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.

I write in response to your inquiry regarding discounted fees for patients who pay cash for professional services.

I write in response to your inquiry regarding chiropractic care of peripheral injuries. A formal Department opinion on that subject was issued in an August 31, 1999 letter from Frank Muñoz, Executive Coordinator for Professional Responsibility. The relevant portion of that opinion is reprinted below: