Governor George Pataki on August 5, 2003, signed into law A.978/S.316.b, legislation that requires chiropractors to acquire continuing education credit as a condition for licensure re-registration. This law goes into effect January 1, 2004. Many other professions in the state including dentists, podiatrists, pharmacists, attorneys and others already have a CE requirement in place. New York joins 47 other states that require chiropractic continuing education. What this means for doctors of chiropractic: + Each chiropractor licensed in New York, excepting those not engaged in chiropractic practice, is required to complete thirty-six (36) hours of acceptable formal continuing education credit per triennium. 6Twelve (12) of the 36 hours required may include self-instructional course work as approved by the Education Department (in consultation with the State Board for Chiropractic.) + Chiropractors must certify at each triennial registration that they have met the requirements of the law; must maintain adequate documentation of acceptable formal CE to support such certification and be able to provide such documentation to the Department upon request. + Doctors of Chiropractic may obtain all 36 of their approved CE credit all in one year within any triennial period or they can spread them out over the triennial period. - Credits for one triennial period, however, may not be carried over, credited or transferred to any subsequent triennium. + DC’s whose re-registration period expires before the first triennial period following enactment of this legislation will have their CE pro-rated a t a rate of one hour per month. A DC who has not satisfied the mandatory CE requirement will not be issued a triennial registration and may not practice chiropractic until a conditional registration is issued by the Department and the individual agrees to make up any deficiencies which the Department may require. 6 The Department cannot extend conditional registration beyond one year. +Chiropractors who are not engaged in the practice of chiropractic are exempt from the CE requirement. Nonetheless, they must file a statement with the SED declaring their exempt status. Continuing Education versus Continuing Competency Importantly, the legislation contains a provision that insures that the legislation cannot be used by the Education Department as a way to require or implement continuing competency testing or certification for chiropractors. The passage of CE legislation in recent years is partly an effort to staunch any effort on the part of the Education Department to require continuing competency testing as opposed to continuing education as a requirement for re-registration and re-licensure. NYSCA President Acknowledges Team Effort NYSCA President E. Daniel Quatro, DC, acknowledged the efforts of the New York Chiropractic College and its president Dr. Frank Nicchi in passing this important piece of legislation as well as the leadership effort of the New York Chiropractic Council, the NYSCA’s legislative coalition partner. Quatro also acknowledged others who stood behind the effort, including NYSCA’s legislative counsel, Don Mazzullo, Esq., and his team - Ric Scanlon, Mary Anne McCarthy, Esq. Amy Kellogg, Esq. Also acknowledged were NYSCA general counsel Ross Lanzafame, Esq. the Past Presidents of NYSCA Dr’s Leonard Venezia and Arthur Kojes, NYSCA Vice President Dr. Mariangela Penna and Dr. Lynn Pownall, NYSCA Board member. “With their steadfast leadership, help and assistance we were able to stave off the prospects of continuing competency in lieu of continuing education.” Quatro said.

As part of the Board’s ongoing effort to improve services, increase efficiency, and limit costs, a new centralized mailing address for all mail related to workers’ compensation claims has been established. This P.O. address is in close proximity to the Board’s mail scanning facility in Binghamton, NY. To help the Board improve our efficiency, effective September 8, 2003, all insurers, attorneys, licensed representatives and health care providers involved with claims being processed in New York City, Long Island, Westchester, Rockland, Putnam or Orange Counties must direct all claims related mail correspondence to the following centralized address. Failure to do so could result in unnecessary delays in processing of claims. New York State Workers’ Compensation Board PO Box 5205 Binghamton, NY 13902 All claim related mail for the remainder of the state should continue to be sent to the appropriate district office addresses. All non-claims related mail should be sent to the appropriate department or office.

Superintendent of Insurance Gregory V. Serio and State Health Commissioner Antonia C. Novello announced that thousands of New York State consumers are exercising their health insurance rights and are winning access to necessary care under the State's External Review Law, according to the latest External Review Report released today. "New Yorkers have been empowered by the External Review Law and are availing themselves of this important appeal mechanism when their essential health coverage is denied by the insurer," Serio said. "Since this Law became effective on July 1, 1999, more than 5,000 consumers have requested external appeals. With an average of 46% of external review cases overturned, this means that over 2,000 New Yorkers have access to health insurance care that would not otherwise have been made available to them. This year’s External Review Report illustrates that under Governor Pataki’s leadership consumers are educated on their health insurance rights and using this knowledge to ensure necessary coverage." "Thanks to Governor Pataki, New Yorkers enjoy the most comprehensive patient protections in America," State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H., said. "The success of the external review process demonstrates that patients in our State know their rights and are taking advantage of the opportunity for a prompt, independent and professional appeal when they believe an insurer has made an arbitrary decision. This Law better ensures that medical treatment decisions are made by doctors and their patients, and that New Yorkers receive the quality health care they need and deserve." The External Review Annual Report, released by the State Insurance and Health Departments, provides a comprehensive overview of New York's External Review Program and includes a description of external review results from the past year. The report also provides information about the external review programs of other states and compares the experience of other states to that of New York. Highlights from the report include: The Insurance Department has received 5,000 requests for external appeals, over 1,300 in 2002. Since July 1, 1999, 1,110 denials of coverage by health insurers have been overturned in whole, 267 denials have been overturned in part and an additional 722 denials have been voluntarily reversed by health plans before an external appeal agent rendered a determination. 183 expedited external appeal requests have been assigned to agents for review since July 1, 1999. An appeal must be expedited if the patient's physician attests that a delay in treatment would pose an imminent threat to the patient's health. Agents must render a decision on expedited appeals within three days. In 2002, 44% of medical necessity denials were overturned in whole or in part by external appeal agents while 50% of experimental or investigational treatment appeals were overturned. External appeal requests are submitted to the Insurance Department, which screens requests for eligibility and completeness and assigns the appeal to one of the state's three certified external review agents. The External Appeal Annual Report, applications to request an external appeal, and external appeal information are posted on the Insurance Department’s Web site at www.ins.state.ny.us. The Insurance Department’s external appeal hotline, 1-800-400-8882 assists New Yorkers in filing external appeal requests. The Insurance Department also has staff on-call seven days a week to handle expedited appeals.

Webster’s dictionary defines “communication” as a transmitting, a giving or exchanging of information, messages, etc. Doctors of Chiropractic have a variety of daily opportunities to communicate with patients and the public at large.

I write in response to your inquiry regarding the scope of practice for chiropractic assistants.

Section 6551 of Education Law defines the practice of chiropractic as

As regards the rendering of a chiropractic diagnosis or analysis, including differential diagnostic work-ups, New York State Education Law authorizes such activity within the lawful scope of chiropractic practice in New York State. The following excerpt of a 1994 response to an attorney addresses this matter:

I write in response to your inquiry regarding chiropractic manipulation under anesthesia.

I write in response to your inquiry regarding chiropractors in New York State using electromyography (EMG). This letter is based on past opinions of the Education Department that have been issued in response to various inquiries from members of the public.

I write regarding your inquiry about chiropractic use of Magnetic Resonance Imaging (MRI).

I write in response to your inquiry regarding chiropractors licensed in New York State providing nutritional service and products.

I write regarding your inquiry about the use of physiotherapeutic modalities by chiropractors licensed in New York State. This letter is based on past opinions of the Education Department that have been issued in response to various inquiries from members of the public.

Article 162, §8351 of the New York State Education Law authorizes the licensure of certified athletic trainers. A person so licensed is authorized to provide services “under the supervision of a physician and limits his or her practice to secondary schools, institutions of postsecondary education, professional athletic organizations, or a person who, under the supervision of a physician, carries out comparable functions on orthopedic athletic injuries, excluding spinal cord injuries, in a healthcare organization.”

Education Law, Article 132, section 6551(3), states that chiropractors licensed in this State may not "prescribe, administer, dispense or use in his practice drugs or medicines." Such durable medical equipment as cervical collars, cervical pillows, traction kits, support belts, whirlpool equipment, orthotic and other non-electrical devices are not "drugs or medicines." Consequently, such items may be purchased without prescription, and, thus, may be ordered or recommended by chiropractors for their patients within the definition of chiropractic practice in Article 132.

I write in response to your inquiry regarding lawful scope of chiropractic practice in New York State and if using x-ray on extra-spinal parts of the human body falls within that scope.

I write in response to your recent inquiry regarding whether or not chiropractors licensed in New York State are permitted to practice homeopathy.

I write in response to your recent inquiry regarding employment of chiropractors by physicians licensed in this state.

Section 6551 of Education Law defines the practice of chiropractic as "detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column."

Section 6551 of Education Law defines the practice of chiropractic as:

I write regarding your inquiry about chiropractic use of Magnetic Resonance Imaging (MRI) and CT scans of the brain in New York State.