Legal Issues

February 3, 2010

Profile: New MAC Attorney Dean Altobelli

When MAC attorney Kevin Moody lost his battle with cancer last year, the chiropractic community in Michigan lost a tireless warrior who fought for years to end discrimination against chiropractic and defend the profession. Kevin’s firm, Miller, Canfield, Paddock, and Stone, is one of the most respected in the state, so we didn’t have to go far in finding our new attorney – Dean Altobelli.

Dean is a Principal Attorney at Miller Canfield, Michigan’s oldest law firm. He earned his law degree from Yale Law School in 1993. Prior to law school, Dean earned a B.S. degree with high honors in Mechanical Engineering from Michigan State. He also attended graduate business school at MSU from 1987-1988.

If his name seems familiar to you MSU football fans, it’s because Dean played defensive back for the Spartans under Coach George Perles, twice earning Academic All-American honors (he finished in the top one percent of his class!), in 1985 and 1986. His excellence in academics, athletics and community service also earned him the 1986 Toyota National Leader of the Year in College Football Award while at Michigan State. Other awards and honors include: the Rey Meyer Award for Excellence; Big Ten Medal of Honor; outstanding student, Michigan Association of Governing Boards; and the National Football Foundation and Hall of Fame Scholar-Athlete award. He was also a Rhodes Scholar Finalist in Michigan.

Dean currently serves as the 2009-2010 Lansing Regional Chair of the Michigan Defense Trial Counsel, a statewide association of attorneys representing the defense in civil litigation. He is a member of the American Bar Association, Ingham County Bar Association, and the State Bar of Michigan.

A native of Escanaba, Dean was appointed by Governor John Engler to serve on the Lake Superior State University Board of Trustees. He served as Chair of the Board from 2004-2005. His term ended in January 2008.

Dean was a candidate for the U.S. House of Representatives in Michigan’s 1st District, which is comprised of the Upper Peninsula and much of the northern part of the state, in 1996. He served as a legislative assistant to Michigan U.S. Representative Dennis Hertel from 1989-1990.

Dean also currently serves as Treasurer of the Michigan State University Football Players Association and has served on the Board of Directors of the Michigan State University “S” Club.

Welcome aboard, Dean. We all look forward to working with you!

 

February 3, 2010

MAC Lawsuit Against Blue Cross in Discovery Phase

By: Dr. Don Reno, MAC President

For many years, Blue Cross Blue Shield of Michigan (BCBSM) has engaged in conduct that has been
discriminatory toward doctors of chiropractic and the patients who would seek our care.

Following years of attempted negotiations and the pursuit of required administrative remedies, our Board of Directors directed our Legal Affairs Committee and our attorney to file an all-encompassing “class action” complaint (lawsuit) to address BCBSM’s:

1) Unlawful policies and procedures as they relate to chiropractic
2) Prior and continued breaches of the provider and PPO contracts
3) Breach of contract as it relates to the 1999 settlement agreement
4) Improper interpretation of the scope of chiropractic
5) Non-payment of chiropractic services for which reimbursement should be allowed
6) Improper limitations on certain chiropractic services which are currently covered
7) Damages to each member of the “class of similarly-situated chiropractic physicians in Michigan.

The MAC cannot – and will not – tolerate discriminatory policies or activities from ANY insurance company. We believe that Michigan law is on our side and that we will prevail against these discriminatory Blue Cross activities.

Stay tuned to the MAC Action Report and Journal for more information on this important lawsuit as it develops.
 

February 2, 2010

MAC Lawsuit Against Blue Care Network in Discovery Phase

For many years, Blue Care Network (BCN) has engaged in conduct that we believe has been highly discriminatory toward doctors of chiropractic and their patients. Under Michigan law, BCN is not allowed to treat one class of providers, say DOs or MDs, differently than DCs. Furthermore, they are obligated to pay for all procedures allowed under a provider’s license at a rate equal to what they pay other provider classes. In our opinion, BCN routinely neglects to observe these anti-discrimination provisions. 

Our attorney has filed a complaint (lawsuit) to address Blue Care Network’s history of discrimination against chiropractors. The complaint address the following issues:

·            Limited access to chiropractic care by subscribers. BCN accomplishes this by various means, primarily by:

o     Limiting the network to a very few DCs.

o     Requiring that patients seeking chiropractic care have a primary care physician (PCP) referral. This tactic is very effective in limiting care by doctors of chiropractic by effectively placing chiropractic care “under prescription” of a medical physician.

o     No other provider—even specialists—are under PCP prescription, except chiropractors.

·            Payment for services that are allowed by our current scope of practice in Michigan.

·            Fair reimbursement for chiropractic services.

After exhausting all efforts to resolve these issues in the administrative arena, as required by Michigan law, we are left with this action as our only option to compel BCN to treat chiropractors and their patients in a lawful and fair manner.

It is the position of the MAC that these actions violate the Michigan Insurance Code. In addition to violating the Michigan Insurance Code, we believe that BCN, through these policies and practices, has also breached its contracts with chiropractors in its network. To maximize the complaint’s effectiveness, we have identified a MAC member doctor who has agreed to join the lawsuit. 

We are asking the court to enter a judgment declaring that through their discriminatory policies and practices, BCN has breached its contracts with chiropractic physicians. We are asking that damages be awarded.

Look for regular updates on this and other critical legal actions in future editions of the Journal and in our weekly emails.