ACA Reinforces 'Zero Tolerance' for Fraud

While ACA has always had a zero-tolerance policy with respect to chiropractors who commit fraud, the association’s recent efforts have provided it with new opportunities to reach out and educate insurers and fraud investigators and to build bridges with other organizations that oppose fraud.

ACA believes strongly that everyone benefits from anti-fraud initiatives: Patients benefit by having an increased level of trust in providers; insurers benefit by saving money; and providers benefit by protecting the reputation of their profession from the inappropriate acts of an unethical minority.

To demonstrate ACA’s strong position against fraud, Laurie Douglass, vice president of insurance relations, traveled to La Quinta, Calif., in September for the International Association of Special Investigation Units annual conference. Douglass’ presence at the conference allowed ACA to interface with SIU investigators from across the country. The gathering also gave the SIU investigators a unique opportunity to question ACA about chiropractic care and to learn more about the profession. In addition, Douglass shared information about ACA’s policies on treatment methods, practice management situations and ACA’s own internal policies for those who are found guilty of fraud.   

In another example of the association’s proactive approach to preventing fraud and educating the insurance industry, ACA held a teleconference on Sept. 28 with more than 20 special investigators from insurance companies across the United States. During the call, ACA highlighted its recent educational efforts with GEICO Insurance. Earlier this year, two ACA member doctors—one in Washington, D.C., and one in Virginia—opened  their clinics to investigators-in-training to help them learn how a chiropractic clinic operates, what kinds of treatment doctors of chiropractic provide and how chiropractic care benefits patients. ACA offered the same opportunity to visit a chiropractic clinic to all the participants on the call. 

Also during the teleconference, former ACA Chairman George McClelland, DC, gave insurance investigators a presentation on ACA’s historical anti-fraud position, its efforts to reach out to other anti-fraud groups and its desire to correct inaccurate perceptions about chiropractic care. Afterward, participants questioned the ACA presenters about the association’s new policy on manipulation under anesthesia, its work with the Federation of Chiropractic Licensing Boards and a variety of other chiropractic treatment protocols.

Providers from all specialty groups are collaborating to achieve greater transparency in the health care system. ACA’s anti-fraud efforts are a part of the trend. This renewed dedication is expressed in “The Charter on Medical Professionalism,” which, according to the September 2006 issue of Health Policy, “outlines important principles that serve as a guide to promote and maintain professional behaviors and attitudes. The responsibilities outlined in the Charter go beyond the basic premises of professionalism…to emphasize an even greater commitment to patients and patient care, underscoring honesty and transparency, patient confidentiality and striving for continuous quality improvement through collaborative efforts across disciplines.”

For more information on ACA’s anti-fraud initiatives and its zero-tolerance policy, visit www.acatoday.org, and click Professional Resources>Zero Tolerance.