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Laws & Rules


HMOs Must Provide Chiropractic Care upon Request by a Subscriber
Wednesday, 24 February 2016
     HMOs that offer services through a managed care system must offer that care through a system in which a primary physician licensed as a chiropractor is designated for each HMO subscriber upon request of a subscriber requesting chiropractic services.1 The designated chiropractic physician is responsible for coordinating chiropractic care the subscriber requests.2 Stated differently, a chiropractic physician must be assigned to each HMO subscriber who wants chiropractic care. That designated chiropractic physician is the gate keeper for that subscriber’s chiropractic care and either treats the subscriber or refers the subscriber to another chiropractic physician on panel for medically necessary care.3
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PIP Law Update: Fourth District Court of Appeals Rules Allstate Policy Is Ambiguous
Wednesday, 19 August 2015
In a lengthy and well written opinion, the Fourth District Court of appeal explained why Allstate’s “subject to” fee schedule language in its policy of insurance was insufficient to put providers and insureds on notice of how it would pay 200% of the Medicare Fee Schedule part B.  In following prior appellate court rulings, the Court reiterated the law that there are two payment methodologies in PIP – the fact finding methodology of determining a “reasonable” amount and the fee schedule amount.  The Court found that Allstate’s policy language did not contain the required “clear and unambiguous” language as to how it would reimburse PIP benefits.  
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PIP Update: Miami-Dade County Court Finds EMC/DC Provision Unconstitutional
Thursday, 19 March 2015

Last week, a Miami-Dade County Court Judge (Judge Michaelle Gonzalez-Paulson), held that the PIP provision precluding a chiropractic physician from not being able to make an EMC determination, violated the equal protection and due process clauses of the Florida Constitution. Continue reading to access the judge's decision.

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Massage Establishment Licenses: Who is Exempt, Who is Not Exempt Under a New 2014 Law
Friday, 14 November 2014

A 2014 law requires some, but not all chiropractors paying licensed massage therapists (LMTs) to be fingerprinted and undergo a criminal background check by January 31, 2015.1  The new law exempts some chiropractors meeting specific criteria from all requirements pertaining to massage establishment licensing, including exempting them from the fingerprinting and background check.

This article discusses who must maintain a massage establishment license, who is exempt from these requirements and who must undergo a criminal background check.  Also discussed is what to do to claim an exemption.

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NACA Applauds Non-Discrimination in Health Care Reform
Friday, 30 July 2010
            (From the ACA “Week in Review” of July 22, 2010) The National Association of Chiropractic Attorneys (NACA) has issued a proclamation recognizing “the historic and profoundly positive legal ramifications for the chiropractic profession and the patient community it serves in Section 2706, ‘Non-Discrimination in Health Care,’ recently enacted as part of the federal Patient Protection and Affordable Care Act.” 
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