December 2005

Are you committing fraud?

by Dr. Terry A. Rondberg

I'm thinking about writing a novel with a chiropractor as the lead. It takes place in the future when chiropractic has all but been outlawed. The hero, Jake Trevor (all thriller heroes seem to have names like that) is what's known as an "underground DC." Using fake IDs and the latest James Bondian devices, he evades the FBI and Homeland Security to give adjustments to people with subluxations. Some are children, others still hold to the widely ridiculed belief in innate intelligence. Trevor is always just one step away from being caught and jailed for this transgression, and an army of opponents, headed by the malevolent archenemy JC Jones, dogs his every move. I'll call it "The Last Chiropractor on Earth."

I haven't yet figured out what year the story will take place in. Maybe 2015 or 2020. Perhaps, the way things are going in real life, 2008 would be closer to the mark.

Sadly, in this case, art imitates life and the premise is not as farfetched as you might think, for there is a growing movement ‑‑driven by a segment of our own profession ‑‑ that would make chiropractic as we know it illegal.

Subluxation correction is being categorized as "fraud" by this contingent. Since the movement is being led by a number of chiropractic "leaders" who have gained power in organizations like the ACA, CCE and FCLB, there is a very real possibility that the change will be devastating and quick, unless the rest of the profession wakes up and takes action.

If you don't' believe me, listen to what one commentator ‑‑ an unofficial mouthpiece for the ACA and winner of that organization's "Service to Chiropractic" award in 2003 ‑‑ said in a recent message distributed via e‑mail:

"Don't think (for) a moment that the FBI isn't aware of what we're doing in this profession ‑‑ it may be just a matter of time and a few patient complaints to turn the typical free exam, NOOPE, TWIP office inside‑out, upside‑down when these agents come with their subpoenas in hand."

What does this ACA‑honored pundit consider fraud? In his words:

"Service fraud is not only when not rendering a service/treatment as claimed on the insurance billing, but not medically necessary care is also considered fraud. Also, it may be deemed fraud when patients get the exact same services on similar schedules, even upon improvement treatment remains the same (3x/wk until the insurance stops). Services based solely on available insurance or for legal reasons, not on need, or services for conditions not found in presenting complaints may be deemed as fraudulent. Pre‑determined scripts (as we saw in the Markson lawsuit), the 4 day ROF, inadequate referrals, and multi‑disciplinary practices are also signs of possible service fraud."

He also notes: "Aggressive marketing, increasing services with 'so what' tests like ZT mobile diagnostics or the Subluxation Station, how to use the CA to build the practice, and how to circumvent reimbursement limitations using MDs and PTs are examples of current fraud methods."

Look at that list carefully. Note, particularly, that he would consider as fraud all care that is not "medically necessary." By standards set by the medical profession that would include almost all care given to children and asymptomatic patients, as well as wellness, preventive and maintenance care. What remained would be three or four visits to treat low back pain in adults. Note, too, his reference to "inadequate referrals." By 'inadequate,' does he mean anything that doesn't fall neatly into the back pain box?

So, according to him, the FBI is lying in wait to catch any DC who strays from the medicalized version of chiropractic therapy. Do you care for children in your office? How about athletes who want to maximize their performance by keeping subluxation‑free? Do you dismiss patients as soon as they show any "improvement?" Does your CA show enthusiasm about chiropractic and ask patients for referrals? Do you use a Subluxation Station or other objective assessment test that doesn't directly support the ACA and its allies?

All those are 'fraud' according to this man, who, in this same treatise salutes the "those men and Women in the ACA, ACC, WFC, CCE, FCER, FCLB, NBCE, RAC, CCGPP and state association leaders who give of themselves to address the many issues that lay before us."

To accomplish this goal of criminalizing subluxation care (what he so colorfully and frequently refers to as "chiro‑babble" or worse) these groups are also targeting many of the schools and companies that have helped keep subluxation‑centered chiropractic alive. Among those this ACA‑sanctioned writer labels as 'evil vendors' or 'chiropractic gurus,' are:

** Christopher Kent and Patrick Gentempo of CLA

** Parker Seminars

** Life University

** Larry Markson

** Dennis Perman

** Bob Hoffman

** Guy Riekeman

As he puts it: "Sadly, as long as Parker, Sanna, Riekeman, Gentempo, and Markson remain the most notable gurus, thousands of DCs will flock to their shows to chant the Money Hum, and the culture of chiropractic may never progress beyond the shysterism and hucksterism that now typifies our profession" ... and ... "We will continue to see the rah‑rah, 3‑ring circus Parker seminars, the new‑age Life Source phonies spouting chirovangelism, or the Markson Chiro Destiny SuperConference [I dunno if Larry Markson, Dennis Perman or Bob Hoffman are my idea of successful people, ya folla?]."

Of course, I'm always on his "hit list" as one of the "evil vendors" who dare to dedicate their lives to making subluxation‑based chiropractors successful and prosperous. In fact, he once called me "the most dangerous man" in chiropractic. He meant it as an insult but I was ‑‑ and am ‑‑ proud to be singled out by this anti‑chiropractic zealot.

He despises and fears me because I'm having an impact. I, and the others on his list ‑‑ as well as all those strong hearted field doctors out there practicing subluxation‑based chiropractic every day, threaten the vision he and his ACA/ACC/WFC/CCE/FCER/FCLB/NBCE/RAC/CCGPP cronies have for our profession. And we're going to keep on threatening it until it shrivels up and dies the ignominious death it deserves.

It's one thing to share our profession with those who want it to become nothing more than a manual therapy, a subset of medicine. It's another thing to allow them to take it over and kick us out.

And, if you think his reports are only the ramblings of an off‑the‑deep‑end chiro‑looney, think again.

"Since practice gurus are the main source of fraud and abuse, the FLCB (sic) has taken upon itself the task to determine how many state boards actually regulate these shysters," he reports.

For once, he's telling the truth. The FCLB is rapidly becoming the 'homeland security' agency of the chiropractic profession, taking it upon themselves to be judge and jury to anyone daring enough to teach traditional, conservative chiropractic.

Keep in mind that the FCLB is funded by the American Chiropractic Association, National Board of Chiropractic Examiners, and the National Chiropractic Mutual Insurance Company (NCMIC).

Already, pushed by these aggressive anti‑subluxation organizations, seven states have enacted regulations governing companies that market services to chiropractors and at least five others are considering similar legislation. The boards will decide whether the company should be allowed to do business in those states. Is there anyone alive who really believes that companies that support subluxation‑centered chiropractic won't be the first ones outlawed by these boards?

If you don't realize ‑‑ or believe ‑‑ that this is the first step toward the criminalization of subluxation‑based chiropractic in general, you could be one of the first to be declared a fraud and sent to jail. And that's NOT the plot of a science fiction novel. It's real. All too real.