Health Law Blog

On July 30, 2012, the Pennsylvania Supreme Court denied State Farm’s petition for an appeal in the case of State Farm Mutual Automobile Insurance Company, et al. v. Robert J. Cavoto, Jr., et al. (No. 943 MAL 2011).  State Farm appealed the Pennsylvania Superior Court’s decision that chiropractors can delegate certain adjunctive procedures under the Pennsylvania Chiropractic Practice Act and the Pennsylvania Motor Vehicle Financial Responsibility Law.

In Pennsylvania, massage therapists are now required to be licensed by the State Board of Massage Therapy.  The Massage Therapy Law (63 P.S. §§ 627.1-627.50) and the regulations set forth the guidelines and define the scope of practice for licensed massage therapists (LMT) in Pennsylvania.  The law and the regulations can be found on the PA Department of State website, and chiropractors who want to hire a massage therapist should review the new law.

Many insurers and insurance plans in Pennsylvania require covered services to be performed by an eligible professional provider (i.e. chiropractor) or performed under that provider’s supervision in accordance with the licensure, certification and/or employment criteria for reimbursement.  The Pennsylvania Chiropractic Practice Act (63 P.S. § 625.101 et seq.) allows for a licensed chiropractor to utilize the assistance of unlicensed supportive personnel performing under the direct on-premises supervision of a licensed chiropractor, so long as no activity or duty is delegated which requires the formal education or training in the practice of chiropractic or the knowledge and skill of a licensed chiropractor.  (emphasis added) 63 P.S. § 625.601.  The insurance industry attempts to avoid paying doctors of chiropractic who properly delegate adjunctive procedures to support personnel.  Adjunctive procedures are defined as “physical measures such as mechanical stimulation, heat, cold, light, air, water, electricity, sound, massage and mobilization”.  63 P.S. § 625.102.  This begs the question – which aspects of adjunctive procedures may be properly delegated to unlicensed support personnel under the Chiropractic Practice Act?

I'm pleased to announce that as general counsel to the Pennsylvania Chiropractic Association (PCA), I am spearheading a seminar to help PA chiropractors understand the issues and trends regarding audits, coding and reimbursement.  I have put together a great lineup of speakers, including David Klein, CPC, CHC, a Highmark representative from the Financial Investigations and Provider Review Department, and lawyers with expertise in Workers' Compensation and Personal Injury.  The seminar is scheduled for Saturday, November 12, 2011, and it is to be held near Harrisburg, PA.  Early signups before October 20, 2011 receive a 20% discount.  You can download the seminar brochure and registration form by clicking on the button below. 

The Martin Law Firm is proud to announce that Jason B. Martin, Esq. has been selected to serve as General Counsel to the Pennsylvania Chiropractic Association (“PCA”).  The PCA is Pennsylvania’s largest professional membership association for chiropractors as well as the state’s largest chiropractic health care association.