Board of Directors
Minutes
The
following are informative minutes of the
The meeting was called to
order at
Motion: Moved by Bronston,
seconded by Henricks to approve the minutes of the
Antitrust Responsibilities
of the Board
This being the first meeting
of newly elected board members, the entire board was briefed on their antitrust
responsibilities. In addition to the briefing each member of the board received
copies of the state and federal antitrust compliance agreements for their
review.
Worker’s Compensation
Kemper Insurance has
challenged the worker’s compensation Necessity of Treatment Dispute Process by
claiming that the state’s expert reviewer may decide liability issues. The
state is defending its process in circuit court by stating that the reviewer
exceeded his authority in commenting on liability questions. The costs of the
appeal of being borne by the state.
HIPAA
The board was given a copy of
an article that recently appeared in the Wisconsin
Chiropractor which discussed the requirements for patient recall programs.
Under HIPAA requirements a patient recall program is considered to be marketing
and cannot be done unless the doctor has had the patient sign an authorization
explicating allowing this type of marketing. The board was encouraged to share
this information with their district members.
Physicians Plus – 98943
Code
Physicians Plus recently sent
a letter to chiropractors stating, in part, that the WCA “approved a reduction
in fees” for the 98943 code. The board was given a copy of the letter sent by
staff to Physicians Plus in which the WCA took exception to the use of this
language on the part of Physicians Plus. The board was reminded that the WCA
does not ever approve fees of any type. To do would be a violation of state and
federal antitrust law. The WCA requested Physicians Plus to change the language
of their letter.
Analgesic Health Care –
Fee Slitting
The board discussed a memo
sent to WCA members which discussed the Analgesic services agreement.
Particular attention was placed on potential violations of the fee splitting
and Stark laws. Board members were encouraged to request that any member
considering these arrangements obtain a written opinion from their attorney as
to its legality.
Rising Medical Solutions –
Denial of E/M codes
Rising Medical Solutions is
routinely denying E/M codes when done on the same day as an adjustment. The
board was encouraged to let their members know that the WCA will write a letter
to Rising for each claim that is rejected.
The
Business Health Care Group
of
This group has proposed
restrictions on what providers charge for their services in the
Member Benefits
The WCA staff is looking at a
broad range of new benefits for its members. The board was updated on the
progress of these discussions and the impediments to some proposals.