Serving Chiropractors and Their Patients

Blog

Chiropractic Law’s blog (or “CL Blog”) is this website’s location to find informative and insightful entries posted by attorneys and other contributors. To learn more about those attorneys and contributors, please visit our contributors pages where you can also obtain contact information. Blog entries will be posted periodically on a wide range of issues of relevance to the chiropractic profession. The identity of the attorney or contributor posting on the blog is referenced with each entry.  Your feedback on all blogs is always appreciated.

Important Notice: Please read the disclaimer when using this website. All material presented on this website is intended for general informational purposes since the services of a competent professional, should be sought for any specific legal needs. Use of this website and transmission of resources and other information does not create or constitute an attorney-client relationship with any attorney contributing to this website.

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How to Handle Electronic Requests for Patient Records

Chiropractors are increasingly receiving requests that patients’ protected health information (“PHI”) be transferred electronically, rather than in paper format. Here are some insights on how to address these types of electronic requests for records under “HITECH” and a review of various legal aspects of this type of request.

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Board Meeting Takes on Issue of Delegation

A major item for discussion at the Examining Board’s next meeting relates to the issue of delegation.  Since the creation of the role of  the “CT” and “CRT”, there has been some confusion as to the extent of matters which can be delegated and the roles of both staff and the doctor in providing adjunctive services to the patient.

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HEARING ON PSCP LEGISLATION RAISES THE REAL CHALLENGES

Just days before the close of the legislative session, the State Senate’s Committee on Health and Human Services granted a public hearing on the controversial legislation introduced by the Wisconsin Chiropractic Association (“WCA”) to allow chiropractors to become “Primary Spine Care Physicians” (PSCP”). By the time their testimony was completed, it became readily apparent that each of these WCA presenters actually began to expose the fundamental problems or “challenges” which chiropractors face that have nothing to do with dramatically altering the scope of practice by creating the PSCP.

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Class Action Decision from Larson Affects Co-Pays

Chiropractic treatment is a common healthcare service that years ago was not routinely covered in health-insurance policies. For more than 27 years, however, Wisconsin has required health insurers operating within the state to cover chiropractic care on an equal basis as other forms of medical care for the same condition.

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Chiropractors Inform Board of Desired Changes

Chiropractors have voiced their concerns for changes

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It Is now OK to Say: “I’m Sorry” to Patients

Although apologies are common place to many during various times in our lives, it could have gotten a Wisconsin doctor into malpractice “quicksand”… until just recently.  Now, there is a new law in Wisconsin which generally allows a health care provider to apologize to an injured patient without fear that the apology can or will be used against them in any subsequent lawsuit.  In the past, doctors were often reluctant to show any remorse to a patient in fear that such a statement could be used as a negative admission in any malpractice claim. In April 2014, this state adopted a law which is now codified into the evidentiary section of the statutes (Wis Stats. 904.14) which ensures that a provider’s statements or gestures of compassion, fault, liablity, remorse, or responsibility to a patient or patient’s relative remains inadmissable as evidence of liablity or as an admission against interest.  This preclusion from evidence applies to a wide variety of situations including civil actions, administrative hearings, disciplinary hearings, and mediation type proceedings.  However, it is noteworthy that the law applies only to such statements or gestures made BEFORE the commencement of such a proceeding. The percieved benefits of the new law include a reduction

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Legislative Effort to Alter Nature of Informed Consent

Following a major Supreme Court decision, a new Wisconsin legislative effort has been initiated by the Republican majority  to revise a physician’s duty of informed consent.  The decision, rendered in the case of Jandre v. Physicians Insurance Co. of Wisconsin, involved a jury verdict decided  nearly a decade ago, in which a medical doctor was found negligent for failing to inform a patient about alternative medical modes of treatment for a condition.  This application of “informed consent” was unique in the case since the doctor was held liable for failing to provide the information on a condition which the physician did not believe that the patient had at the time the doctor provided information to the patient. The Wisconsin Supreme Court approved a standard of care involving informed consent which is referred to as the “reasonable person standard”.  Under this standard, the physician is required to disclose to the patient of treatment information necessary for a reasonable person (patient) to make an intelligent decision with respect to the choices of treatment or diagnosis.  As a result, physicians must disclose information to the patient even if the doctor  does not believe that the patient had a condition which requires the alternative mode of care or treatment. 

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Recent WI Court Decision Addresses Medicare Claims Submission

A Court decision was recently rendered in Wisconsin which addresses the intracacies of claims submission to medicare in situations involving treatment of patients involved in “tort” or negligence cases where there is a third party- insurer  available to pay for treatment expenses.  That third party can commonly be a workers compensation insurer of the patient’s employer or liablity insurer of  a negligent driver involved in an accident with the doctor’s patient. In the case of Conrad Laska v. General Casualty Company, the Wisconsin Appellate court noted several important medicare reimbursment concepts in these types of situations.  In this case, a hospital filed a statutory lien against a tort or third party payor seeking payment out of any eventual settlement or jury verdict, rather than billing medicare for an injured parties treatment.  The Court reviewed several medicare reimbursement concepts in its decision which are worthy of consideration by the chiropractor treating patients involved in these situations. First, the Court reviewed the “Provider Agreement Statute” (42 USC 1395cc-Special “legal speak” for the United States Code)  Under this statute, a provider participating in the medicare program “may not charge any individual or any person for…services for which such individual is entitled to payment under

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Preserve Medical Payments For the Treating Chiropractor

Chiropractors have contacted our office lately with concerns relating to their ability to receive payments under a patient’s medical pay coverage of an automobile insurance policy.  As most doctors are aware, many automobile policies contain “med pay” provisions which provide coverage for the health care treatment provided to an insured  under the policy.  The insurerd commonly includes any passengers in an automobile involved in an accident.  Treating chiropractors should always question a patient to determine if this type is coverage is available since the limits of the med pay is typically paid without the types of challenges or discounts often made  to coverage proveded by a health insurer. Some doctors have noticed recently that attorneys representing patients have unilaterally  “invaded” the payment process by either advising the med pay insurer to pay the patient/attorney the limits of coverage or redirect all payments to a provider other than the chiropractor.  Although payments are usually made to whichever proviider first provides the care and submits a claim, many policies have been interpreted by attorneys as allowing the patient to  control and manage the amount of coverage available to them.  There have even been situations where the attorney has expressly told the insurer not

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A Thought for the New Year

This past fall,Dr. Chester Wilk spoke at  one of the WCA’s  Southeast District meetings. Dr. Wilk spoke on a variety of topics in an open setting to over 25 interested doctors.  During his comments; which ranged from discussing the theme of a new book to a biographical sketch of his attorney in the landmark case involving the AMA,  Dr. Wilk managed to  “grip” the interest of the doctors with his high energy and intensity as a strong advocate for chiropractic.  All of this coming from an icon within the profession who , himself, never seemed to appear tired despite the late hour of the meeting and his advancing age. Throughout all the interesting stories mentioned by him, there were two comments Dr. Wilk made just before concluding the meeting which have “stuck” with me.  As many indivduals engage at this time  in both reflections upon and expectations for the New Year, I thought it could be an appropriate time to share those two comments. The first comment was said very publically and prominently at the beginning of the meeting. Dr. Wilk mentioned that he believed that every state chiropractic organizations should have its own recognized “spokesperson” who would be available to present and respond to chiropractic

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