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CORPORATE EVIDENCE-BASED PRACTICE and MARKETING FIND AN ARIZONA MEMBERSHIP and INSURANCE LAWS, ARIZONA STATE BOARD of CHIROPRACTIC EXAMINERS IMPORTANT REPORTS, ARTICLES, BOOKS and LINKS
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LEGISLATIVE INFORMATION PAGETABLE OF CONTENTS
Just because you do not take an interest in politics doesn't mean politics won't take an interest in you! -- Pericles (430 B.C.) Therefore, join ACS so that your political interests are protected. Click here for a membership application and join today.
ARIZONA CHIROPRACTIC SOCIETY LEGISLATIVE MISSION STATEMENTIf a health insurance policy covers reasonable and necessary services provided by a medical or osteopathic physician then the policy must cover reasonable and necessary services provided by a chiropractor if the patient's problem is within the scope of practice of a chiropractor. No discrimination should be allowed against the usual and customary procedures employed by a chiropractor including adjustments, physiotherapy, rehabilitation, dietary measures, exercise, etc. This mission statement has been at the root of the Arizona Chiropractic Society's successful passage of four insurance equality laws since 1990, and is the basis of the Society's continuing efforts at the present time.
ARIZONA CHIROPRACTIC SOCIETY LEGISLATIVE LOBBYISTRepresenting ACS at the Arizona Legislature is Edward J. Wren, a veteran of 25 years at the Capitol. His areas of expertise include health care, law enforcement and the hospitality industry. He also represents University Physicians, the faculty of the UA Medical School. Ed's bio is posted here. He has special empathy for the mistreatment of patients by insurance companies since he was once a prominent victim of HMO malpractice, written about in a local newspaper article with a full color photo. Ed is Government Relations Director for the Arizona Juvenile Diabetes Association and an Honorary Member of the Arizona Highway Patrol Association. He is widely respected at the Legislature.
ARIZONA STATE LEGISLATUREHomepage for the Arizona State Legislature
NOVEMBER 2009 LETTERS BETWEEN ACS LOBBYIST AND ARIZONA ATTORNEY GENERAL REGARDING LEGAL OPINION ABOUT INSURANCE EQUALITY LAWIn November 2009, ACS lobbyist Ed Wren sent a letter to Arizona Attorney General Terry Goddard requesting action on the request for a legal opinion made by Arizona State Senators Linda Gray and Rebecca Rios. Read his letter in PDF format by clicking here. Shortly thereafter, the Attorney General's Office responded to Mr. Wren. You can read the entire letter in PDF format by clicking here. Bottom line: The Attorney General will soon issue a legal opinion regarding whether current discriminatory copayments and deductibles for chiropractic care are illegal.
LIVE VIDEO TESTIMONY FROM THE ARIZONA LEGISLATURE OF DR. IMMERMANView live streaming Arizona Legislative video testmony of Dr. Immerman on 02/16/09 to the Arizona House of Representatives House Banking and Insurance Committee regarding why chiropractic must be included in all health insurance policies. Click here and the hearing on HB2323 Small business health insurance will begin. Advance the cursor to the 50:30 minute mark to see Dr. Immerman speak. 2010 ACS MESSAGE TO ARIZONA LEGISLATURE:CHIROPRACTORS ARE PART OF THE SOLUTION AND HERE IS THE EVIDENCE TO PROVE ITWhat happens when you add chiropractic care to a large health plan like AHCCCS? This has been thoroughly researched and here is the answer: ABSTRACT
Methods: A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit. Results: Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year, P<.001). Having chiropractic coverage was associated with a 1.6% decrease (P = .001) in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared withthose without coverage, had lower utilization (per 1000 episodes) of plain radiographs (17.5 vs 22.7, P<.001), low back surgery (3.3 vs 4.8, P<.001), hospitalizations (9.3 vs 15.6, P<.001), and magnetic resonance imaging (43.2 vs 68.9, P<.001). Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode–related costs ($289 vs $399, P<.001). Conclusions: Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care. Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs. Click here to link to the full article at the publisher site.
What happens when chiropractors become primary care physician (PCP) gatekeepers? This has been thoroughly researched with results published in peer-reviewed medical literature: Clinical and Cost Outcomes of an Integrative Medicine IPA Journal Manipulative Physiological Therapeutics 2004 Jun;27(5):336-47. Abstract Objective: We hypothesized that primary care physicians (PCPs) specializing in a nonpharmaceutical/nonsurgical approach as their primary modality and utilizing a variety of complementary/alternative medicine (CAM) techniques integrated with allopathic medicine would have superior clinical and cost outcomes compared with PCPs utilizing conventional medicine alone. Results: Analysis of clinical and cost outcomes on 21,743 member months over a 4-year period demonstrated decreases of 43.0% in hospital admissions per 1000, 58.4% hospital days per 1000, 43.2% outpatient surgeries and procedures per 1000, and 51.8% pharmaceutical cost reductions when compared with normative conventional medicine IPA performance for the same HMO product in the same geography over the same time frame. Conclusion: In the limited population studied, PCPs utilizing an integrative medical approach emphasizing a variety of CAM therapies had substantially improved clinical outcomes and cost offsets compared with PCPs utilizing conventional medicine alone. While certainly promising, these initial results may not be consistent on a larger and more diverse population. Link to abstract and publisher site for full study by clicking here.
This study is the 3-year update to the above research and confirmed the earlier findings: J Manipulative Physiol Ther. 2007 May;30(4):263-9. Abstract Objective: Our initial report analyzed clinical and cost utilization data from the years 1999 to 2002 for an integrative medicine independent physician association (IPA) whose primary care physicians (PCPs) were exclusively doctors of chiropractic. This report updates the subsequent utilization data from the IPA for the years 2003 to 2005 and includes first-time comparisons in data points among PCPs of different licensures who were oriented toward complementary and alternative medicine (CAM). Results: Clinical and cost utilization based on 70 Conclusion: During the past 7 years, and with a larger population than originally reported, the CAM-oriented PCPs using a nonsurgical/nonpharmaceutical approach demonstrated reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone. Decreased utilization was uniformly achieved by all CAM-oriented PCPs, regardless of their licensure. The validity and generalizability of this observation are guarded given the lack of randomization, lack of statistical analysis possible, and potentially biased data in this population. Click here to link to the abstract and the full study at the publisher site. Attention policymakers: If you want to save money and improve outcomes, consider chiropractors as PCPs.
MANDATE LITE BILLS MUST REMOVE PROVIDER SECTIONS -- ACS TAKES ACTION AT LEGISLATURESee live streaming video of Dr. Immerman's testimony on behalf of the entire chiropractic profession at the Legislature on February 16, 2009 by clicking here then scrolling down to the House Banking and Insurance Committee for that date. In 2009, SB 1325, HB 2323 and HB 2324 were introduced to give uninsured individuals and small businesses the option to buy health insurance policies free of many “mandates’ including the requirement to be fair to chiropractic. Certain well-intentioned but misinformed individuals believed that removing chiropractic will lower health insurance costs when the reverse is the truth. ACS joined the fray and lobbyied heavily to get these bills amended or killed. Unfortunately, they were passed and signed into law. Below are excerpts from our position papers. HEALTH INSURANCE COVERAGE EXEMPTION LEGISLATIONARIZONA CHIROPRACTIC SOCIETY FACT SHEETFactSections of SB 1325, HB 2323 and HB 2324 will increase insurance premiums and should be removed. SB 1325, HB 2323 and HB 2324 are intended to lower health insurance premiums by exempting certain policies from so-called “mandated benefits.” These bills unfortunately contain flaws that will have the opposite effect. Amendments are needed to remove the sections which will increase premiums. Here are the facts:
ExplanationThere is a misperception that chiropractic is an “add-on” to health insurance policies when in fact it is a “substitute” for more expensive forms of care like epidural injections and surgery for covered back conditions. It has been proven scientifically that when chiropractic is added to a health care plan there are fewer surgeries, hospitalizations, MRIs and x-rays, and overall costs for back care decrease.
ConclusionSB 1325, HB 2323 and HB 2324, as currently drafted, will increase health insurance costs by eliminating a less costly alternative treatment for back conditions leaving patients only able to access a more expensive alternative consisting of high technology and in-patient, surgical solutions. Therefore, the sections in the bill exempting plans from chiropractic coverage are counterproductive and should be removed.
Also sent before the hearing and forming the basis of our testimony was the following letter:Dear Members of House Banking and Insurance Committee, These bills will exempt certain health insurance plans from mandates for some coverages for benefits and some coverages for providers. The Cato Institute states that when there are more providers in the marketplace, there is more competition and lower healthcare costs. Therefore, the sections of HB 2323 and HB 2324 which would eliminate providers from the marketplace who compete with MDs would foster a medical monopoly, decrease competition and increase costs. It is true there are certain laws in place which mandate presence of providers such as chiropractors in health plans. This was in direct response to the medical profession’s illegal “boycott and conspiracy” against the chiropractic profession which earned the AMA a permanent injunction order, see attached, still in force today, which forbids further efforts to destroy the competition. We need these laws. Previous Republican-controlled conservative legislatures back to the days of Senate President Bob Usdane, Senator Jan Brewer, Speakers Mark Killian and Jeff Groscost enacted these laws to allow medical freedom of choice and dismantle the medical monopoly. Please do not undo their work. They were just as concerned about cost containment as you are today. Please read the very brief Cato Executive Summary below and then consider appropriately amending these bills to eliminate all reference to providers. Cost reduction efforts should increase the different types of providers involved in the marketplace, not reduce the number as would be the impact of HB 2323 and HB 2324. This is the conclusion of The Cato Institute.
December 15, 1995
The Medical Monopoly: Protecting Consumers or Limiting Competition?by Sue Blevins Sue A. Blevins is a writer and health policy consultant based in Boston. Executive SummaryNonphysician providers of medical care are in high demand in the United States. But licensure laws and federal regulations limit their scope of practice and restrict access to their services. The result has almost inevitably been less choice and higher prices for consumers. Safety and consumer protection issues are often cited as reasons for restricting nonphysician services. But the restrictions appear not to be based on empirical findings. Studies have repeatedly shown that qualified nonphysician providers--such as midwives, nurses, and chiropractors--can perform many health and medical services traditionally performed by physicians--with comparable health outcomes, lower costs, and high patient satisfaction. Licensure laws appear to be designed to limit the supply of health care providers and restrict competition to physicians from nonphysician practitioners. The primary result is an increase in physician fees and income that drives up health care costs. At a time government is trying to cut health spending and improve access to health care, it is imperative to examine critically the extent to which government policies are responsible for rising health costs and the unavailability of health services. Eliminating the roadblocks to competition among health care providers could improve access to health services, lower health costs, and reduce government spending.
ACS WORKS TO PASS NEW INSURANCE EQUALITY LEGISLATION AND TO ENFORCE EXISTING LAWACS has consistently led the way in lobbying for powerful insurance equality legislation for chiropractic in the Arizona Legislature for the past twenty years. If you want such legislation to pass, join ACS. You can find a membership application here. Read testimonials written by Arizona chiropractors about ACS by clicking here. No man's life, liberty, or property is safe while the legislature is in session. Mark Twain (1866)
KEY LETTERS FROM LEGISLATORSThese letters from elected leaders in Arizona document the ACS involvement with insurance equality legislation over the past twenty years. History tends to repeat itself so Arizona chiropractors count on ACS to pass new legislation in the future. Letter from Rep. Bill English in 1989 to Dr. Immerman. Rep. English was the prime sponsor of 1989 and 1990 insurance equality law. The law was passed in 1990 and expanded in 1991 to become ARS 20-461(A)17 and ARS 20-461(B). Letter from Senate President Bob Usdane in 1990 to Dr. Immerman regarding ARS 20-461. Letter from Rep. Debra Brimhall regarding passage of HMO chiropractic legislation in 2000 and Dr. Immerman. Letter from Rep. Debra Brimhall to the profession regarding passage of HMO chiropractic legislation in 2000 Letter from House Speaker Jeff Groscost to Dr. Immerman in 2000 regarding passage of HMO chiropractic legislation Read all of these letters by clicking here.
ACS ASKED LEGISLATURE IN 2008 TO REDUCE CHIROPRACTIC COPAYS AND DEDUCTIBLES FROM SPECIALIST TO PCP LEVELSIn January 2008, at the request of ACS, the Arizona Legislature considered a bill to reduce copays, coinsurance and deductibles for chiropractic care from specialist to primary care physician (PCP) levels. ACS lobbyist and former state representative Debra Brimhall Pearson met with legislators full-time for months in advance to prepare. In addition, Dr. Immerman and many ACS members met with legislators. Here is the link to the bill as originally introduced. Copays are now often as high as $55 for specialists of which DCs are now illegitimately considered one, while copays for PCPs are usually $20. Deductibles for DCs can be $500-$1500 versus $0 for a PCP. Patients are driven by finances to choose PCPs and not DCs. Such discrimination is unlawful based on the insurance equality laws passed by ACS and its ancestor organizations in 1990-1991 (see www.AZChiropractors.org). Therefore, ACS is also working to gain proper enforcement of existing law On 10/24/07, a stakeholders’ meeting was held by House Health Committee Chair Bob Stump. Attendees included Senator Gray, ACS, AAC, and BCBS representatives. BCBS announced that it would lower $60-$70 copays to $55, open up the PPO network to all DCs (which would subject all claims to the copay as compared to non-PPO claims where no copay applies), and no longer call DCs specialists. ACS rejected the $55 copay as clearly far too high and grossly discriminatory. ACS stated it would be moving forward with legislation to require full parity with PCPs. AAC refused to join ACS in the legislation and thanked BCBS for its show of good faith with the new $55 copay. AAC stated that this amount of incremental gain is acceptable with the hope that future negotiations in years ahead may provide further relief. Twenty-five BCBS of AZ executives and employees gave campaign contributions to Rep. Stump from 10/17/07 to 10/30/07, apparently at a fundraiser at Nixon's Restaurant in late October. This was a few days after the stakeholders' meeting on 10/24/07. Attendees at the fundraiser included the BCBS CEO, the President, and a former state insurance commissioner who is now BCBS' lead lobbyist. The total raised was over $2800. The report containing the details was filed 1/31/08 with the Arizona Secretary of State and is posted here. Shortly after the stakeholders' meeting and the fundraiser, one of the attendees at both functions, BCBS lobbyist Chuck Bassett, wrote a damning ten page letter stating that all chiropractic care is merely "feel-good" care that is "not medically necessary" and should not be covered by insurance. He further wrote that BCBS of AZ is not interested in the findings of peer-reviewed scientific studies regarding the clinical or cost effectiveness of chiropractic. His letter is posted here. ACS member Nels Larson, D.C., stated in an email to the AAC: “My income has gone down almost100K THIS YEAR! Guess why? A great majority was from BCBS. While you sit and ‘negotiate’, all of the doctors I know are going broke. This is not good. So far I'm not sure whose side you are on.” On January 3, 2008, AAC President Rich Guarino, D.C. sent an email to all members stating that the AAC would not be supporting any insurance legislation in 2008. Read the email here. ACS was left to carry the bill alone.
2007 LEGISLATIONSB 1504 Chiropractors; Copays, Coinsurance, Deductibles: As of June, 2007, ACS is working very hard to get the language of this bill passed. Sponsored by chiropractic legislative champions Senators Linda Gray and Rebecca Rios, it has already passed the full Senate and almost passed the House in the conventional manner. If enacted, it would require insurers to charge copayments, coinsurance and deductibles for chiropractors that are the same as they are for medical and osteopathic primary care physicians. At the current time in Arizona, there are huge disparities creating burdensome financial barriers for patients when they seek chiropractic care. This bill would level the playing field and make it possible again for patients to use their insurance benefits for chiropractic care.HB 2115 Professions; Disciplinary Action; Continuing Education: This law gives the Chiropractic Board the option of ordering chiropractors to take continuing education courses for minor violations of the Chiropractic Act instead of disciplining one's professional license. For example, if a doctor has been found in violation of the record keeping rules, the Board under the new law is able to order course work instead of imposing discipline. This bill was signed by the Governor on April 16, 2007 and became law ninety days after the end of the legislative session. This bill was a joint effort of ACS and AAC. Both associations and their lobbyists worked very well together to develop the bill and guide it successfully through the legislative process.FINAL NOTES ON 2007 LEGISLATIVE SESSION: ACS' effort to pass SB 1504 copayments/deductibles failed on the second to the last day of the legislative session, although we were able to defeat Mandate Lite. Please read the July 2007 ACS News for complete information. ACS is the only state association in Arizona with an effective legislative program.ACS 2007 LEGISLATIVE POSITION PAPER REGARDING COPAYMENTS AND DEDUCTIBLES -- COMPREHENSIVE Read the ACS position paper supplied to support legislation to end discriminatory copayments and deductibles. It is a comprehensive and fully documented package of information that you do not want to miss.
ACS LITIGATION AND LEGISLATION FORCED BLUE CROSS BLUE SHIELDTO OPEN ITS PARTICIPATING AND PPO NETWORKS TO CHIROPRACTOR IN 2004 AFTER NEGOTIATIONS FAILEDACS litigation and legislation forced Blue Cross Blue Shield to open its Participating and PPO networks to chiropractors in 2004 after negotiations completely failed to solve the problem. The Arizona Chiropractic Society joined a federal lawsuit against Blue Cross Blue Shield in 2003. ACS sued BCBS for "limiting access of qualified chiropractic providers to enroll or contract under BCBS’ plans which provide preferential treatment for enrolled or contracted providers." The most glaring discrimination had been BCBS’ closure of the Participating Physician network to any new chiropractors which had caused huge problems in offices, most notably all payments were sent to patients even if assignment of benefits’ forms were signed. This lawsuit increased the pressure on BCBS. From 1998 to 2003, ACS ran legislation every year to force BCBS to accept assignment of benefits, thus bypassing the need for membership in the Participating Physician Network. In the 2004 legislative session, Senator Mark Anderson, ACS Legislator of the Year, introduced SB 1177 on behalf of ACS. Click here to read the full text of SB 1177 along with details about its progress through the Legislature in 2004 from the Legislature's website. The bill was scheduled to be heard in the Senate Health Committee on 2/26/04. Just before the hearing, a deal was struck between ACS, Senate Health Committee Chair Carolyn Allen and BCBS. The deal was that if BCBS would open up its Participating Network to ALL Arizona chiropractors, then ACS would drop its effort to pursue legislation and Sen. Allen would not hear SB 1177 in her committee as had been scheduled. BCBS agreed and its lobbyist wrote a letter dated 3/08/04 stating: "This confirms Blue Cross Blue Shield of Arizona is about to perform a complete analysis of the chiropractic network." The letter was signed by Charles Bassett, Government Relations Director, BCBS of AZ. Finally the war was won! Click here to read a copy of the actual letter by Mr. Bassett. Therefore, as a result of the lawsuit and legislative pressure, on October 8, 2004 BCBS opened its participating network to ALL Arizona chiropractors. Once a contract with the chiropractor was signed, then BCBS began to send payments directly to the doctor. ACS and AAC had tried negotiations with BCBS on this matter for many, many years and they had always failed. In 2003, Dr. Immerman spoke directly with the President of BCBS of Arizona who he had known and worked with for fifteen years. The BCBS President adamantly refused to voluntarily open the network since this would allegedly increase chiropractic utilization, a negative outcome according to BCBS. There is no question that it took a viable threat of a new law to force BCBS to open its network, along with a federal lawsuit. The AAC repeatedly claims that a few meetings in 2003 and 2004 with BCBS were the cause of BCBS caving in and deciding to open its networks to chiropractors. This is simply false. It took the threat of impending and viable ACS legislation together with an underlying ACS federal court lawsuit to change BCBS policy. It is naïve, ignorant and/or disingenuous to state otherwise. This repeated attempt to rewrite history solely to justify the existence of the AAC must stop once and for all.
2004 LEGISLATIVE SESSION AND PARTIAL REPEAL OF INSURANCE EQUALITYArlan Fuhr, DC and Activator Methods International split from both the AAC and ACS and supported a United HealthCare and insurance industry bill which now allows all insurers to single out chiropractors and spinal adjustments for medical necessity reviews and post payment audit reviews. Read the full story in the American Journal of Clinical Chiropractic by clicking here. The United HealthCare effort would have failed without the additional assistance of AAC lobbyist Barry Aarons who also helped pass this law. Here are the details as published in the August 2008 ACS Newsletter which was distributed to the entire Arizona chiropractic profession and is posted online at www.AZChiropractors.org. As of May, 2010, no one has ever accepted ACS' ongoing invitation to offer any corrections or rebuttals to this story. Therefore, this report stands as fact. In 2004, United HealthCare (UHC) asked the Arizona Legislature to enact a new law to greatly facilitate its ability to review and cut chiropractic claims. UHC felt that the chiropractic insurance equality law passed by ACS in 1990-1991, ARS 20-461(A) 17 and B, stood in its way. At a critical juncture, AAC lobbyist Barry Aarons stated the AAC’s opposed position was neutral when in truth it was "opposed," thus causing the bill to pass. The law UHC wanted changed required that utilization review be applied equally to MDs, DOs and DCs. UHC wanted to single out DCs but could not under the extremely well crafted ACS law. Therefore, in 2004, UHC persuaded legislators to introduce SB 1094 Unfair Claims; Medical Necessity Review. (See http://www.azleg.gov/, click Change Sessions, go to 2004, Bills, SB 1094.) Both ACS and AAC immediately joined in denouncing this legislation. Both knew that intense UHC utilization review would result in significant problems with payments as chiropractors were singled out for “special” attention. Both groups instructed their lobbyists to adamantly oppose this legislation. The AAC lobbyist was Barry Aarons. On 02/09/04 Wayne Bennett, DC, then co-chair of the AAC Public Policy Committee, told members in an email they should say the following to legislators: “The passage of this legislation would facilitate discrimination against chiropractic services and a reduction of care for our patients . . . The Arizona Department of Insurance concurs with that observation!” ACS sent many of the same alerts to its members. In a complete surprise to both ACS and AAC, Activator Methods International testified in favor of the bill at the Senate Health committee hearing on 02/12/04. AMI is controlled by Dr. Arlan Fuhr, a former AAC leader, First Vice President, Chair of the Legislative Committee, and current leading supporter. An Activator attorney told legislators AMI supported SB 1094 and that it had 800 members in Arizona. Both ACS (then ICP) lobbyist Debra Brimhall and AAC lobbyist Barry Aarons testified in opposition. The 02/12/04 minutes can be found at http://www.azleg.gov/FormatDocument.asp?inDoc=/legtext/46leg/2R/comm_min/Senate/021204+HEA%2EDOC.htm. Dr. Fuhr has been asked repeatedly why he supported the UHC legislation when the leaders of AAC and ACS were strenuously opposed. He has never responded as of May, 2010. AAC lobbyist Aarons stopped helping his client the AAC and instead began to help United HealthCare and AMI after SB 1094 passed the Senate Health Committee and headed to the full Senate for a final, critical vote. Here is the evidence. Sen. Barbara Leff voted against SB 1094 in the Senate Health Committee on 02/12/04 after she heard testimony against the bill from the ACS and AAC lobbyists. But when the bill came up for a vote by the full Senate on 03/02/04, Sen. Leff voted yes. Here is her explanation for why she changed her vote. In a 03/09/04 email, Sen. Leff wrote: “I voted against the UHC Bill in committee but by the time it got to the Floor and was amended, the Chiropractic Association (AAC) no longer opposed it.” She has said Mr. Aarons told her the AAC was neutral, not opposed. Sen. Carolyn Allen, the Chair of the Senate Health Committee and the prime sponsor of the bill, made a floor speech on 03/02/04. She stated that the AAC was no longer opposed to the bill based on what she was told shortly beforehand by Barry Aarons. She then voted yes on that basis. On 06/17/04, then-Sen. Mark Anderson confirmed that Sen. Allen had stated to the full Senate that Mr. Aarons was the source of information regarding the AAC’s position supposedly new "neutral" position on SB 1094. Also on 06/17/04, then-Rep. Karen Johnson, Chair of the House Rules Committee, confirmed that Mr. Aarons had told her the AAC was neutral on SB 1094, and so she did not need to continue to hold the companion bill in her committee. Holding the bill had the effect of killing the measure prior to this time. Following Mr. Aarons’ information about the new AAC position, Rep. Johnson released the bill from committee over the objections of ACS, thereby permitting it to pass into law. According to these four legislators, Mr. Aarons’ position on SB 1094 shifted from one of total opposition to neutrality. At the same time, however, the position of the AAC, Mr. Aarons’ client, did not change at all. In an 11/03/04 email, Wayne Bennett, DC stated: “I was the Co-Chairman of the AAC Public Policy Committee during the last year when the 1094 battle was being fought. I was on the Public Policy Committee for several years prior to that time, and was involved in the long, drawn out battle on this issue from its ugly beginning. I was personally present at most of the meetings involving 1094, including those with Barb Leff. I can tell you without any uncertainty that the AAC was never, at any point in time, from beginning to end, EVER, neutral on 1094. You can check this out for yourself. If you look at the records of every committee meeting in the House and Senate where this issue was debated (from beginning to end) you will see that the AAC is ON RECORD as having opposed the bill.” Mr. Aarons denied he told any legislator the AAC had changed position to neutral on SB 1094. On 03/12/04, ACS was told in an email from the AAC that “Barry assures me that his message is and has been the message that we crafted, drafted, and reaffirmed as I passed on to you. He says that he has never told any legislative entity that the AAC is "neutral" on the bill. I believe him.” The integrity of the four sitting legislators named as sources for this report is beyond question. There is no doubt that Sen. Leff told the truth when she wrote the AAC (through its lobbyist) advised it no longer opposed SB 1094. Sen. Allen is one of the most highly esteemed legislators in Arizona. She sponsored the AAC’s AHCCCS bill two years ago and the ACS Chiropractic Board bill this year. No one doubts her word when she stands up in the Senate and says a certain lobbyist, in this case Mr. Aarons, informed her that his client, the AAC, is neutral on her bill. One’s word is everything at the Capitol. Then there is Sen. Johnson, retiring this year after 12 years, and Rep. Anderson, retiring after 14 years to run for the U.S. Congress. All four stated, one in writing, that Barry Aarons said “it is fine to vote yes on SB 1094, go right ahead, AAC does not object.” Two no votes changed to yes in the Senate as a direct result, and this provided the margin of victory. The bill then passed into law. The will of both ACS and AAC was defeated, directly because Barry Aarons told key legislators the AAC had switched positions from "opposed" to "neutral." It is widely believed that Dr. Fuhr was instrumental in the process of hiring Mr. Aarons for the ACS. Also, Mr. Aarons served for some period of time, and possibly during the legislative session of 2004, as a member of the Activator Methods Business Advisory Panel. AMI joined with UHC to support SB 1094 against the opposition of both ACS and AAC. Mr. Aarons was in the lobbyist business with former registered lobbyist Judi Hamilton, now married to Dr. Fuhr. These connections may help explain, but never justify or excuse, Mr. Aarons’ and Dr. Fuhr’s joint effort to help UHC. Arizona chiropractors have been slammed in the pocketbook following passage of the 2004 law. Every DC has to struggle to get paid by UHC and all other insurers now that chiropractic can be legally singled out for utilization review. This was illegal prior to 2004. The landmark ACS chiropractic insurance equality law prohibited such discrimination. ACS and AAC had the bill stopped before Mr. Aarons gave legislators the green light to cause it to pass. Arlan Fuhr and AMI had already provided great encouragement for passage. This is intolerable and so the truth must be known, especially since obstructionist and uncooperative behavior has been Mr. Aaron’s modus operandi ever since. Mr. Aarons is still the lobbyist for the AAC but has yet to explain why he helped UHC in 2004 achieve its goal of weakening chiropractic insurance equality law in Arizona. ACS finds no reason to trust this behavior will not be repeated in the future. Therefore, ACS will maintain a strong presence in the Legislature to protect the interests of the chiropractic profession in Arizona.
1999 LEGISLATIVE SESSIONNumbers add up differently in fight over health care bill, Phoenix Business Journal, March 5, 1999 Chiropractic boycott must cease, Editorial by Alan M. Immerman, D.C. Phoenix Business Journal, August 20, 1999
Webmaster's note: For comprehensive information about every annual ACS legislative campaign dating back to 1995, go to the page where all ACS Monthly Newsletters are posted and read the details.
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274 member-months over a 7-year period demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 85% pharmaceutical costs when compared with conventional medicine IPA performance for the same health maintenance organization product in the same geography and time frame.
