h/t to Damin Toell (who really needs to update his blog already) and many thanks to DG for publishing this at NFP. Acupuncture is now going to be deemed to be payable at the MD or DO rate.
Where was the DOI when “Power Acupuncture” represented the law, and the carriers were getting socked for $100 acupuncture visits, notwithstanding the DOI’s proclamation that acupuncture was only payable at the chiro rate? As an aside, it looks Judge Gonzalez in Great Wall Acupuncture v. GMAC, 6/15/2007 NYLJ 22, (col. 3)(Civ. Ct. Bronx Co. 2007) called this one three years ago.
While it is unfortunate that the carriers will be paying more for these acupuncture visits, the good news is that my summary judgment motions will consume about 40 less pieces of paper, since a definitive fee schedule will have been established.
9 Responses
Judge Gonzalez’s decision was on a motion drafted and argued by the incomparable Eva Gaspari.
Jason, why is it unfortunate that carriers will be paying at a higher rate? If the carriers raised the fees they pay their attorneys (which havent changed in years!) wouldnt you be jumping for joy?
Kurt, except for the matrimonial bar (where the going rate is $450 an hour and the standard retainer allows the attorney to impress a mortgage on the client’s property) and the fee that white shoe firms charge, the rates in this profession have remained somewhat static. I tend to think that the fees that are paid to certain professionals in the fee schedule should be increased a bit, i.e., chiropractors should get more than $33.70 per session. I put acupuncturists, however, on the bottom of the list of professionals who should be given fee increases.
Sort of egocentric J.T. but it is your blog. A Billion Chinese do not know what they are talking about.
Yes J.T. the lesson is push back against the Defense bar and they grow less bold because bold is time and you get so little money.
I would not begrudge you a raise though. If I did it would mean that I was some sort of sicko fanatic plagued by jealousy.
I am a believer of legitimate chiropractic medicine, and think that they are being underpaid. I believe the acupuncture chiropractor rate fairly reimburses most of the L.AC’s that are out there. It is just my opinion – it is neither right or wrong.
Opinions are like *&#@(). Everyone has one and they all stink.
Think of all the money you made defending the insurance industry against inflated acupuncture rates and Power Acupuncture. Why don’t you donate it back to the insurance companies — those poor fellas.
Okay enough of the gutter one-upmanship. You clearly can’t keep up anyway.
Intellectual question: Read the precise langauge of the proposed fee schedule. The key words “permissible” and “charge.” Add the old opinion of the DOI and the Great Wall decision and it progeny.
Can insurance companies still pay the Chiro rate. Under the plain langauge of the fee schedule yes they can.
Please edify J.T. Am I missing something. Does permissible charge in industry usage mean that is what the insurance company must pay given no shennanigans and medical necessity.
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Oh my goodness. Thanks J.T. I will call.
That poor man James Willis. A whole bunch of his shipmates tried to lynch him on board a destroyer for dancing with a white woman while on shore leave. He went to prison for defending himself. He was permanently injured badly and rendered deaf as a side effect of treatment he recieved for TB contracted in prison. He went on to live a successful life, raise a family and now has died a combat veteran of WWII. He earned his stripes escorting convoys across the Atlantic and then the Pacific.
God Speed Mr. Willis — Fireman First Class. May your seas always be calm.