The NYSCA is pleased to share with you the news that the Association’s hard work has been rewarded. Bill A8402 has been passed both the Assembly and the Senate. It now awaits Governor David Paterson’s signature for final approval. Included in this omnibus piece of legislation was the language of NYSCA’s retrospective audit bill.

ABSTRACT Background: Red yeast rice is an herbal supplement that decreases low-density lipoprotein (LDL) cholesterol level. Objective: To evaluate the effectiveness and tolerability of red yeast rice and therapeutic lifestyle change to treat dyslipidemia in patients who cannot tolerate statin therapy. Design: Randomized, controlled trial. Setting: Community-based cardiology practice. Patients: 62 patients with dyslipidemia and history of discontinuation of statin therapy due to myalgias. Intervention: Patients were assigned by random allocation software to receive red yeast rice, 1800 mg (31 patients), or placebo (31 patients) twice daily for 24 weeks. All patients were concomitantly enrolled in a 12-week therapeutic lifestyle change program. Measurements: Primary outcome was LDL cholesterol level, measured at baseline, week 12, and week 24. Secondary outcomes included total cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, liver enzyme, and creatinine phosphokinase (CPK) levels; weight; and Brief Pain Inventory score. Results: In the red yeast rice group, LDL cholesterol decreased by 1.11 mmol/L (43 mg/dL) from baseline at week 12 and by 0.90 mmol/L (35 mg/dL) at week 24. In the placebo group, LDL cholesterol decreased by 0.28 mmol/L (11 mg/dL) at week 12 and by 0.39 mmol/L (15 mg/dL) at week 24. Low-density lipoprotein cholesterol level was significantly lower in the red yeast rice group than in the placebo group at both weeks 12 (P < 0.001) and 24 (P = 0.011). Significant treatment effects were also observed for total cholesterol level at weeks 12 (P < 0.001) and 24 (P = 0.016). Levels of HDL cholesterol, triglyceride, liver enzyme, or CPK; weight loss; and pain severity scores did not significantly differ between groups at either week 12 or week 24. Limitation: The study was small, was single-site, was of short duration, and focused on laboratory measures. Conclusion: Red yeast rice and therapeutic lifestyle change decrease LDL cholesterol level without increasing CPK or pain levels and may be a treatment option for dyslipidemic patients who cannot tolerate statin therapy. Annals of Internal Medicine 16 June 2009 Volume 150 Issue 12 Pages 830-839

Abstract Background: Reduced intake of micronutrients during pregnancy exposes women to nutritional deficiencies and may affect fetal growth. We conducted a systematic review to examine the efficacy of prenatal supplementation with multimicronutrients on pregnancy outcomes. Methods: We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for relevant articles published in English up to December 2008. We also searched the bibliographies of selected articles as well as clinical trial registries. The primary outcome was low birth weight; secondary outcomes were preterm birth, small-for-gestational-age infants, birth weight and gestational age. Results: We observed a significant reduction in the risk of low birth weight among infants born to women who received multimicronutrients during pregnancy compared with placebo (relative risk [RR] 0.81, 95% confidence interval [CI] 0.73–0.91) or iron–folic acid supplementation (RR 0.83, 95% CI 0.74–0.93). Birth weight was significantly higher among infants whose mothers were in the multimicronutrient group than among those whose mothers received iron–folic acid supplementation (weighted mean difference 54 g, 95% CI 36 g–72 g). There was no significant differences in the risk of preterm birth or small-for-gestational-age infants between the 3 study groups. Interpretation: Prenatal multimicronutrient supplementation was associated with a significantly reduced risk of low birth weight and with improved birth weight when compared with iron–folic acid supplementation. There was no significant effect of multimicronutrient supplementation on the risk of preterm birth or small-for-gestational-age infants. CMAJ • June 9, 2009; 180 (12). doi:10.1503/cmaj.081777.

New York State Education Law, section 6551(1) defines the practice of chiropractic as:

The American Chiropractic Association (ACA) obtained on June 5 a draft bill designed by Sen. Edward M. Kennedy (D-Mass.), chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP). This opening salvo is the first of many pieces of health care reform legislation that will be debated in the coming months within the U.S. Senate and House of Representatives. The ACA Board of Governors discussed the draft June 6 during a previously scheduled meeting. The ACA government relations department is carefully reviewing the bill. According to ACA’s government relations staff, the bill, titled the “American Health Choices Act,” would direct individuals and businesses to obtain health care insurance. The draft contains language creating a federally-sponsored “public plan” that would compete with private insurers. The public plan aspect of the legislation is troublesome to Republicans, many of which have declared that a public plan would wipe out current private insurance; however, the public plan option recently gained approval by the Obama administration. Other major provisions in the draft bill include: -----Providers and hospitals that serve patients under the new public plan would be paid 10 percent above current Medicare rates. -----Premiums will cover most of the costs associated with the public plan. -----New insurance exchanges called “Gateways” would be created to enable individuals to shop for insurance, similar to how consumers shop for air fares on Internet travel sites. -----Federal subsidies for mid- to low-income families to purchase insurance. The bill does not include specific language regarding physician status or services that would be available under the public plan. Instead, a new “Medical Advisory Council” would decide a schedule of services considered “essential health care benefits.” Each year, the council would issue new recommendations, which would take effect automatically unless rejected by Congress. The HELP Committee is scheduled to address the bill the week of June 15. The other Senate committee of jurisdiction, Finance, is looking to address health care reform sometime later in June. The House of Representatives is planning to address health care reform throughout the summer and pass a bill before the August recess. ACA urges all doctors of chiropractic to continue to contact their legislators in Washington and demand that chiropractic interests are protected in any health care reform plan developed on Capitol Hill. Doctors of chiropractic and state associations are also strongly encouraged to enlist their patients and other chiropractic supporters in the ChiroVoice advocacy network. ACA will continue to issue updates on pertinent reform activities as they become available. Stay informed throughout the national health care reform debate via:

According to a newly released patient survey by a leading consumer group, chiropractic is the top rated treatment for back pain. Of the 14,000 survey respondents who suffered from back pain in the past year, 58 percent rated chiropractic/spinal manipulation as helping a lot. When asked how satisfied they were with practitioners, 59 percent of respondents said they were “highly satisfied” with the back pain treatment received from their doctors of chiropractic whereas only 34 percent said the same about their primary care physicians. Most survey respondents had, on average, tried five or six different treatments for their back pain. Click on the link below to watch a report from CBS News:

The New York State Chiropractic Association asks members to support the ACA chiropractic advocacy network, ChiroVoice.org (ChiroVoice). Through this chiropractic advocacy network, patients and chiropractic supporters can stay informed about important health care issues and contact their legislators in Washington. Chiropractic supporters will be able to educate policymakers about the value of chiropractic and work to positively impact any legislative efforts to reform the current national health care system. ChiroVoice will also enable the NYSCA to mobilize patient support at the state level for legislative action when necessary. Ask your patients to sign up now! (Please be sure to adhere to all HIPAA regulations if signing patients up in your office.) The time is now for ChiroVoice! The opportunity to challenge some of the long standing issues beleaguering our profession. Prevention... Wellness... Fee Parity....Anti Discrimination Statutes, Full Scope Medicare, etc. These are just a few of our issues to be debated in DC. Historically, when given the chance to compete on a level playing field our profession shines. Along the same lines, historically the way we get there is through grass roots activities. The ACA has iniated ChiroVoice. Yet, many docs have not asked patients and staff to sign up. Please take time today to get your patients and staff involved. The Senate is marking up legislation this week and the House in a few weeks. President Obama wants a bill on his desk by the fall if not sooner. We can shape our future. It is said "Inaction has as significant of an impact as action," please don't let inaction cause us to fail. It's up to all of us to get involved, be involved, stay involved and be triumphant...we all benefit! Thanks for your help! Louis Lupinacci, DC, FICC NYSCA Vice President H. William Wolfson, DC, FICC NYS Downstate Delegate

Greeley, Colo.—On May 7, two directors of the National Board of Chiropractic Examiners (NBCE), were honored by the Federation of Chiropractic Licensing Boards (FCLB) who bestowed upon them the 2009 George R. Arvidson Award for Meritorious Service. This award is the highest individual honor presented annually at the FCLB annual meeting. NBCE President Dr. Vernon R. Temple was honored by the FCLB for his exceptional leadership, innovation and service to chiropractic. Dr. Temple was first elected to serve the National Board as District III director in the year 2000. Since then, Dr. Temple has also served on the NBCE Executive Committee as secretary and vice president. He was elected as president of the board in 2007 and will continue in that role until May 2010. Dr. Temple is a graduate of Palmer College of Chiropractic in Davenport, Iowa, and has been in practice in Vermont since 1978. He is a diplomate of the American Board of Chiropractic Orthopedists. He is a former chairman of the Federation of Chiropractic Licensing Boards and has also served as president of the Vermont Board of Chiropractic Examination and Regulation. NBCE Director Dr. Oliver R. Smith, Jr., and outgoing president of the FCLB received an Arvidson Award for his work in financially stabilizing the FCLB and strengthening the organization’s focus. Dr. Smith previously served as president, vice president, treasurer, and District IV director of the FCLB. He served as and NBCE director from 2005-2009 and was elected as director-at-large on the NBCE board in May 2009. He is a past president of the Texas Board of Chiropractic Examiners and received the Keeler Plaque Award in 1997 as an outstanding chiropractic practitioner in Texas. Dr. Smith is a graduate of Texas Chiropractic College. Headquartered in Greeley, Colo., the NBCE is the international testing organization for the chiropractic profession. Established in 1963, the NBCE develops, administers and scores legally defensible, standardized written and practical examinations for candidates seeking chiropractic licensure throughout the United States and in many foreign countries.

BLOOMINGTON, Minn. – The College of Chiropractic at Northwestern Health Sciences University awarded 72 students with doctor of chiropractic degrees during a commencement ceremony on April 17, 2009. The auditorium was filled with students, family members and friends attending the graduation ceremony. Graduates hailed from 13 different states, two Canadian provinces, and one other foreign country. Bachelor of science degrees were also awarded to 22 of the new graduates. The commencement address was delivered by Mary Jo Kreitzer, PhD, RN, FAAN, founder and director of the Center for Spirituality & Healing, University of Minnesota. Anthony Lawther, a Northwestern student and valedictorian from the graduating class, delivered the student greeting. The presidential greeting was presented by Mark Zeigler, DC, president of Northwestern. Northwestern Health Sciences University offers a wide array of choices in natural health care education including chiropractic, Oriental medicine, acupuncture, therapeutic massage and human biology. The University has nearly 900 students on a 25-acre campus in Bloomington, Minnesota.

SENECA FALLS – New York Chiropractic College president Frank J. Nicchi, DC, MS, was recently elected president of the Association of Chiropractic Colleges, (ACC) a consortium of some nineteen chiropractic colleges located in the United States, Canada and New Zealand. According to David O’Bryon, JD, the association’s executive director since 1996, the organization assists its member institutions by providing leadership in chiropractic education, research and service. Nicchi’s election took place during the 2009 Association of Chiropractic Colleges-Research Agenda Conference (ACC-RAC) held in Las Vegas on March 12th. Nicchi has been a member of the ACC Board of Directors since September, 2000 and was previously the organization’s vice president, treasurer and chair of the institutional statistics committee. “I am honored to be the president of the ACC,” Nicchi said. “It’s a vital organization that advances scholarly activity within the chiropractic academic community and promotes high standards throughout the profession.” Dr. Nicchi also serves on the Board of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) as the ACC representative. This year’s conference also saw the election of Fabrizio Mancini, DC, president of Parker College of Chiropractic in Dallas, as vice president and Richard G. Brassard, DC, president of Texas Chiropractic College in Pasadena, TX, as secretary/treasurer. The fourth member of the executive committee is ACC past-president Carl Cleveland III, DC, of Cleveland Chiropractic Colleges–Kansas City and Los Angeles.

GREELEY, Colo.—On May 8, the National Board of Chiropractic Examiners (NBCE) held its Annual Board Meeting in conjunction with the Federation of Chiropractic Licensing Boards’ (FCLB) 83rd Annual Educational Conference in Hollywood, CA. At the meeting, NBCE delegates elected Dr. Paul N. Morin (ME) as District III Director, replacing Dr. Mary-Ellen Rada (NJ). The delegates re-elected Dr. Norman E. Ouzts, Jr. (SC) as District V Director. Dr. Robin R. Lecy (SD), District I Director; Dr. Donna L. Craft (MI), District II Director; and Dr. Theodore J. Scott (UT), District IV Director will continue their terms. NBCE Directors-at-Large Dr. Vernon Temple (VT), and Dr. N. Edwin Weathersby (AZ) were re-elected to their at-large positions. Dr. Oliver Smith was elected as a new at-large director and NBCE Director-at-Large Dr. Richard L. Cole (TN) will continue his term. The two remaining positions on the 11-member NBCE Board of Directors are filled by the president and vice-president of the Federation of Chiropractic Licensing Boards: Dr. Daniel Saint-Germain (Quebec, Canada) and Dr. Lawrence O’Connor (NJ), respectively, were appointed to serve on the NBCE Board of Directors. The Executive Committee was then elected by the board. Dr. Vernon Temple was re-elected as President, Dr. N. Edwin Weathersby as Vice President and Dr. Theodore Scott as Treasurer. Dr. Richard L. Cole was elected to the Executive Committee as Secretary. Headquartered in Greeley, Colo., the NBCE is the international testing organization for the chiropractic profession. Established in 1963, the NBCE develops, administers and scores legally defensible, standardized written and practical examinations for candidates seeking chiropractic licensure throughout the United States and in many foreign countries.

Members should be aware; the FTC has developed Red Flag Rules which require “creditors” – including health care providers -- to conduct a risk assessment to determine if they have accounts at risk for identity theft. These rules went into effect in November, 2008 with an implementation date of May 1, 2009. The AMA disputed the FTC’s inclusion of health care providers as creditors, but the FTC determined that health care providers do fall within the ambit of the rules. According to the Equal Credit Opportunity Act, a “creditor” is “any person who regularly extends, renews or continues credit.” “Credit” is defined as a “deferment of payment for goods or services rendered.” For health care providers, this means every time you submit a health insurance claim to an insurance carrier first, and then bill the patient for co-payments or deductibles after services are rendered you are deferring payment and thus are acting as a “creditor.” Medical identity theft occurs when an individual seeks care using the name or insurance information of another person. This can result if false billing and potentially life-threatening corruption of a patient’s medical records. The bottom line comes in assessing risk in your practice of possible identity theft. The FTC requires that office practice’s have written policies in place – an “Identity Theft Prevention Program” -- and a plan to “prevent and mitigate” the effects of identity theft. If you have a small practice in which all your patients are known to you or your staff, you are at lesser risk and may only need an initial copy of a state issued photo ID that is checked at each visit to ensure that the patient is who he/she says she is. There is greater risk in a large multi-doctor office or facility. It would also be required to have a procedure in place in the event that you are notified by a state or local agency that the consumer’s identity has been misused. In order to assist the membership with implementation of the Red Flag Rules, the NYSCA has put together a “Model Identity Theft Prevention Program” for members. In addition to all the information and contacts you would need in case of identity theft, this includes a “turn key” manual that only requires you to fill in your office information. They do require you to have a meeting to explain the new procedures to your staff. Everything else is done for you. Many groups are selling packages for $100 or more; as a member benefit, the Red Flag Rules package can be downloaded from the NYSCA website free-of-charge. Download your copy, fill in the information and be in-compliance by the May 1, 2009 deadline. Membership has its privileges. Sincerely, Mariangela Penna, DC President, New York State Chiropractic Association GO TO MEMBERS ONLY TO VIEW THE “Model Identity Theft Prevention Program” by clicking on the link below:

Red Flags Rule Enforcement Delayed Three Months Due to Congressional pressure supported by ACA, the Federal Trade Commission announced today it will delay enforcement of the new "Red Flags Rule" until August 1, 2009. This will give creditors and financial institutions more time to develop and implement written identity theft prevention programs. ACA will continue to monitor this important policy and support members in compliance. More information on the Red Flags Rule

The Virginia Chiropractic Association (VCA) and the Virginia Society of Chiropractic (VSC) announced their intent to unite into a single entity and the formation of a Unification Committee. The unification will create a single, more influential association in the Commonwealth of Virginia that will better serve chiropractic doctors, patients, and the profession as a whole. The goal is to reduce duplication, allowing the profession to devote more resources and expertise to public policy, education, legal and legislative initiatives. Over the past several years, the organizations have begun collaborating more and more frequently, assisting each other in legislative activities and conducting joint educational programs. Both presidents accepted honorary memberships in the other organizations and face-to-face meetings and conference calls between the two Boards and staff became regular occurrences. The Unification Committee is charged with fleshing out the myriad of organizational, operational, and legal details and considerations involved in bringing the two groups together. In addition, it will outline a plan to provide a framework for the rules that will govern the organizations during the consolidation period, thereby ensuring a smooth transition.

Seneca Falls: Saturday, April 4, New York Chiropractic College held commencement exercises in the campus Athletic Center and conferred degrees upon 44 candidates in its Doctor of Chiropractic program. The commencement address was delivered by Carl S. Cleveland III, DC, who has served as president of Cleveland Chiropractic College since 1981 and is a noted author, educator and international lecturer. A fourth generation chiropractor, Dr. Cleveland is the grandson of the college’s founders, Dr. Carl S. Cleveland, Sr. and Dr. Ruth R. Cleveland and he has served as president for the Association of Chiropractic Colleges and for the Council on Chiropractic Education. Valedictorian, Robert James Sedlor addressed his classmates and Catherine Elizabeth McArdle was salutatorian. During the ceremony, the eighth annual convocation of the American College of Chiropractors recommended the following to be enlisted as Fellows: Carl S. Cleveland, III, DC; NYCC Board of Trustees member George M. McCllenad, DC; NYCC faculty member Vincent F. Loia, DC (NYCC 1981); and Ms. Laurie Reynolds, Executive Assistant to the President of NYCC and Executive Secretary to the NYCC Board of Trustees. For further information about New York Chiropractic College’s degree programs please visit

The May 2009 issue of Consumer Reports Magazine reports the results of its recent survey of more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. About 80 percent of U.S. adults have at some point been bothered by back pain. The Consumer Reports Health Ratings Center recently surveyed more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. More than half-said pain severely limited their daily routine for a week or longer and 88 percent said it recurred through the year. Many said the pain interfered with sleep, sex, and efforts to maintain a healthy weigh… This article is the archived version of a report that appeared in May 2009 Consumer Reports Magazine. Read the entire Consumer Reports Magazine report by clicking on the link below: Consumer Reports Magazine Reports on Aching Backs

Doctors beware: There are many rumors within the chiropractic profession about Medicare policies. ---Did you know that you still have to bill Medicare if you are a non-participating (non-par) physician? ---You still have to follow Medicare documentation requirements if you are non-par? ---You are still subject to reviews if you are non-par? There is no visit cap for chiropractic in Medicare? Read the MLN matters article by clicking on the link below:

WASHINGTON, D.C. —During a conference call today with reporters, Senator John D. (Jay) Rockefeller IV (D-W.Va.), Chairman of the Senate Finance Subcommittee on Health Care, and Congressman Joe Courtney (D-Conn.), Member of the House Education and Labor Committee, announced the introduction of the Pre-existing Condition Patient Protection Act that would end insurance discrimination against those who live with pre-existing or chronic illness. “We have 133 million Americans living with chronic illness – insurance companies should no longer be allowed to reap profits by denying care to sick Americans,” said Senator Rockefeller. “We as a nation can no longer stand by and continue to allow this practice to occur. These medical services are not optional, and most times, they are not affordable without insurance. Our system is broken—which is why we must eliminate the ability of insurers to deny coverage for pre-existing conditions in every single market. The time for serious action is now.” “It is wrong and impractical to commit ourselves to health care reform without addressing the faulty and ill-advised pre-existing condition exclusion,” stated Congressman Courtney. “This discriminatory practice prevents millions of hardworking Americans from changing or finding new jobs and in this economy that is just plain wrong. Senator Rockefeller and I agree that it is time for the most advanced nation in the world to have a world-class health care system that is fair and affordable.” Background The Pre-existing Condition Patient Protection Act will eliminate pre-existing condition exclusions in all insurance markets, a major step forward for the 133 million Americans living with at least one chronic condition. Eliminating pre-existing condition exclusions is a priority of the Obama Administration and Senator Rockefeller and Congressman Courtney plan to work closely with President Obama to enact this vital legislation. Insurance market reform must be a central part of comprehensive health reform. Both Senator Rockefeller and Congressman Courtney believe that all individuals should have access to comprehensive, meaningful, and affordable health insurance coverage—and this legislation is a critical component of achieving that goal. Summary of the legislation ****The Pre-existing Condition Patient Protection Act is a bill to protect consumers excluded from receiving health insurance coverage due to a “pre-existing condition.” ****The Pre-existing Condition Patient Protection Act would require the Secretary of Health and Human Services to submit a report to Congress on the extent of adverse selection (i.e. which happens when less healthy people disproportionately enroll in a risk pool) that occurs because insurers can no longer exclude patients with pre-existing conditions. This report must include data from private insurers on the characteristics of their insured population. This new reporting requirement would provide transparency on the true mix of patients and patient claims experience among private insurers; and ****Require the Government Accountability Office to submit a report to Congress addressing the impact of this legislation on reducing the number of uninsured and underinsured, as well as its effect on the affordability of health insurance coverage. This is meant to highlight both the positive impact this new policy will have on making coverage more accessible for individuals with chronic conditions, but also recognize that without further regulatory changes, coverage may not be affordable for these individuals. ****The Pre-existing Condition Patient Protection Act of 2009 has been endorsed by twenty-two organizations, including: American Autoimmune Related Diseases Association; American Heart Association/American Stroke Association; Association of Black Cardiologists, Inc.; Association of Community Cancer Centers; Breast Cancer Network of Strength; Children’s Cause for Cancer Advocacy; Congenital Heart; Information Network; Dermatology Nurses’ Association; First Focus; International Myeloma Foundation; Lung Cancer Alliance; Lupus Foundation of America; Mended Little Hearts; National Association of Pediatric Nurse Practitioners; National Patient Advocate Foundation; Oncology Nursing Society; Ovarian Cancer National Alliance; Pediatric Stroke Network, Inc.; Sarcoma Foundation of America; Sudden Cardiac Arrest Association; The Leukemia & Lymphoma Society; and The Wellness Community.

Federal Trade Commission (FTC) regulations stating that financial institutions and creditors are required to develop and execute written identity theft prevention programs otherwise known as the “Red Flags Rules,” are slated to go into effect May 1, 2009. Until recently, there was much ambiguity regarding the regulations and questions were raised as to whether physician offices fell under the FTC red flags guidelines. In February, the FTC issued a statement clarifying that Identity Theft Red Flag Rules do indeed apply to physicians including doctors of chiropractic. Read the FTC statement by clicking on the link below: