administrative Law Judge who made some biased and outrageous, anti-chiropractic statements while presiding at a hearing. As soon our lobbyist informed us of this ALJ's highly inappropriate and offensive remarks, we demanded that he be removed from his position. WCB is presently investigating this matter at our and NYSCA's request.
The Council successfully amended Assembly Bill No. 9834 specifically to include chiropractic. If you recall from a previous update, Assemblywoman Linda Rosenthal introduced a bill earlier this year, which proposed to mandate that certain providers be included in health insurance plans in order to offer alternative treatment to opioids for pain management. We met with the Assemblywoman, pointed out the omission, explained the benefits of chiropractic care as the logical alternative to drugs for the management of pain, and she quickly amended her bill at our request to include chiropractic.
We had a productive follow-up call with the Workers' Compensation Board on April 26 to discuss implementation of a Council-supported law from last year, which requires the WCB to create an Advisory Council to make recommendations to reform the IME process in Workers' Comp. The Board is soliciting our opinion on improving the process and adopting best practices to make IME's truly "independent" once again, which has long been a Council priority.
For those attending, enjoy the mid-year convention at Turning Stone. We have prepared a more detailed memo on our legislative efforts over the past six months, and we encourage you to read it, which can be found in your packets.
The New York State Legislature passed the $168.3 billion FY 2019 budget by the April 1 deadline. One area lawmakers sought to address in the budget is the opioid crisis. The budget creates an “opioid stewardship” program, which requires opioid manufacturers/distributors to contribute to a $100 million annual fund to defray the costs of prevention, treatment, and recovery services for individuals with a substance abuse disorder. Additionally, over $200 million in state funding has been allocated to address the heroin and opioid crisis, including a $30 million increase in funding for the Office of Alcoholism and Substance Abuse Services (OASAS) to enhance prevention, treatment, and recovery programs; residential service opportunities; and public awareness and education activities. On behalf of the Council, we are also attempting to schedule direct meetings with OASAS and the NYS Department of Health to further raise awareness on how chiropractic can be a natural solution to help combat the opioid crisis in New York.
Other legislative highlights over the past month include:
The state legislature is busy working on the 2018 state budget, which must be finalized by April 1. Thankfully, there are no major budget issues this year that negatively impact chiropractic practice (such as changes to the Workers' Compensation system), but we are nonetheless carefully monitoring the process on behalf of the chiropractic profession. Other highlights over the past month include:
- ●Dr. Bryan Ludwig and Perry Ochacher met with the new Chair of the Worker’s Compensation Board (WCB) on March 27, to discuss the Medical Treatment Guidelines, including the materials we sent WCB over the past year showing how various carriers are not operating in compliance with these guidelines, as well as other issues involving continuing fee disparity in chiropractic reimbursement, and IME reform.
- ●We are preparing for Chiropractic Lobby Day in Albany as April 24 draws near, when we will meet with legislators to advance our legislative agenda, presently in formation. The meetings, agenda and other items are being coordinated with NYSCA, who will also be participating that day.
- ●We drafted a support memo for a bill (A.6820/S.4611) that would create a tax credit for certain clinicians participating in preceptorship programs, which we support in principle but believe should be extended to cover chiropractic preceptorships as well.
- ●Additionally, we met with Assemblywoman Linda Rosenthal regarding her bill (A.9834) requiring insurance coverage of “alternative treatment options” for pain management, where we educated her on the role of chiropractic as the number one drug-free alternative for treating pain and confirmed that her bill includes chiropractic care.
- ●We have completed final revisions of our "Patient Health Non-Discrimination Act" bill draft, working with Council leadership. Our next step is to approach our allies and partners on this bill, as well as potential bill sponsor in the state legislature, who will help us convert our "concept bill" into formal bill language, where it can be introduced in the NYS Legislature for consideration and action.