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Wilton Manors, Florida, Broward County, Florida
2608 NE 16th Avenue Wilton Manors, FL 33334-4319 Telephone: 954-463-3036 Fax: 954-565-5557 www.chiropractorwiltonmanors.com Business Hours: Monday, Wednesday and Friday: 9:00am – 1:00pm and 3:00pm – 7:00pm Tuesday and Thursday: 9:00am – 1:00pm and 3:00pm – 6:00pm Weekends By Appointment 24 HOUR EMERGENCY SERVICE Emergency clients welcome Licensed Chiropractor #MM13657, Insured

Monday, August 22, 2011

Scott, Atwater look to fix or kill no-fault auto insurance, Ft. Lauderdale Chiropractor Troy Lomasky Notes Tampa Tribune PIP Story

FATAL WRECK 7885831.JPG
THE ASSOCIATED PRESS
Florida has one of the highest rates of uninsured motorists.


http://www.tbo.com/

By CATHERINE WHITTENBURG | The Tampa Tribune
Published:  August 21, 2011
TALLAHASSEE -- The number of car crashes in Florida is dropping, yet auto insurers in Florida are paying more every year on personal injury claims -- all told, $940 million more since 2008.

Who else pays? You do, if you're an insured Florida driver.

The main cause: fraudulent personal injury claims, which drive up everyone's premiums, said State Insurance Commissioner Kevin McCarty.

"It comes out of the pockets of Joe and Mary Lunchbox," he said at last week's Florida Cabinet meeting. "And the thing about it is, it's through no fault of your own."

Florida consumers can't afford that, say Gov. Rick Scott and Chief Financial Officer Jeff Atwater, who have suggested it's time either to fix the current system or stop requiring Florida drivers to carry $10,000 in personal injury protection insurance. PIP covers a driver's injuries from an accident regardless of who is at fault.

Lawmakers have tried to reform the system to prevent fraudulent PIP claims, but they continue to pile up.

Studies show that auto insurance would be cheaper if drivers did not have to carry PIP. But Florida also has one of the highest rates of uninsured motorists, and is one of only two states where drivers don't have to have insurance covering injuries they inflict on others.

All of which means that injured drivers without PIP would more likely face covering the cost of their own treatment. That could drive up the cost of health insurance and health care, PIP supporters say. Would repealing the PIP mandate trigger too many unintended consequences?



* * * * *



The number of Florida drivers has remained stable since 2005, while the number of crashes has dropped, McCarty said.

Yet the cost of PIP claims climbed 70 percent from 2008 to 2010, from $1.43 billion to $2.37 billion.

That cost the average two-car family nearly $100 extra last year on auto insurance, even if their driving records were spotless, according to the Insurance Information Institute.

"Some of that increase can be attributed to increased medical costs," McCarty said. "But not 70 percent … fraudsters and hucksters [have] perfected the system of finding the weak points and taking advantage of that."

PIP is part of the no-fault auto insurance system that Florida adopted in 1971. Billed as a way to reduce insurance costs and litigation, no-fault limits an injured motorist's right to sue in exchange for prompt payment of medical bills and lost wages through PIP.

But as government and grand jury reports have shown, PIP fraud has grown exponentially in the form of staged crashes, inflated claims of medical treatment and outright false claims of injury.

South Florida is the state's ground zero for fraudulent claims, though insurers also report a high rate of staged accidents in the Tampa Bay area.

The Legislature reenacted Florida's PIP law with anti-fraud reforms in 2007, but problems continued, prompting more anti-fraud proposals this spring. They failed, in part, because lawmakers comingled anti-fraud provisions with more controversial caps on attorneys' fees.

PIP is one of the most heavily lobbied issues at the capitol, given the high stakes for the legal, insurance and medical communities.

PIP is still a great idea, said Atwater, who hopes lawmakers will pass potent new measures in 2012 to drive down fraud.

Otherwise, he said, "if [PIP] is going to continue to run the route it's going, where it's going to become unaffordable, people are going to go uninsured. I think we have to look at the alternatives."

Scott, who often speaks about consumer "choice," said earlier this month that he was considering proposing legislation to make PIP coverage optional. Tuesday, he said he would defer to McCarty to hammer out a PIP proposal.

Repealing PIP should be part of the debate, McCarty said after Tuesday's Cabinet meeting. "Many of the things that were thought to be the benefits of PIP have not panned out." One alternative, he said, may be requiring bodily injury liability insurance, which covers other people's injuries or death when the insured driver causes an accident.

Because bodily injury insurance requires assignment of fault, "you're not going to stage an accident," McCarty said. "It simply takes the fraud out of the system." .

Sen. Ellyn Bogdanoff, who sponsored anti-fraud legislation this spring, panned replacing PIP with bodily injury insurance. "When does the hospital get paid? You have to prove a certain level of liability."

Bruce Ruben, president of the Florida Hospital Association, agreed. Bodily injury protection, he said, "requires litigation before the insurance is available."

The medical community is highly protective of PIP. When the mandate sunset in 2007, hospitals and other providers argued that failing to reinstate it would simply shift auto insurers' costs to the healthcare system.

Injured drivers without PIP would rely on their health insurance, Ruben said, potentially raising premiums. The rate of uncompensated care would increase, as many injured motorists without PIP or health insurance would be unable to afford their treatment.

Hospitals and patients who do have health insurance would wind up paying for that, Ruben said.

Cost-shifting is a valid concern, said Michael Carlson, head of the Personal Insurance Federation of Florida, a trade group of auto insurers including State Farm and Allstate.

But Carlson pointed to a 2008 study in Colorado that indicated health insurance rates rose only 1.6 percent when that state dropped its no-fault/PIP system in 2003. Auto insurance rates plunged by 35 percent.

The switch, however, also drove down payments to hospitals, ambulances and other providers by $80 million, the Colorado Springs Gazette reported. "While there have not yet been any major layoffs, some rural hospitals have had trouble finding specialists to serve on trauma care calls for fear they will not get paid."

Colorado lawmakers responded in 2008 by requiring drivers to carry a $5,000 medical payments benefit unless they opt out.

In Florida, where Allstate and State Farm pushed in 2007 to end the PIP mandate, even large insurers have mixed views today, said Carlson. "Our position is that the PIP system is broken and needs to be fixed."

Bogdanoff, R-Ft. Lauderdale, said she plans to introduce PIP legislation again next year. So does Rep. Jim Boyd, R-Bradenton, who sponsored a similar bill. Among the provisions they say are key: requiring in-depth accident reports, as opposed to the current "short form," to prevent people not injured from filing a PIP claim.

"I hope that with the attention being brought to the issue now, and the visibility and exposure, that we get some substantial and meaningful reform this session," Boyd said.


cwhittenburg@tampatrib.com (850) 222-8382

To view this story online, go to:  http://www2.tbo.com/news/breaking-news/2011/aug/21/scott-atwater-look-to-fix-or-kill-no-fault-auto-in-ar-251578/

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, near Ft. Lauderdale, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients, weekends & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.

Sunday, August 21, 2011

The Florida Current: How can Florida doctors survive in an HMO world? Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week

Reprinted from The Florida Current
http://www.thefloridacurrent.com/

By Christine Jordan Sexton, 8/18/2011

Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week.

State Rep. Darren Soto is hosting a meeting at the Florida Hospital in Orlando on Aug. 25 to answer questions from doctors and hospitals about how to play in the new mandatory managed care environment, said Soto, a Democrat from Orlando. This isn’t the first meeting on the statewide Medicaid managed care project, but it may be the first one where the agenda is aimed at answering health care providers’ questions. Soto said providers need to understand how the changes impact their businesses if they want to stay in business.

"This won't be political," said Soto, who actually voted against the sweeping reforms along with the other Democrats in the House of Representatives. "It's an effort for me to help educate the doctors and administrators and others folks who are potentially dealing with Medicaid reform. …. This is geared toward providing information on what would be a huge reform affecting loss of doctors offices."

Agency for Health Care Administration spokesperson Michelle Dahnke confirmed that Dudek -- and not a proxy -- will be at the meeting.

This is not the first time that Soto has hosted meetings in Orlando with agency secretaries. He previously met with former Department of Health Secretary Ana Vimonte Ros and former Department of Community Affairs Secretary Tom Pelham, who addressed autism in the Hispanic community and the foreclosure crisis, respectively.

"If you ask the right way you can get a lot of secretaries to come down," said Soto.
Filed in: Health Care
Tags: Medicaid Reform

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Dervices include: consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties. Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors

State Representative Bryan Nelson: We need to give fixing Florida PIP one more shot



Above:  Chairman Rep. Bryan Nelson, R-Apopka, guides an Insurance & Banking Subcommittee meeting. Photo Credit: Mark Foley, Florida House of Representatives

Reprinted from The Florida Current
http://www.thefloridacurrent.com/

By Christine Jordan Sexton, 8/18/2011

 As calls for tackling Florida’s personal injury protection (PIP) program grow louder one influential lawmaker has made clear he doesn’t want to scrap the long standing system that pays $10,000 in health care costs regardless of which driver is at fault.

Rep. Bryan Nelson, R-Apopka, said he believes the program can be altered to address some of the problems that have been bedeviling the system if the Legislature were to adopt fee caps and utilization schedules and agree to limit attorneys’ fees, similar to what the Florida Legislature accomplished with workers’ compensation in 2003.

Nelson is chairman of the House Insurance and Banking Committee, which will likely hear any PIP related bills the Legislature tackles in the 2012 session.

“We need to give it one more shot and try to fix it,” Nelson said of PIP. “If we can’t fix it, then we’ll flush it.”

An insurance agent, Nelson said his goal is to reduce insurance premiums for Florida drivers by $1 billion.

Nelson is the latest politician to chime in on whether the state’s no fault system be eliminated or at a minimum retooled. Gov. Rick Scott said earlier this summer he could support eliminating the no fault insurance program but at a Cabinet meeting on Tuesday said he would wait to follow the lead of Insurance Commissioner Kevin McCarty.

McCarty--who has served as insurance commissioner under Govs. Jeb Bush, Charlie Crist and now Scott--said he was going to meet with legislators in the coming weeks to discuss the issue.

McCarty gave a lengthy presentation at the Cabinet meeting showing that PIP benefits paid have increased by more than $500 million since 2008 even though the number of licensed drivers has remained steady and the number of accidents has dropped.

A decision was made in 2003 to allow the program to expire but a coalition made up of hospitals, health insurers companies and some automobile insurance carriers successfully lobbied to modify the program and have it reinstated into law.

When the insurance industry supported organization the National Insurance Crime Bureau released a report earlier this year revealing the percentage of questionable PIP claims in Florida rose 34 percent from 2008 to 2010 legislators once again re-examined the program in 2011. The NICB rated Miami, Tampa and Orlando among the top five cities in the nation for questionable claims.

The Office of Insurance Regulation also released the Report on Review of the 2011 Personal Injury Protection Data Call, which showed that costs in the PIP system are increasing and that PIP payouts have gone from about $1.5 billion in 2008 to approximately $2.5 billion in 2010. The OIR report also showed that Florida PIP claims involve about twice as many medical treatments than the average and the costs are $4,000 higher than the average costs.

Florida is one of ten states to have no fault automobile insurance program.

This past session PIP was just one of a whole long list of insurance related the Legislature tackled including sinkholes, homeowners and medical malpractice. In the end, the legislation fell by the wayside.


PIP isn’t expected to compete with other insurance issues in 2012 though, Nelson said.

“This is a huge issue and hopefully we’ll address it in a meaningful way, not a superficial way,'' he said.


Filed in: Insurance
Tags: Personal Injury Protection

Tuesday, August 16, 2011

From the South Florida Sun-Sentinel's House Keys Blog: Push for legislation to fight auto insurance and PIP fraud already underway

From the Sun-Sentinel's "House Keys" blog today, August 16, 2011:



About five months before the start of Florida’s 2012 legislative session, efforts are already underway to promote policies that could fight personal injury protection insurance fraud.

Only a few provisions in bills proposed this year cleared the state Legislature. At a Cabinet meeting Tuesday, Insurance Commissioner Kevin McCarty, Gov. Rick Scott and Chief Financial Officer Jeff Atwater expressed support for new PIP legislation.

Atwater said the state should “stop throwing consumers to the wolves” and Scott urged McCarty to meet with legislative leaders to “have something happen this session.”

Robin Westcott, the state's new insurance consumer advocate, announced recently that she plans to develop PIP legislative proposals by December. She'll issue recommendations after meeting with a working group of legislators and others.

Personal injury protection, or PIP, pays medical bills for policyholders injured in auto accidents, regardless of which driver is at fault. It's intended to protect Floridians who don't have health insurance and to avoid lawsuits and their costs for minor injuries. Florida drivers are required to carry $10,000 worth of coverage.

The proposed legislation this year would have, among other things, made it more difficult for people to file claims and for lawyers to collect huge fees. A broad coalition including insurers supported most of the proposed changes. But legal and healthcare industry representatives pushed only for those changes that they felt wouldn't hurt people with legitimate claims.

McCarty provided information from a report his office did to support the need for legislation. He said:

PIP claims payouts increased more than 50 percent from under $1.5 billion in 2006 to about $2.3 billion in 2010 even as the number of licensed drivers has increased only slightly and the number of crashes have dropped.

To view this posting online, click here.

Ft. Lauderdale Chiropractor Troy Lomasky Notes Florida Insurance Commissioner Kevin McCarty's Personal Injury Protection (PIP) Presentation at August 16 Florida Cabinet Meeting


Florida Insurance Commissioner Kevin McCarty made a presentation on Personal Injury Protection (known as PIP or No-Fault Insurance) to the Florida Cabinet this morning, August 16, 2011. He reviewed the various types of auto-related insurance coverages available in Florida and discussed the issue of statewide fraud.

To view his presentation, click here.

Type of auto insurance:

Liability – Coverage for all sums the insured is legally obligated to pay due to an
accident
• Bodily Injury (BI) – Provides coverage for death or serious and permanent injury to
others when you are legally liable for an accident involving your automobile.
• Medical Pay (Med Pay) – Provides coverage for medical treatment for the insured
or resident family member resulting from an auto accident, regardless of fault, as
well as any person occupying the covered auto.
• Personal Injury Protection (PIP) – Provides coverage for medical benefits, lost
wages and funeral benefits for insured or resident family member when injured in
their own vehicle, in someone else’s vehicle, as a pedestrian or as a bicyclist.
• Property Damage (PD) ‐ Coverage in the event that negligent acts or omissions of
an insured result in damage or destruction of another’s property.
• Uninsured Motorist (UM) – Coverage provided to the insured, resident family
members and any other person occupying the covered automobile for bodily
injury resulting from an accident involving an uninsured or underinsured driver.

Saturday, August 13, 2011

Ft. Lauderdale Chiropractor Dr. Troy Lomasky Notes Florida Surgeon General Issues Emergency Suspension of Daytona Practitioner

Insurance fraud is a big problem in Florida and gives good chiropractors a bad name.  If you are a victim of fraud, or suspect insurance fraud, report directly to the Florida Department of Financial Services, Division of Insurance Fraud by clicking here.


Florida Surgeon General suspends chiropractor's license; order claims insurance billing fraud By LYDA LONGA, STAFF WRITER 
August 13, 2011

http://www.news-journalonline.com/
Daytona Beach News Journal

DAYTONA BEACH -- The state surgeon general in suspending the license of chiropractor Joseph Wagner blasts the 61-year-old as an irresponsible practitioner who flouted the law by billing insurance companies for services he never performed and treating at least two patients with controlled substances.

Dr. Frank Farmer, the surgeon general for the Florida Department of Health, said Friday that issuing the emergency suspension order for Wagner's license was the "best way to resolve the issue."

"Dr. Wagner's actions demonstrate such a propensity to inappropriately exceed the scope of his license and to mislead third parties ... and make it clear that Dr. Wagner will continue to practice in violation of Florida law unless action is taken to prevent him from doing so," the order states.

In the 14-page document issued late Thursday, the Department of Health details how Wagner submitted fake insurance reimbursement claims to Geico insurance company for treatments he supposedly gave two patients identified in the order as "KR" and "JR."

The order also claims that Wagner called in prescriptions for both patients under the name of another doctor who never evaluated or even met the individuals.

The license of that doctor, John P. Christensen of West Palm Beach, was suspended by Farmer on Aug. 4. That same day, the FBI, the Florida Department of Law Enforcement and other law enforcement agencies raided the Wagner Chiropractic & Acupuncture Clinic at 542 N. Ridgewood Ave., confiscating patient records.

The seizure of records was in connection to the Christensen matter, FDLE officials said; two other clinics were busted that day, as well -- one in West Palm Beach and one in Port St. Lucie.

In addition, Wagner's son, John Wagner, who is also a chiropractor with a separate clinic on Mason Avenue, is implicated in the same investigation, Department of Health and FDLE officials said.

John Wagner was placed on probation by the state's Board of Chiropractic Medicine in April, records show, because he erroneously diagnosed a patient. The patient is one of six that were seen by either Joseph Wagner or John Wagner in a two-year-period and were prescribed medications under Christensen's name, records show.

Joseph Wagner's other son is Volusia County Councilman and personal injury attorney Josh Wagner. Neither Joseph Wagner nor Josh Wagner returned phone messages left Friday.

The door to the Wagner clinic was locked Friday morning.

In the order issued against Joseph Wagner on Thursday, it states that he saw the two patients for only minutes at a time each week, yet he billed Geico a total of 53 times for extensive services that he never performed. Wagner claimed that he gave the patients various chiropractic treatments, in addition to 30-minute counseling sessions, the order shows.

"Dr. Wagner's egregious and inappropriate coordinated effort to submit insurance claims for chiropractic services not rendered demonstrate exceptionally poor judgment," the order states. "And his behavior is the antithesis of what is required and expected of chiropractic physicians."

As for the controlled substances that the Department of Health details Wagner as having prescribed, those included hydrocodone, Xanax for anxiety and the muscle relaxant Soma.

Patient "KR" told investigators that the doses Wagner prescribed to her were "excessive" and she took the medication only as needed. Wagner prescribed 40 hydrocodone, 21 Xanax and 21 Soma each, to "KR" and her husband "JR," weekly, the order shows.

Investigators said Wagner would call in the prescriptions and they would be issued under Christensen's name.

"Dr. Wagner's egregious and inappropriate prescribing of potentially addictive and dangerous drugs, through the use of Dr. Christensen's medical license and DEA number, to chiropractic patients, constitutes a breach of the trust and confidence that the Legislature placed in him," the order says.

According to state records, Wagner, graduated with a business degree from Bethune-Cookman College in 1972. He went to chiropractic school at the Cleveland Chiropractic College in Kansas City from 1973 to 1977.

A native of Daytona Beach, Wagner graduated from Father Lopez High School in 1968. He became a chiropractic physician licensed in Florida in 1978 and studied to be a doctor at Universidad Federico Henriquel, the same now-defunct school in the Dominican Republic that Christensen attended.

-- Staff Writer Jay Stapleton contributed to this report.

Ft. Lauderdale Chiropractor Troy Lomasky Notes Orlando Sentinel Editorial on PIP: Fix PIP, but don't kill the no-fault program

Orlando Sentinel Editorial: Fix PIP, but don't kill the no-fault program

August 7, 2011
Gov. Rick Scott suggested late last month that it's time Florida scrapped its requirement that motorists carry personal-injury protection, which pays medical benefits for injuries suffered in automobile crashes no matter who's at fault.

The state would be better off if Scott instead worked with the Legislature to reform PIP, while keeping it mandatory. Making it optional or getting rid of PIP would likely cause more problems than it would solve.

That's not to say PIP hasn't been a headache, even after the Legislature passed a bill in 2007 intended to scale back abuses in the system. Lawmakers required that participating health care providers charge customary fees, which lawmakers said should prevent hospitals and clinics from charging exorbitant rates, which had caused auto insurers to increase premiums.

Lawmakers also gave prosecutors more resources to pursue questionable medical claims associated with staged accidents.

But PIP's problems have persisted or worsened. A report from Florida's chief financial officer, Jeff Atwater, indicated that the number of PIP claims jumped 40 percent since 2006, even though the number of traffic accidents in Florida fell by 33,000 between 2005 and 2009.

Atwater also reported that questionable auto insurance claims rose in Florida by 34 percent from 2008 to 2010. The heightened claims, Atwater suggested, are causing insurers in many cases to double PIP premiums in hopes of covering their costs.

So, scrap PIP or make it optional? That, we've said, would only make things worse. For decades, PIP has limited auto accident lawsuits, which were choking courts and delaying payments to legitimate health-care providers. Rip up PIP and the courts will gridlock.

Remove the PIP requirement and motorists will pay substantially more for their health insurance, which increasingly would cover auto injuries. More deadbeats also will drive without insurance, forcing others to pay for their care after accidents.

Some auto insurers also would love to replace a diminished PIP system with one mandating more expensive — and more profitable — bodily-injury protection.

Better, then, to retain PIP but curb its excesses. Scott and legislators could make health providers that handle PIP claims part of a registry that subjects them to review and reprimand. They could limit the times some health providers and schemers try billing insurers to game the 2007 restrictions on fees they can charge.

Scott and legislators say they're all about fighting fraud. They should work to free PIP of it, not bury the state's flawed but worthy personal-injury-protection program.

Copyright © 2011, Orlando Sentinel




Ft. Lauderdale Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients, weekend & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Ft. Lauderdale Chiropractor Troy Lomasky Notes Broward Palm Beach New Times Blog: 411-PAIN Catches Attention of Florida Bar

411 Facebook-thumb-200x227.jpg
(Graphic from Facebook)

 
411-PAIN Catches Attention of Florida Bar

 
By Lisa Rab
August 12, 2011
http://www.browardpalmbeach.com/

 
Several months after New Times raised questions about the 1-800-411-PAIN Referral Service, the Florida Bar is taking a closer look at the local company and its competitors.

 
At its annual convention this summer, the bar held a public hearing on for-profit lawyer referral services. The bar has received written criticism about 411-PAIN, a Broward-based company that solicits clients who have been in car accidents. Last fall, two former clients filed a class-action lawsuit accusing 411-PAIN of false advertising, deceptive trade practices, and a civil conspiracy. The company denied the allegations.

 
When clients call 411-PAIN, they are sent to chiropractor clinics and also given referrals
to lawyers who handle car accident injury cases. The company's owner is chiropractor Robert Cash Lewin, and the 411-PAIN network includes 36 medical clinics and about 100 attorneys in Florida.

 
The company is registered with the Florida Bar, and at the bar hearing, a lawyer for 411-PAIN submitted a letter defending his client.
"Although the Florida Supreme Court has allowed private lawyer referral services for more than a quarter century, only recently has The Florida Bar begun to scrutinize their operation," Tim Chinaris wrote.

 
"Historically, private lawyer referral services operated quietly and attracted little attention from the Bar. In the past few years, however, some services have advertised heavily and started to provide significant competition to established personal injury law firms. Not coincidentally, the Bar has now turned its attention to these services. It is no secret that some lawyers and law firms would like to drive private lawyer referral services out of business because the services attract clients that used to go to those lawyers. The committee should not permit itself to be used as a cover for blatantly anti-competitive regulation action."
But an investigator for the Florida Department of Financial Services, which looks into insurance fraud, expressed skepticism about businesses that offer referrals to both doctors and lawyers --  sometimes all in the same location.

 
"Why does a lawyer have an office in a doctor's office, and why is the lawyer signing up clients in a doctor's office, and why is that allowed by the Florida Bar?" Howard Pohl asked at the hearing.

 
Good question.


Follow The Pulp on Facebook and on Twitter: @ThePulpBPB. Follow Lisa Rab on Facebook and Twitter.


Information from the Florida Bar on PIP
 
According to Florida law, if you own a motor vehicle with four or more wheels you must carry $10,000 of personal injury protection (PIP) insurance and a minimum of $10,000 of property damage liability insurance. You may have a deductible of up to $2,000 for PIP coverage and $500 for Property Damage Liability.
 
Personal injury protection (PIP) insurance covers you regardless of whether you cause an accident (are "at-fault") -- up to $10,000 minus your deductible amount. PIP is designed to reduce the necessity of suing for reimbursement of medical and related bills from auto accidents. PIP pays:
  • 80 percent of reasonable medical expenses related to the accident
  • 60 percent of lost wages as a result of the accident
  • $5,000 for death benefits
For accidents that happen in Florida, PIP covers you, relatives who live in your home, certain passengers who do not own a vehicle, and others who drive your car with your permission. Pedestrians and bicyclists are also covered if they are Florida residents. PIP coverage also provides coverage for acts of violence against the policyholder while driving including injuries sustained as a result of road rage or a car-jacking.
For accidents that happen outside Florida but inside the U.S. or Canada, PIP covers you and relatives who live in your home. In this case, you must be driving your own vehicle. Persons other than you or your relatives are not covered.
 
Property Damage Liability Insurance pays for damage you, or members of your family, cause to another person’s property while driving. The term "property" includes, for example, a fence, telephone pole or building, as well as another car.

Coverage applies even if you drive someone else's car. Depending on the terms and conditions of your policy, it may also include anyone else who uses your car with your permission.
 
Bodily Injury Liability coverage (BIL) is generally not required in Florida. However, if you have been convicted of a DUI, BIL is required for a period of three years after your license has been reinstated. If you were convicted on or before October 1, 2007, you must get a minimum of $10,000 worth of coverage per person and $20,000 worth of coverage per incident. If you were convicted after October 1, 2007, you must have $100,000 worth of coverage per person and $300,000 worth of coverage per accident.
 
BIL pays for serious and permanent injury or death to others when your car is involved in an accident, and the driver of your car is found to be at fault to some extent. This policy pays for injuries caused by you and relatives who live with you, even if they are driving someone else’s car. It also covers people who drive your car with your permission. BIL coverage applies only after PIP benefits are exhausted. With this type of policy, the insurance company will also pay for your legal defense if you are sued.
 
All auto insurance policies must include a summary and an outline of coverage in clear understandable terms.
Plain language" descriptions must include the following:
  • A brief description of the benefits and coverage and a breakdown of how the premium is applied.
  • A summary of what is or is not covered under specific conditions. This would apply to such items as deductibles and limitations.
  • A summary of the policy's renewal and cancellation provisions.
  • A description of any credits or extra charges.
Although not required by law, many drivers buy other types of insurance coverage in addition to the mandatory PIP and property damage liability insurance. Common optional coverage purchased includes: collision, comprehensive, uninsured motorist, medical payment, towing, rental reimbursement, and accidental death and dismemberment.
 
Collision Insurance pays for repairs to your car if it collides with another vehicle, crashes into an object or turns over. It pays regardless of who causes the accident. Collision insurance does not cover injuries to people or damage to the property of others.
 
Comprehensive Insurance pays for losses from incidents other than a collision. Examples would be fire, theft, windstorm, vandalism, flood or hitting an animal. Damage caused by falling objects is also covered under this policy.
 
If you have comprehensive coverage, windshield replacement is the only claim for which you are not charged a deductible. Florida law requires this waiver to encourage drivers to immediately replace damaged windshields.
 
YOU MAY BE REQUIRED TO PURCHASE COMPREHENSIVE AND COLLISION INSURANCE IF YOUR CAR IS FINANCED. However, it is illegal for the lending institution to require you to purchase insurance from a particular company or agent.
 
Uninsured Motorist (UM) Insurance pays if you, your passengers or family members are hit by someone who is "at-fault" and does not have insurance, or has insufficient liability insurance to cover the total damages sustained by you. This applies whether you are riding in your car, someone else's car or are struck by a car as a pedestrian. UM Insurance also applies in a hit-and run situation, or in a “phantom” vehicle accident.
 
UM Insurance pays for medical expenses, lost wages (beyond your PIP coverage), bodily injury, sickness, disease or death resulting from a motor vehicle accident that you and your passengers suffer.
 
Medical Payment Insurance covers medical expenses beyond those covered by PIP which result from accidental injury. Medical payments insurance differs from bodily injury liability coverage in that it covers the medical expenses of you, members of your family, and your passengers regardless of who is "at-fault."
Medical Payment Insurance applies whether the injury occurs in your car, someone else's car, or on the street as a pedestrian. Note that health insurance also covers medical expenses from auto accidents beyond those covered by PIP.
 
Rental Reimbursement Coverage will permit you to be reimbursed for car rental if an accident leaves your car unable to be driven. If the other driver was "at-fault," that driver's liability insurance coverage may reimburse you for renting a vehicle similar to your own.
 
Rental cars companies often sell collision damage coverage which, although similar to insurance, is not insurance and does not fall under the regulatory authority of the Department of Insurance. If you have collision coverage or property damage liability, you may be covered for damage to rental cars driven by you, depending on the terms and conditions of your policy. You may also be automatically covered by your credit card company if you used the card to rent the vehicle. Check your policy before you rent a car and call your agent or credit card company if you have any doubts.
 
Accidental Death and Dismemberment Insurance provides coverage, up to the limits of the policy, for accidental death or dismemberment in an auto accident, regardless of who is "at-fault." It covers you and relatives who live in your home.
 
When you buy auto insurance:
 
1. Request a quote from several licensed insurance agents. Be sure to ask for the same coverage from each so your comparisons will be accurate. A quote is an estimate of your premium -- it is not a firm price or a contract, however, it is against the law for an agent to intentionally quote you a low premium just to get your business.
2. Be sure the information on your application is accurate. False or inaccurate information could cause the company to cancel your policy or refuse to pay a claim. Always get a copy of the signed application form.
3. Be sure to get a binder from the agent once you sign the application. A binder is your temporary proof of insurance until a formal policy is issued. It should show the name of the agent and insurance company, list your cars and the coverage you purchased, and be signed by the agent.
4. Always make checks or money orders payable to the insurance company -- never to the agent or the agency.
5. You should receive your policy no later than 60 days after the effective date. If you do not receive your policy, contact your agent.
6. Immediately report any changes affecting your policy to your agent. This would include address or name changes, the addition of a new driver or car, or any change in the use of your car.
7. Keep track of your policy renewal date. Policies are usually for a term of 6 or 12 months. Most companies will send you a bill at least 45 days in advance of your renewal and premium due date.
Property Damage Liability insurance is not required for motorcycle operators unless a driver is required to prove "financial responsibility" due to traffic violations or failure to pay for damages they caused in an accident. Neither PIP nor Medical Payments Insurance is required for a motorcyclist. Indeed, PIP is usually not sold to motorcyclists. However, in order to operate or ride on a motorcycle without headgear, you must have an insurance policy providing at least $10,000 in medical benefits for injuries incurred as a result of a crash.
 
If your child is a legal resident of Florida, attends college in another state, and uses a car registered in Florida, you must have PIP and property damage liability coverage on the car. The state where your child attends school may have other car insurance requirements.
 
Any person who has a car in Florida for more than 90 days during a 365-day period must purchase PIP and property damage liability insurance. The 90 days do not have to be consecutive.
 
If you have recently moved to Florida, it's best to immediately find an insurance agent who will assist you with auto insurance information. Check with your local Department of Highway Safety and Motor Vehicles Office for information on driver licensing and auto registration procedures on htttp://www.flhsmv.gov/offices/
 
.
AUTO SERVICE WARRANTIES. The warranties are only good only for a specified length of time and only ensure the repair or replacement of items defined in the contract. Service warranties are contracts that are regulated by the Insurance Department. Whether a service warranty is worth the money will depend on how the warranty suits your needs.
 
Finally, remember these consumer tips:
 
1- Read your policy. . . Be sure you understand your policy. If you have any questions, call your agent or the Department of Insurance toll-free at (800) 342-2762 (http://www.myfloridacfo.com/consumers/Guides/Auto/overview.htm ).
2- The choice of insurance company and agent is yours. . . You do not have to buy auto insurance from the dealer who sold you the car or the lending institution financing your car.
3- Your policy can be amended. . . You can add a new or additional car or driver to your existing policy.
4- The clock is ticking. . . If you think you have a claim, contact an attorney as soon as possible. If you wait too long, a statute of limitations may prevent you from pursuing a valid claim.
 
If you would like more information on automobile insurance requirements in the state of Florida, contact the Department of Highway Safety and Motor Vehicles Customer Service Center at (850) 617-2000.
 
If you believe you need legal advice, call an attorney. If you need help selecting an attorney, call The Florida Bar Lawyer Referral Service at (800) 342-8011, or the local lawyer referral service or legal aid office listed in the yellow pages of your telephone book.
 
 
Ft. Lauderdale County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Friday, August 12, 2011

Ft. Lauderdale Chiropractor Troy Lomasky Notes Florida Insurance Consumer Advocate to Convene Personal Injury Protection (PIP) Working Group; Members to Include Insurance Companies, Consumers, Medical Industry



The Florida Current reported on August 11, 2011, that Florida Insurance Consumer Advocate Robin Westcott will convene a working group to focus on problems with Florida's Personal Injury Protection (PIP/No-Fault) system.  Hyperlinks to last year's Consumer Advocate PIP Roundtable are below the article:

New insurance consumer advocate getting into battle over no-fault auto insurance
Christine Jordan Sexton, 8/11/2011

There are growing sings that the big insurance battle for the 2012 session may not be property insurance but the state's no-fault automobile insurance.

Florida's new insurance consumer advocate Robin Westcott is now jumping into the fray. Westcott on Thursday said she's creating a "working group" on personal injury protection (PIP) insurance.

Westcott said she wants to keep a new working group on personal injury protection relatively small and that it will include lawmakers, consumers and insurers and representatives from the medical industry, perhaps people who testified before the Legislature last year on the issue.

She said she hopes to have committee members announced “in the next week” and that the group would work through November to submit its recommendations to the Legislature, which meets in January.

While she acknowledged that it is a “pressing time frame” to finalize its recommendations by November, Westcott said, “many of the issues are framed for us.”

PIP is a no fault insurance system that provides $10,000 worth of medical coverage for automobile related injuries, regardless of who is at fault.There are growing concerns about fraud in the system, though.The Office of Insurance Regulation released the Report on Review of the 2011 Personal Injury Protection Data Call, which showed that costs in the PIP system are increasing and that PIP payouts have gone from about $1.5 billion in 2008 to approximately $2.5 billion in 2010. The OIR report also showed that Florida PIP claims involve approximately 100 medical treatments at an average total cost of $12,000 compared to the national average of about 50 treatments at an average total cost of $8,000.

The insurance industry-supported group the National Insurance Crime Bureau released a report earlier this year revealing the percentage of questionable PIP claims in Florida rose 34 percent from 2008 to 2010. The group also rated Miami,Tampa and Orlando among the top five cities in the nation for questionable claims.

The Legislature in 2011 considered changes to the PIP program but ultimately did not pass anything substantial. Sen. J.D. Alexander included in a budget conforming bill provisions that would have capped attorneys fees but was forced to remove it after criticism that the issue wasn’t vetted. Ultimately nothing passed.

But all signs are the issue will be revisited. Gov. Rick Scott has said that he is likely to come out with his own ideas about PIP and the Senate Banking and Insurance Committee is reviewing the PIP system in the interim between the 2011 and 2012 session.

Westcott said the time frame is ambitious but manageable. “There was so much debate (during the 2011 session) and so much said. We’re going to see where we are and see where we can go.”



Personal Injury Protection Roundtable
Part 1 | Part 2 | Part 3 |Part 4 | Part 5 | Part 6


Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.

Sunday, August 7, 2011

The psoas major: The most amazing muscle you've never heard of

Anterior Hip Muscles 2.PNG



By DANIELA VELÁZQUEZ | The Tampa Tribune
Published: August 6, 2011

It doesn't have thousands of songs devoted to it like the heart. And it doesn't have the epic story of love, war and country that goes with the Achilles' heel.

But even though you've likely never heard of it, your psoas major is one of the most important muscles in your body.

Usually called the psoas (pronounced "so-az"), this muscle and your body's main hip flexor run along your spine, from the diaphragm to pelvis, wrapping around your hip bones.

There's a good chance the pain you have in your lower back, hip and groin means there's something amiss with your psoas. It also could be responsible for a litany of other conditions, including poor circulation and digestive problems.

Every time you walk, run, bike or otherwise use your lower body, your psoas moves and guides the connection between your torso and your legs.

In addition to its key role in keeping you upright, the psoas is also the first muscle to recognize your primal fear and stress instincts, says somatic expert Liz Koch.

That causes the psoas muscle to stay contracted much of the time, pulling on other muscles and creating tension in other places of your body.

"You want a good fight or flight response, but you don't want to be on call 24/7," Koch says. "That's the reason (your body is) exhausted all the time."

The psoas is one of three muscles in the iliopsoas group and one of two muscles that connects your torso to your legs. The iliacus lines the bowl of the pelvis. These two muscles are constantly in a state of balance to keep you upright. (The third muscle — the psoas major — is considered a devolving muscle and is present in less than half of the population.)

Because of its proximity to the spine, the psoas is also deeply connected to all the parts of the nervous system, making it the main storehouse for all sorts of trauma, the emotional leftovers of our fight or flight response.

"The psoas is this crazy muscle that was not working when we were quadrupeds," says Brooklyn-based Jonathan FitzGordon, who teaches people how to walk with proper alignment.

"The psoas is a pulley; it is holding the spine up."

FitzGordon says he sees all sorts of issues related to the tenderest part of our bodies, literally the human filet mignon, including poor foot circulation, leg-length discrepancies and having one foot arch or shoulder higher than the other. And for all you desk dwellers out there, don't think your psoas gets a break; sitting in a chair keeps the psoas contracted, and thus tighter.

I didn't know anything about this muscle until a few years ago. I jumped and twisted to make an amazing catch in a game of Ultimate Frisbee; and somewhere between the Frisbee landing in my hand and my feet hitting the ground, I tweaked my back.

Within an hour, I couldn't stand up straight. I called in sick to work and got an appointment with a trusted massage therapist. She suggested releasing my psoas.

"So-az? Uhh, OK."

"Just breathe. It will hurt," she said, as she pushed down on my lower belly and pelvis.

I saw flashes of mustard yellow and grey as I tried to breathe more than wince. I felt nauseous. And then, I felt my back release without pain.

To address psoas-related issues we have to do the opposite of what we're used to: We have to relax.

"Everyone needs to stop," says FitzGordon. "If you don't relax, it never gets a break."

For information, visit FitzGordon's website at www.corewalking.com, or Koch's website, www.coreawareness.com, for free articles and videos about working with your psoas.

Saturday, August 6, 2011

Expectations of Chiropractic Treatment: Study says sound of "Snap, Crack and Pop" Doesn't Necessarily Mean You've Had a Good Chiropractic Adjustment

Patients often think that just because they hear a "pop" or cracking sound, that this means their chiropractic adjustment has been successful.  The study synopsis below indicates this isn't the case.
  • A study by Peter J. Miller and Alessandra S. Poggettia, Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth BH5 2DF, United Kingdom, published February 2011.

It has been demonstrated that the ‘audible release’ is not necessarily an indicator of a successful chiropractic adjustment. However, it seems widely believed that patients attribute a therapeutic value to the cracking noise. The objective of this study is to understand the patient opinion on the mechanism and perceived therapeutic value of joint cavitation, and associated audible release.

Design
A qualitative semi-structured interview study.

Setting
Interviews were carried out on a one to one basis at the Anglo-European College of Chiropractic (AECC).

SubjectsEight patients were recruited from the AECC clinic reception. Patients were invited to participate in the study if they had been suffering from a long-standing problem treated with manipulative chiropractic care and had attended the AECC clinic for a minimum of 4 months. Students from the AECC were excluded.

Methods
Signed informed consent was gained. Interviews were recorded and transcribed verbatim. The eight transcripts were then analysed through a process of thematic analysis.

Results
Patients perceived the audible release as resulting from bones being moved, or the sound to a release of gas bubbles from the joint space. Patients showed a divergence of opinion as to whether the audible release guaranteed a successful adjustment.

Conclusion
Patients do not need to have a deep understanding of the mechanisms for the sound they hear. The majority of the patients associate the crack with a physical feeling of release; therefore they assume that the sound is proof of a well-achieved adjustment. Nevertheless, patients do not discard the therapeutic benefit of an adjustment that did not achieve the audible release. This appears to be due to their past experiences and their trust in the chiropractor.

For more information, click here.




Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Broward Chiropractor Dr. Troy Lomasky Notes Florida Office of Insurance Regulation 2011 Personal Injury Protection (PIP) Data Report

PIP Reference Document: 
In 2011, the Florida OIR issued a report compiling data from Florida insurers writing personal auto line of business.  The report shows that the cost of  Personal Injury Protection (PIP/No-Fault) claims in Florida rose dramatically over the period beginning in 2006 and ending in 2010, with the last two years being especially bad. Combined loss ratios have gone from the mid 90% to more than 115%.  Frequency of PIP claims have climbed dramatically even though overall crashes reported by Highway Safety are down.  The report indicates that Tampa has become the new “staged crash” capital of Florida.

To access the report on the http://www.floir.com/ Web site, go to:  http://www.floir.com/siteDocuments/PIP_04-08-2011.pdf

Broward Chiropractor Troy Lomasky notes chiropractors treat horses at Kentucky Junior League Horse Show; Horse makes immediate recover from stomach ailment

Chiropractors treat horses at Junior League Horse ShowBy Cole Claybourn — cclaybourn@herald-leader.com

July 16, 2011

  
Two "miracle stories" helped shape her life, Anita Jackson said.

After dealing with a serious stomach ailment that traditional medicine couldn't cure, she saw a chiropractor. Within 15 minutes after an adjustment, she said, her symptoms were gone.

Shortly after that, when she was 19, she had a similar experience with her horse, which also had stomach problems. A veterinarian said that nothing could be done and that the horse would die soon.

"So I'm lying in the field with my horse, and the vet was explaining what was going on with my horse's stomach and intestines," Jackson said.

She realized, " 'If my chiropractor was able to help me with my stomach problems,' I thought, 'Why not?' " She hit the horse on the spine with all of her strength, and the horse was up and walking in less than 20 minutes.

Jackson said that moment changed her life.

"I knew somehow, some way, I would treat humans as well as animals," she said.

Jackson and her husband, Bruce, who run Jackson Chiropractic Wellness Center in Versailles, do exactly that. They were at the Lexington Junior League Horse Show at The Red Mile this week to provide chiropractic treatment to show horses, working on nearly 20.

They have been doing animal chiropractic since 1994 and have worked in the chiropractic field since 1986.

Bruce Jackson said it's actually much easier to adjust a four-legged animal than it is to adjust a human.

"Most people think it takes a lot of force to adjust a horse. It takes very little force," he said. "The reason it takes so much force for a human is because a human's upright, is tight." Anita Jackson explained that being on all fours results in less gravitational stress on the body.

A one-time adjustment for a horse usually costs $100 to $150, Anita Jackson said.

Some people wait until the last minute at horse shows to decide whether they want their horse worked on, but Anita Jackson said it "absolutely" can make a difference in how a horse performs.

She used one horse, Cosmic Charm, as an example. The horse was suffering from pain in the lower back; after chiropractic care, Cosmic Charm can be shown.

"And he's winning," she said.

Cosmic Charm's trainer, James Wallen, said that Cosmo, as the horse is affectionately known, was hurting "all the way around" and that Bruce Jackson's treatment resulted in "night and day improvements."

Cosmo "wasn't responding well to his training," Wallen said. "But after chiropractic, he was much more relaxed. He didn't look like he was walking on pins and needles."

Some horses can develop a "bad attitude," which means they can form an intolerance to treatment, Anita Jackson said. But a bad attitude can also result from an animal's pain.

"A woman brought her dog in and said, 'This dog is vicious. It might bite you,' " Jackson said. "The entire life of this dog, she has been more contrary than pleasant. This dog has probably been hurting its entire life, but two weeks later it's a different individual."

While the Jacksons treat humans and animals, Anita Jackson said hardly anything compares to when treatment helps an animal; signs of success might include a horse's licking its lips, or a soft meow from a cat.

"It's unbelievably rewarding," she said. "The satisfaction, gratification and appreciation that the patient has for fixing their problem — whether that's relieving pain or discomfort — it's priceless."



Read more: http://www.kentucky.com/2011/07/16/1813531/chiropractors-treat-horses-at.html#ixzz1UHH5wdYl





Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Broward Chiropractor Dr. Troy Lomasky of Coast Chiropractic in Wilton Manors Notes Aetna, American Speciality May Have Improperly Denied Chiropractic Claims in Connecticut

Note:  Coast Chiropractic of Wilton Manors (Broward County, Near Fort Lauderdale) takes all major insurance, including Aetna.

Aetna agrees to revisit Connecticut chiropractic claims
8/2/11
Reprinted from the Hartford Business Journal

Attorney General George Jepsen announced Tuesday that Hartford health insurer Aetna and American Specialty Health Networks Inc. have agreed to review and reprocess chiropractic benefit claims that may have been denied improperly under Connecticut law.

Aetna was responding to questions raised by Jepsen after several complaints were made by chiropractic providers on behalf of themselves and their patients.

The complaints were that Aetna's claims administration agreement with San Dieog-based American Specialty Health Network, which took effect July 1, did not include all the chiropractic services covered under state law.

Connecticut law requires health insurance plans to cover chiropractic care "to the same extent" coverage is provided for services rendered by a physician, Jepsen said.

"Aetna's prompt and fair response to this issue means providers will be paid for covered services and Aetna's enrollees will continue to receive the care to which they are entitled," Jepsen said. "Everyone benefits from this cooperation."

Chiropractors licensed in Connecticut are permitted to provide a wide range of services, including the use of X-ray and other diagnostic technology, the administration of foods and vitamins and preventative care. If health insurance plans cover those services when provided by physicians, they also must be covered when provided by chiropractors in Connecticut.

Jepsen said Aetna told his office that the claim system will be updated to include the procedure codes for qualifying services a chiropractor can provide in Connecticut. In addition, ASHN will review eligible claims submitted since July 1 and reprocess those denied incorrectly.



Aetna Apparently Dropped Chiropractic Coverage In July Against State Law, Attorney General Says Insurer Cites Inadvertent Coding Problem, Says It's Reprocessing Claims
August 2, 2011|By MATTHEW STURDEVANT, msturdevant@courant.com, The Hartford Courant

Aetna and American Specialty Health Network apparently dropped coverage for chiropractic services in July, but the insurer agreed to pay bills after chiropractors complained to the attorney general.

Aetna said the issue was an inadvertent coding problem and not a dispute over coverage of chiropractic care.

"We determined that a new national agreement with a chiropractic benefits vendor did not specify all of the procedure codes that chiropractors in Connecticut can perform within the scope of their license," said Aetna spokeswoman Cynthia Michener. "We are currently reviewing claims submitted within the past month to see if any were denied improperly. If so, we will reprocess those claims."

Connecticut law mandates that health insurers provide coverage for chiropractic care "to the same extent" coverage is provided for services rendered by a physician. State-licensed chiropractors can offer services a patient might also get from a physician, such as use of an X-ray and other diagnostic machine to determine medical problems. If those services are covered when provided by medical doctors, they must also be covered when provided by chiropractors in Connecticut.

Attorney General George Jepsen asked about Aetna's claims administration agreement with American Specialty Health Network, which apparently dropped coverage for chiropractic services starting July 1, against state law. The insurer has agreed to review and reprocess the claims that were improperly denied.

"Aetna's prompt and fair response to this issue means providers will be paid for covered services and Aetna's enrollees will continue to receive the care to which they are entitled," Jepsen said. "Everyone benefits from this cooperation."

Estimates were not available to detail how many patients and providers were affected by the dropped coverage or how much was unpaid in claims. Since July 1, American Specialty Health Network provided claims administration and other services for chiropractic benefits available through Aetna health plans, except for Aetna's Traditional Choice plan in Connecticut, according to Jepsen's office.




Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Florida's Motor Vehicle No-Fault Law (Personal Injury Protection or PIP statutes)

Florida's Motor Vehicle No-Fault Law (Personal Injury Protection or PIP statutes):  Click on a hyperlink below to go to a section:

627.730 Florida Motor Vehicle No-Fault Law.
627.731 Purpose
627.732 Definitions
627.733 Required security
627.734 Proof of security; security requirements; penalties.
627.736 Required personal injury protection benefits; exclusions; priority; claims.
627.737 Tort exemption; limitation on right to damages; punitive damages.
627.739 Personal injury protection; optional limitations; deductibles.
627.7401 Notification of insured’s rights.
627.7403 Mandatory joinder of derivative claim.
627.7405 Insurers’ right of reimbursement.
627.7407 Application of the Florida Motor Vehicle No-Fault Law.

Broward Chiropractor Troy Lomasky Notes Consumer Reports Review of the Benefits of Chiropractor Visits, Chiropractic Treatment, Massage; "It's magical," Says Florida Patient

Consumer Reports noted in this 2011 review of chiropractic and other alternative treatments, which said that in one in four respondents undergoing chiropractic treatment for any condition said their chiropractor was more interested and insightful than their medical doctors.


Alternative therapies
Last reviewed: September 2011



This article appeared in September 2011 Consumer Reports Magazine.



Complementary care: Carola Hamann of San Francisco likes to play hockey despite hips that ache from arthritis and other ailments. She says that combining yoga, chiropractic care, and conventional physical therapy has helped keep her on the ice. (Photograph by Frank Morgenstein)


Done anything alternative lately? If so, you have a lot of company. When we surveyed 45,601 Consumer Reports subscribers online, we found that three out of four were using some form of alternative therapy for their general health. More than 38 million adults make in excess of 300 million visits to acupuncturists, chiropractors, massage therapists, and other complementary and alternative practitioners each year in the United States.

Despite the hoopla over alternative therapies, when we asked respondents how well the therapies they used worked for 12 common health problems, results showed that they were usually deemed far less helpful than prescription medicine for most of the conditions.

Even widely used dietary supplements ranked far below over-the-counter medications in many cases. But hands-on treatments such as chiropractic and deep-tissue massage, as well as the mind-body practice of yoga dominated the lists of helpful alternative treatments for discomfort from conditions such as back pain, neck pain, and osteoarthritis.

Carola Hamann, 42, of San Francisco said she has found that yoga, combined with monthly chiropractic adjustments and some exercises her physical therapist recommended, has helped a lot to relieve pain in her hips from osteoarthritis and other concerns. She keeps her medical doctor informed about therapies she has tried but notes that her chiropractor "sees how everything's connected."

Of alternative treatments used for general health, mainstream vitamins and minerals were the most widely used, with 73 percent of respondents taking them. But 57 percent said they used dietary supplements other than vitamins or minerals. And about one in five reported using mind-body therapies such as yoga or hands-on therapies such as massage.

A total of 30,332 survey respondents gave us their perceptions of the helpfulness of treatments for their most bothersome conditions over the past two years. The respondents were Consumer Reports subscribers, and our findings might not be representative of the general population. Respondents based their opinions on personal experience, so the results can't be compared with scientific clinical trials. And our results do not take into account the power of the placebo effect, the tendency of people to find even simulated or sham interventions helpful.

Why these treatments?
For most conditions we asked about, the No. 1 reason respondents gave for choosing an alternative treatment was simply that they were "a proponent" of it.

"Some people use these therapies because it's just the way they were raised," says Richard Nahin, Ph.D., M.P.H., senior adviser for scientific coordination and outreach at the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Some say they have gone through a transformational process, such as a major illness that has caused them to look at their life in a different way, Nahin says. Others believe dietary supplements are safer than prescription medication because they're natural, even though that's not necessarily the case, he says.

And for some conditions, people choose alternative treatments to avoid the side effects of conventional medications. That was true for about two out of five respondents suffering from insomnia.


Adjustment



Michael Shannon of Ocala, Fla., gets treatment from chiropractor Dennis Seese, D.C., of Belleview, Fla.
Photograph by Steve Williams

When Michael Shannon, 63, of Ocala, Fla., reinjured his back in 2008 he immediately found the closest chiropractor. After the initial 90-minute session, he walked out feeling that it had helped a lot. "It was amazing," Shannon says. After four more chiropractic sessions of about 15 minutes each, along with occasional sessions of massage therapy, he was largely symptom-free. When he feels his back tightening up again, he schedules another adjustment. "It's magical," he says.

One in four respondents undergoing chiropractic treatment for any condition said their chiropractor was more interested and insightful than their medical doctors. More than 30 percent of respondents who had acupuncture felt the same way.

The role of doctors
Our survey found that the wall between conventional doctors and alternative medicine isn't as high as you might assume. Our readers said doctors were generally aware of their use of alternative therapies for their medical conditions.

For instance, 57 percent of people who got Shiatsu massage, usually for back or neck pain, said their doctors knew about it, and so did 81 percent of those who sought chiropractic care.

Sixty-five percent of those who practiced progressive relaxation said their medical caregivers knew about it, as did 68 percent of readers who meditated. A majority of those taking dietary supplements, vitamins, and minerals said their doctors were aware of it.

But doctors were selective in their endorsement of dietary supplements, our survey showed. They tended to point patients toward products with some clinical evidence behind them, such as fish oil for cardiovascular problems, and glucosamine and chondroitin for osteoarthritis.


Integrative healing:  Avis Brown of Morgan Hill, Calif., says that deep-tissue massage, meditation, and dietary changes have helped free her from the painful symptoms of fibromyalgia. (Photograph by Robert Houser)


"We have to be responsible captains of our own health ship," says Avis Brown, 65, of Morgan Hill, Calif., a reader who participated in our survey. "And doctors are our navigators." She said that she received a diagnosis of fibromyalgia about 18 years ago but that massage, meditation, and a sugar-free diet have helped her remain free of symptoms for more than 10 years.

In many cases, a substantial minority of respondents using a particular treatment said their doctors were the ones who had pointed them to it in the first place. Twenty-eight percent of readers who used deep-tissue massage, usually for back or neck pain, said their doctors had recommended it. So did 26 percent of people who used deep-breathing exercises and 21 percent who went to a chiropractor.

Though it's still a rarity, some doctors are adding alternative treatments to their own therapeutic tool kit. Brenda Bourassa, 65, of Winslow, Maine, gets regular acupuncture treatments for her neck pain from Rick Hobbs, M.D., a family physician in nearby Waterville. She says that she was skeptical at first but that the treatments have helped. "I believe that eventually it will eliminate the pain, not just relieve it on a temporary basis," she says.

Hobbs said he became interested in acupuncture in 2004. He now limits his practice mainly to acupuncture and integrative medicine and is president of the American Academy of Medical Acupuncture. "People still think of me as a family doctor as well as an acupuncturist," he says. "My patients stuck with me."



Copyright © 2004-2011 Consumers Union of U.S., Inc.

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida, near Ft. Lauderdale.  A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.

California Chiropractor Who Assisted in Helping Fraud Prosecutors Receives State Settlement For Board of Chiropractic Harrassment

California Governor Jerry Brown approves $600,000 settlement in chiropractor board firing

The former executive director of the state Board of Chiropractic Examiners alleged that she was harassed and fired for helping prosecutors investigate fraud in the industry.
By Patrick McGreevy, Los Angeles Times
July 27, 2011

Reporting from Sacramento -- The former executive director of the state Board of Chiropractic Examiners will receive $600,000 to settle a claim that she was harassed and fired for helping prosecutors investigate fraud in the industry.

Gov. Jerry Brown on Tuesday signed a bill authorizing the settlement, under which the state did not admit any wrongdoing.

Catherine Hayes' lawsuit alleged that board members tried to intimidate her into not cooperating with a 2006 probe by the San Joaquin County district attorney's office into whether several chiropractors had engaged in insurance fraud. Eventually, she said, they retaliated by firing her.

Hayes' allegations were an embarrassment to the administration of then-Gov. Arnold Schwarzenegger. Among those she accused of retaliation was Richard Tyler, the board chairman and a friend of Schwarzenegger who at one time served as his personal chiropractor. Also named in the suit was board member Francesco Columbu, a chiropractor and two-time Mr. Olympia bodybuilder — as well as the best man at the governor's wedding to Maria Shriver.

Hayes' lawsuit alleged that the former governor's friends ran the board with more interest in protecting the chiropractic profession than consumers.

"In light of all the facts, it was a just settlement," said Anthony Poidmore, an attorney for Hayes.

Board members have denied the allegations.

"We're very pleased that this was settled," Executive Officer Robert Puleo said Tuesday, "and we look forward to moving forward on the board's consumer protection mission."

The Legislature approved the Hayes settlement after board members voiced concern that a similar lawsuit had resulted in a big jury award.

In that case, former employee Carole Arbuckle was awarded $1.25 million in damages and $800,000 in legal fees after a jury found that the board's administrators in 2001 had retaliated against her for reporting that a board member had allowed a chiropractic license to lapse.

Brown signed 11 other bills Tuesday, including a measure banning the sale of animals on street corners in hopes of reducing the number of puppy mills in California. SB 917 by Sen. Ted Lieu (D-Torrance) also sets tougher penalties for those convicted of animal abuse or cruelty, allowing a maximum jail sentence of one year in cruelty cases and a fine of up to $20,000.

The governor also signed into law a measure that designates any building used for dog-fighting or cockfighting to be a public nuisance, which makes it easier to evict the tenant. SB 426 is by Sen. Ron Calderon (D-Montebello).

patrick.mcgreevy@latimes.com

Copyright © 2011, Los Angeles Times



Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.

Florida Department of Financial Services Personal Injury Protection (PIP) Newsletter: The PIP Source

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Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.

Florida Department of Health begins disciplinary review of 2 Daytona chiropractors after clinic raid

Patients have a tough job in finding the right chiropractor these days.  Coast Chiropractic of Wilton Manors applauds the State of Florida's crackdown on practitioners and clinics who contribute to our nation's prescription drug crisis.   Dr. Troy Lomasky does NOT issue prescriptions for pain medications. 

The following report was published by the Daytona Beach News-Journal (http://www.news-journalonline.com/):


Health Department begins disciplinary review of 2 Daytona chiropractors after clinic raid
By LYDA LONGA, Staff writer 
August 6, 2011

DAYTONA BEACH -- State health investigators will review the actions of two Daytona Beach chiropractors, whose clinic was raided by the FBI this week, to determine if they should be disciplined for violating state licensing standards, the state's surgeon general said Friday.

As the clinic reopened for business Friday, Florida Surgeon General Dr. Frank Farmer confirmed that father and son Joseph Wagner and John Wagner are the two licensed chiropractors mentioned by their initials in an order Thursday that suspended the medical license of West Palm Beach-based Dr. John P. Christensen.

According to state investigators, Joseph Wagner and John Wagner -- with Christensen's authorization -- prescribed pain pills and other drugs to patients at the Wagner Chiropractic & Acupuncture Clinic at 542 N. Ridgewood Ave. The prescriptions were issued in Christensen's name despite the fact that he never evaluated the patients, investigators said.

Joseph and John Wagner are the father and brother of County Councilman Joshua Wagner, respectively.

A review will "be done expeditiously" by state Department of Health investigators to determine if the two Wagners violated licensing standards for chiropractic medicine, said surgeon general Farmer of Ormond Beach. Chiropractic physicians are among a host of medical professionals licensed by the state, although they cannot prescribe medication.

The FBI, the Florida Department of Law Enforcement and Volusia Bureau of Investigation raided the Wagner clinic Thursday and seized patient records. It is one of three clinics in the state under investigation for insurance fraud and prescribing pain pills by a doctor who never saw the patients, state investigators said.

According to investigators, both Christensen and Joseph Wagner had been carrying out these activities in their Daytona Beach, West Palm Beach and Port St. Lucie clinics.

No one was arrested Thursday. The investigation is ongoing, said FDLE spokeswoman Heather Smith.

The Wagner clinic was open for business Friday morning. A female employee, dressed in a nursing uniform, said the doctor was only conducting "chiropractic business" on Friday.

Two patients were inside the clinic, and workmen were sweeping and working in a middle room of the clinic. Joseph Wagner asked a reporter to leave by pointing to the front door. Then in Spanish, he told the reporter that he would be happy to talk. But when the reporter responded in Spanish, he asked the reporter to leave, saying, "Be nice" in English.

Christensen and the two Wagners have been under investigation for the last three years, state investigators said.

The Department of Health, working with the lead investigating agency, FDLE, determined that Christensen had allowed Joseph Wagner and John Wagner to use the doctor's Drug Enforcement Agency prescribing privileges so the two chiropractors could prescribe medications to patients, according to state records.

Prescribed pills included Lortab painkillers, the anti-anxiety medication Xanax, and Soma, a muscle relaxant, the order shows.

State investigators also claim Christensen billed and received payment from insurance companies for "non-existent evaluations." An order from surgeon general Farmer states Christensen defrauded various insurance agencies by sending them fake invoices and medical records. The bogus records were placed in the files of six patients who never met or received treatment from Christensen, the order says.

Documents show the six patients, who are listed only by their initials in the state order, were seen by Joseph Wagner and John Wagner. Each time, the patients were prescribed Lortab, Xanax or Soma, or all three, according to the order.


Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.  He does NOT prescribe medication.