2004 Legislative Session and Partial Repeal of Insurance Equality


Arlan 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 Oct., 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.

ACS continues to extend an open invitation to Dr. Fuhr and Mr. Aarons to answer the charges made here. Any statements provided up to 300 words will be printed unedited. This offer has been extended for years with no response. This fact alone speaks volumes.

BREAKING NEWS: A response from Dr. Fuhr was printed in the Oct., 2004 issue of the American Journal of Clinical Chiropractic and just discovered. Click here to read his thoroughly inadequate excuses for opposing both his own association, the AAC, and ACS (the called ICP) and helping UHC pass its bill.