The MAC: Celebrating Our First Decade!
Part VI: Beginning of the Fight Against the Blues (2009-2011)
January 1, 2017, marked the 10th Anniversary of the Michigan Association of Chiropractors! As we begin our second decade, we will be looking at where we’ve been, where we are, and where the profession is going with one, unified organization working hard every day for the chiropractic profession in Michigan.
In 2009, right in the middle of the effort to expand Michigan’s chiropractic scope of practice, the MAC embarked on another major fight – to end discriminatory policies in Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN).
For more than a decade, the Blues engaged in conduct we believed was discriminatory toward doctors of chiropractic and the patients who would seek our care. After years of pursuing administrative remedies, the MAC Legal Affairs Committee, chaired by Dr. Tom Klapp of Ann Arbor (pictured, left), recommended to the Executive Committee and Board of Directors that we prepare lawsuits against both BCBSM and BCN.
Under Michigan law, insurers are not allowed to treat one class of providers differently than another. In our opinion, the Blues routinely neglected to observe state anti-discrimination provisions.
In early 2009, MAC attorney Kevin Moody filed suit against BCN, addressing the following issues:
- A limited DC network
- The requirement that patients seeking chiropractic care have a primary care physician (PCP) referral.
- Not paying for all services that are allowed by our current scope of practice in Michigan.
Later that year, we filed suit against BCBSM. This suit addressed BCBSM’s:
- Unlawful policies and procedures as they relate to chiropractic
- Prior and continued breaches of the provider and PPO contracts
- Breach of contract as it relates to the 1999 settlement agreement
- Improper interpretation of Michigan’s scope of chiropractic
- Non-payment of chiropractic services for which reimbursement should be allowed
- Improper limitations on certain chiropractic services which are currently covered
Both legal actions were filed as “class action” lawsuits. A class action lawsuit is one in which a group of plaintiffs with similar injuries caused by the same action sue the defendant as a group.
First Major Victory – Class Certification Granted!
It wasn’t until April 2011 that we got our first major victory in the case – class certification was granted. In an unprecedented favorable ruling, Ingham County Circuit Court Judge Paula Manderfield granted the MAC’s motion for “class certification” in our legal actions, meaning that the cases would move forward as a class action. This was an extremely promising development, but it was only the first step in a long, major effort to come!
Chiropractic Legal Warriors: Dr. Nicholas Griffiths and Dr. Toby Mitchell!
|The MAC Executive Committee, Board of Directors, members, and Michigan’s chiropractic community at large would like to sincerely thank Dr. Nicholas Griffiths of Dearborn and Dr. Toby Mitchell of Niles, who acted as the plaintiffs in our lawsuits against Blue Care Network and Blue Cross Blue Shield of Michigan, respectively. These brave, dedicated doctors stepped forward to put their professional well-being on the line, putting their names to lawsuits against two of Michigan’s largest health insurers. Their steadfast courage and dedication to chiropractic in our state are awe-inspiring, and we are all in their debt.|
Partnership with the State of Michigan Begins
In 2010, the MAC entered into a partnership with the Michigan Department of Community Health to promote Governor Granholm’s “Healthy Michigan” initiatives. This partnership continues to this day and has led to such public relations efforts as our screening programs at health fairs and small businesses across the state. It has made the MAC a vital player in the health care arena in Michigan. More on these programs in later articles in this series.
Dr. Michael Callton Files to Run for State House of Representatives
In 2009, Nashville chiropractor Dr. Michael Callton filed to run for election to the Michigan House of Representatives. Dr. Callton, a Republican, received numerous prestigious endorsements from prominent local GOP lawmakers. His early political career included stints on the School Board, Nashville Village Council, and Barry County Board of Commissioners
“Being a chiropractor, correcting Michigan’s chiropractic scope of practice and creating insurance equity are two of my top priorities,” Dr. Callton told the Journal at the time. “When I was graduated from National College of Chiropractic in 1989, I was told not go to Michigan because of how chiropractors were treated there… Michigan is my home. It’s where I was born...where my family lives...and for better or worse, where I will work my entire chiropractic career. The way chiropractors are treated in Michigan is just plain wrong.”
In November 2010, Dr. Callton won his election, becoming the first chiropractor in state history to be elected to the Michigan Legislature. He would be re-elected in 2012 and 2014, ending his career in the House as Chair of the Health Policy Committee, the body responsible for deliberating on issues related to public health, health professionals, mental health and wellness, and overall access to healthcare. Dr. Callton plans to run for the Michigan Senate in 2018.