If you are seeking chiropractic care in New York (NY), you can locate a New York chiropractor by visiting the New York State Chiropractic Association (NYSCA) web site at www.NYSCA.com were over 6000 New York (NY)chiropractors are listed by city, zip code or last name. To find an online Chiropractor follow these instructions. Go to NYSCA’s web site at www.NYSCA.com. Once on the Home Page select “Find a Doctor” button and then enter the City, zip code or last name. It is that simple. This search will allow the public to find a NY Chiropractor or a Chiropractic Office in a city near them. NYSCA is dedicated to maintaining the most up-to-date and accurate Chiropractor Directory of NY chiropractors and information on Chiropractic for the public.

Assemblyman Latimer, of the 91st District, a strong and outspoken proponent of Chiropractic attends NYSCA District 8 (Westchester) April 12 Meeting. The Assemblyman 91st District encompasses City of Rye, Town of Rye (Village of Port Chester, Rye Brook, and Mamaroneck), Town of Mamaroneck, Larchmont and part of New Rochelle. Assemblyman started his appearance before the NYSCA District 8 meeting with a comparison. "Political life is like being Elizabeth Taylor's seventh husband - you know what's expected of you but can you equal the performance?" District 8 President Dr. Janusz Richards stated that Assemblyman Latimer equaled the performance Wednesday night, with his most informative talk, giving all present very specific direction on how to best accomplish our legislative aims. "Get your story to the legislators - let them know what you do." Mr. Latimer distributed handouts of our insurance equality correction bill (A04527) and our workers compensation bill (A08340) both of which he is a co-sponsor. He has worked closely with us in the past. However, he admitted that Wednesday's meeting was a learning experience for him, i.e. NYS Business Council's history of opposition to chiropractic legislation and the reasons why. Although a freshman Assemblyman, who is running for re-election this November, he comes from a most accomplished background. Originally schooled and worked in the hotel industry he is married with one daughter. He is a former City of Rye Councilman, Past Chairman of the Westchester County Democratic Party, and Past Chairman of the Westchester County Board of Legislators. It was a most profitable evening for all those that attended. All came away with strong feelings of support for this true friend of the profession. Ms. Taylor would be proud of him!

On April 30, 2006, a group of DC’s represented NYSCA at the the New York State Democratic Committee’s Dinner held at the famous Waldorf Astoria Hotel. In attendance were Dr. H. William Wolfson, President NYSCA Suffolk Chapter and ACA NYS Metro Delegate. Dr. Louis Lupinacci, NYSCA Board member and ACA NYS Alternate Metro Delegate. Dr. Don Littlejohn, NYSCA Board member and co-chair NYSCA Legislative Task Force. Dr. Michael Bernstein, President NYSCA Nassau Chapter, NYSCA Board member and co-chair NYSCA Legislative Task Force. Dr. Peter Samsone, President NYSCA Manhattan Chapter, and Dr. Michael Minardo a NYSCA member. These doctors attended, on behalf of NYSCA, and made their presence known to the elected officials. The doctors were able to meet and speak with the many Democratic leaders in attendance. Senator Hillary Clinton, Attorney General Eliot Spitzer, Assembly Speaker Sheldon Silver, former NYS Governor Mario Cuomo, former HUD Andrew Cuomo and Comptroller Alan Hevisi, are just a few democratic leaders these doctors were able to thank for their support of our profession. These leaders were all aware of NYSCA’s presence and told our members of their appreciation for attending this exciting event.

Assemblyman Latimer, of the 91st District, a strong and outspoken proponent of Chiropractic attends NYSCA District 8 (Westchester) April 12 Meeting. The Assemblyman 91st District encompasses City of Rye, Town of Rye (Village of Port Chester, Rye Brook, and Mamaroneck), Town of Mamaroneck, Larchmont and part of New Rochelle. Assemblyman started his appearance before the NYSCA District 8 meeting with a comparison. "Political life is like being Elizabeth Taylor's seventh husband - you know what's expected of you but can you equal the performance?" District 8 President Dr. Janusz Richards stated that Assemblyman Latimer equaled the performance Wednesday night, with his most informative talk, giving all present very specific direction on how to best accomplish our legislative aims. "Get your story to the legislators - let them know what you do." Mr. Latimer distributed handouts of our insurance equality correction bill (A04527) and our workers compensation bill (A08340) both of which he is a co-sponsor. He has worked closely with us in the past. However, he admitted that Wednesday's meeting was a learning experience for him, i.e. NYS Business Council's history of opposition to chiropractic legislation and the reasons why. Although a freshman Assemblyman, who is running for re-election this November, he comes from a most accomplished background. Originally schooled and worked in the hotel industry he is married with one daughter. He is a former City of Rye Councilman, Past Chairman of the Westchester County Democratic Party, and Past Chairman of the Westchester County Board of Legislators. It was a most profitable evening for all those that attended. All came away with strong feelings of support for this true friend of the profession. Ms. Taylor would be proud of him!

On Friday, October 21, NYSCA Board member, Lynn Pownall, DC, DACBN presented a letter to the New York State Board for Chiropractic addressed to the State Board chair, Ali M. Jafari, DC on behalf of NYSCA President, Mariangela Penna, DC. The letter addressed a number of professional issues that have an impact on the State Education Department’s mission “[t]o protect the public by fostering high standards of professional . . . practice.” The Association stated that it “believes that public protection and patient safety are not being served by the current state of professional practice by any state agency, including the State Education Department, and such altruistic sentiments as contained in the SED mission statement and goals are not being met.” “Patient protection and the standards of practice for chiropractic and the other licensed professions generally, are within the purview of the State Education Department,” Dr. Penna noted, “but the professions are not only affected by the laws and regulations of the SED, but by all of laws and all of regulations of all of the state agencies combined. In view of the current state of professional practice, the NYSCA submits that SED’s attitude in view of its stated mission to ‘protect the public’ by ‘fostering high standards of professional . .. practice’ without looking at the totality of the laws and regulation that affect patient safety and professional practice is agency-centric -- more inclined to protect the status quo rather than being patient-centered/ public safety conscious or concerned about establishing ‘high standards of professional . . . practice.’ As laudable as they are, patient protection/public safety and standards of professional practice are missions and goals that cannot be met or compartmentalized solely the province of the SED without an examination of all areas of law and regulation of the state in their totality. The NYSCA submits that the SED, as well as the other state agencies, have surrendered important regulatory and standards setting responsibilities collectively to the whims of the market place.” The NYSCA letter noted that the utilization review practices of health plans, insurers, HMOs and MCOs, Individual Practice Associations (IPAs) and independent Utilization Review agents based on proprietary guidelines not open to public scrutiny amounted to a “defacto regulation of the profession” by self-interested, private enterprises – entities raking in record profits and whose only interest is their own financial bottom for the benefit of their shareholders and does not represent “quality” health care or “high standards of professional practice.” “Who is minding the fox?,” Penna asked. The NYSCA also charged that the termination practices by plans amounted to a constructive, albeit financial, delicensing of chiropractic professionals. “Health care is everyone’s responsibility – patient, provider, employer, insurer, government and governmental agency,” Penna noted. “Health care needs to be patient-centered, evidence-based, efficacious, efficient, cost-effective, patient-responsible and transparent for everyone’s benefit. Presently, this is not the case. But the State Boards can help, including the State Board for Chiropractic," Penna said. “The development of practice guidelines and standards and written review criteria are within the ambit of the regulatory functions of a disinterested State Education Department charged with establishing and maintaining “high standards of professional . . . practice” for the public’s protection, and that the promulgation of these guidelines and standards, Penna stated, should be developed and disseminated in concert with all interested parties.” Dr. Penna’s statement was joined by a statement expressing similar sentiments by the American Chiropractic Association (ACA) given by ACA downstate delegates, H. William Wolfson, DC who is also the NYSCA District 7 President (Suffolk County).

Tarrytown, NY - “The NYS Board of Chiropractic and the Education Department are committed to the protection of the public and to the highest standards of professional services.” Cynthia Laks, Executive Secretary State Board of Chiropractic April 2004. On October 21, 2005, Dr H. William Wolfson, ACA NYS Metro Delegate addressed the Board regarding the abuses managed care companies have been perpetrating on the public and chiropractors in New York State. The American Chiropractic Association, the countries largest chiropractic organization has been taking managed care companies to task. The ACA has received numerous complaints from D.C.’s here and around the country about the abuses of managed care companies. The following is the text Dr. Wolfson read to the NYS Board. PRESENTATION TO THE NYSBC Mr. Chairman, Ms. Executive Secretary and Ladies and Gentleman of the Board, my name is Dr. H. William Wolfson. I have been a practicing doctor of chiropractic for the past 23 years and currently serve as the New York Metropolitan Delegate for the American Chiropractic Association. I am also President of the New York State Chiropractic Association, Suffolk County Chapter. I thank you for your time today and the opportunity to present what I believe are serious issues facing patients of chiropractors in New York State. Doctors of chiropractic in this state and doctors of chiropractic everywhere have an ethical obligation to practice in the best interest of their patients. I also realize this Board takes its responsibility to protect patients in this state very seriously. Permit me then to draw your attention to the activities of the ACN Group and other managed care companies. I request that this Board act and question the practices of this and other companies, as they directly affect patient care in this state. Over the course of the past several months, I have received repeated complaints and concerns from ACA and NYSCA members to the effect that ACN policies and procedures severely impact the doctors ability to provide quality patient care. I present to you the following: a letter of September 6, 2005 from the American Chiropractic Association to the New York State Department of Health outlining in specific terms the concerns and problems reported to the ACA in connection with ACN’s policies and practices. I would direct your specific attention to a copy of an August 3, 2005 letter sent to ACA’s General Counsel from the New York Chiropractic College. The College reviewed the criteria utilized by ACN in its administration of chiropractic services in New York. The startling conclusion of the College stated in part that “If NYCC were to use the ACN material above as a cornerstone for our educational process, we would need to significantly alter our curriculum, protocols, and practices and would expect to see a significant decline in positive patient outcomes”. Also included in ACA’s correspondence is a very detailed statistical analysis prepared by Dr. Jeffrey Simonoff-a professor of statistics at New York University. Dr. Simonoff, in commenting on his analysis, stated: “the [ACN] summary statistics certainly suggest that such [cost and visit-limiting controls] could be affecting practice by [in effect] truncating the number of visits from above.” In our opinion, Dr. Simonoff’s analysis supports the view that chiropractic services are artificially being reduced by ACN’s statistical maneuvering. Consequently, chiropractic benefits that have otherwise been promoted and paid for by employers-are being denied to the detriment of patient health and well being. I have personally spoken with case managers from ACN regarding patient treatment parameters and was told the average was less than seven visits per patient per year. It appears ACN has shifted the bell curve over time, consistently terminating those providers who don’t fall within their arbitrary statistics. As noted, my members have complained to the ACA, NYSCA and to my office stating that ACN has prevented patients from receiving needed chiropractic care by placing arbitrary numbers on allowed visits. My members have told me that they have written the same exact information on the required ACN forms for different patients and have received totally different authorizations for allowable visits. In my opinion and in the opinion of the ACA, utilization and treatment parameters as well as other criteria utilized by ACN are arbitrary, not based on the chiropractic principles taught by New York Chiropractic College and are not consistent with commonly accepted standards of care practiced in this State. Therefore, in our view, such parameters and criteria pose an improper interference with the doctor patient relationship and restrict necessary patient care. I would also like to submit for your consideration a letter of September 29, 2005 from the Federation of Chiropractic Licensing Boards to all Federation member boards. I would imagine that this Board may have already received this communication. But with your indulgence, I would like to make reference to several statements contained in the letter. In its letter, Dr. N. Edwin Weathersby writes on behalf of a unanimous Board of Directors, that managed care organization utilization criteria or payment policies “which interfere (or attempt to interfere) in a doctor’s ethical obligation to use sound chiropractic case management in the treatment of his or her patient, or otherwise seek to limit or to restrict the provision of needed chiropractic services, may constitute an inappropriate interference in the doctor patient relationship and pose a threat to safe, quality patient care.” The FCLB letter goes on to cite the previously mentioned conclusion of New York Chiropractic College and states: “If MCO guidelines require and/or restrict doctors to incorporate standards of care which are below those which are accepted in the profession and taught in our chiropractic colleges, then corrective actions should be undertaken”. Ladies and Gentleman of the Board and fellow colleagues, I would respectfully implore you to take that recommendation under consideration and continue to insure that the publics right to chiropractic care remains unimpeded. I urge the Board to assist the appropriate state regulatory authorities in protecting the publics right to access chiropractic care. I thank you for your time and thank you for continuing to protect the rights and best interests of chiropractic patients in the great State of New York.

The New York State Chiropractic Association is proud to announce the May 2005 election results. The individuals below are elected to the following office: PRESIDENT Dr. Mariangela Penna VICE PRESIDENT Dr. Bruce A. Silber SECRETARY Dr. Robert Brown TREASURER Dr. Richard J. Tesoriero DIRECTOR Dr. Robert J. DeSantis, Jr.* Dr. Malcolm Levitin Dr. Louis Lupinacci* Dr. David B. Kartzman Dr. Lloyd Kupferman (* serving for a 2nd term) The new officers and Directors will assume their elected office on June 1, 2005. NYSCA thanks all the candidates that participated in this year’s election and congratulates our new Officers and Directors. In this election, nearly 450 ballots were cast representing one of our highest voter “Turn-Out” ever.

"Perseverance is the hard work you do after you get tired of doing the hard work you already did". -Newt Gingrich On May 3rd a historic course of events took place when over 100 doctors of chiropractic "Marched on Albany" to make our voices heard and that of our patients'. We met one on one with individual legislators and explained why they needed to support NYSCA/NYCC Joint Legislative Task Force's Technical Corrections Bill and other relief legislation. The DC's who attended were well briefed and prepared to answer the questions asked by these legislators. Afterwards, we all met for an informal gathering to wind down and socialize with each other. The day was a huge success and time will tell if out efforts were worthwhile. We will discuss the day's event at our meeting. In addition, the delegates report will be given on what transpired at the House meeting May 14-15, 2005. No matter what the outcome, all of us need to decide what our purpose is--in practice, in life, family… More than ever before we need to come together as chiropractors and fight this battle and win…once and for all. It will take hard work, commitment-both financial and time, but the ultimate victory will benefit all of us and our patients. We are unique, we are different and we are here to stay!

On April 28, 2005 the New York Chiropractic Legislative Task Force met with Attorney General Eliot Spitzer and the chief of the AG's Health Bureau, Mr. Joseph Baker regarding our issues with insurance inequality. Officers of both, the New York State Chiropractic Association and the New York Chiropractic Council as well as NYSCA attorney Ross Lanzafame, Esq. and NYSCA legislative counsel Don Mazzullo, Esq. and the NYCC legislative counsel, Andy Roffé, Esq. represented the Task Force. The meeting gave the Task Force the opportunity to discuss the non-compliance with the insurance equality law and the abuses put forth by the carriers and their IPA/Utilization Review agents. Mr. Spitzer and Mr. Baker understood our issues and recognize the areas where they might be of assistance in intervening with the Insurance Department. The Task Force will be in continuing communication with the Attorney General’s office with regard to these issues and there will be future meetings with the Health Care Bureau and the Attorney General’s aides to resolve these issues.

The New York State Chiropractic Association proudly presents the 2nd program for Achieving Excellence in Chiropractic Practice In the 21st Century Certificate Program Saturday, April 9, 1 PM to 7:00 PM at the New York Chiropractic College Postgraduate Center Levittown, NY. Call the NYCC Postgraduate Center at 800-434-3955 Today and Reserve Your Please. This is the second in a series of symposiums designed to enhance your professional skills so you can master both the challenges of today’s managed care arena and tomorrows changing healthcare delivery system. The total series is 36 C.E. credit hours. There are 6 symposiums with a certificate included upon completion. Each symposium is 6 C.E. credits. The second Program will be broken down into a Six Hour session and will feature: • Comparison Shopping: Cost of Chiropractic Care vs. Medical Treatment, Dr. Anthony Rosner, Director of Research at the FCER, PhD. Harvard • Distinguishing Fact from Fiction in Clinical Studies, Dr. Anthony Rosner • Medicare P.A.R.T. Documentation: the National Standard, Dr. Peter Pramberger, NY Chiropractic Advisory Committee (CAC) representative (1 CA will be able to attend for an additional $25 for this discussion) The Fee for this sensational program is $120.00 per session for NYSCA members. For non-NYSCA members- $150.00 per session SEATING IS LIMITED, SO RESERVE YOUR SEAT TODAY! For Reservations, Please call the NYCC Postgraduate Center at 800-434-3955 Committee Members: Chairman: Louis Lupinacci, D.C., Mariangela Penna, D.C., Thomas Ventimiglia, D.C., James Kaufman, D.C., John Pellegrino, D.C., Angelo Ippolito, D.C., Janusz Richards, D.C., Michael Siciliano, D.C., Malcomb Levitin, D.C., Michael Bernstein, D.C., Lloyd Angel, D.C., Richard Scherer, D.C., Richard Meoli, D.C.., Peter Pramberger, D.C., Lloyd Kupferman, D.C., Bruce Silber, D.C. What is the Center for Excellence? The Center of Excellence for Chiropractic Practice in the Downstate region is a program sponsored by the New York State Chiropractic Association. The purpose of the program is to advance the clinical knowledge and skills of the doctor of chiropractic on a quest toward best practice procedures. The program emphasizes patient centered care that is effective and efficient. The program is designed for progressive doctors who wish to develop their skills and promote themselves in an integrated healthcare model. The Center for Excellence is the result of the New York State Chiropractic Association long range planning toward integrating the practice of chiropractic into the mainstream of healthcare The New York State Chiropractic Association has presented a series of conferences on the integration of chiropractic practice into mainstream health care over the last several years. We have discussed the challenges that face our profession today and in the future, and some possible solutions to these challenges. In light of the changes coming up on the horizon of health care, it is apparent that the need for change and new initiatives are more important than ever. Here is a brief list of some of the challenges we face: 1. The healthcare industry is demanding that the healthcare that is delivered be evidenced based 2. The trend toward consumer driven health care will shift more responsibility to the patient 3. There is a need for chiropractors to be part an integral part of the patient’s healthcare team 4. There is a need to define and establish a model for “best practice” chiropractic care Goals of the Center for Excellence 1. Integrate chiropractic into the mainstream of health care 2. Develop the skills of the field practitioner to work in interdisciplinary teams as the practitioner of choice in providing patient centered health care that is effective for neuromusculoskeletal care of spinal conditions (injuries, disorders, diseases, illnesses, ailments or complaints) 3. Train doctors to utilize evidence based practice parameters and best practices procedures by employing quality improvement outcome measures and informatics 4. Help develop models for the role of chiropractic care in mainstream healthcare such as the “Bridges for Excellence” program or the “Leap Frog Program” 5. Increase public awareness and the healthcare industry awareness of the role of chiropractic in today’s health care system and for the future 6. Help develop Wellness care protocols for the Doctor of Chiropractic Proposed Center for Excellence Action: The committee has come up with 5 specific projects that we feel the downstate area can develop. Project Planning Strategies: I. Initiate educational Center for Excellence Conferences throughout New York State Set up a series of conferences to keep doctors informed of current healthcare trends II. Develop a chiropractic model for integration with mainstream healthcare including: Develop protocols for working as a part of an integrated healthcare team Develop protocols for standards of patient centered care III. Develop a Low Back Pain Model for programs such as the Bridges to Excellence Help to establish professional interdisciplinary teams with the doctor of chiropractic as the doctor of choice for conservative care of the low back Help to promote NCQA accrediting protocols and AHRQ protocols for chiropractic IV. Initiate a Research in Practice Clearing Center for the practitioner Collect actuarial studies on the effectiveness of chiropractic care Collect existing research information for the public information committee Collect data and consensus documents for reasonable and customary chiropractic care Collect data and consensus documents on standards of chiropractic care and treatment V. Public Information Program: Promote the web based public service program to disseminate to the media Develop protocols to establish chiropractors as spinal experts Develop protocols to establish chiropractors as health/wellness experts Develop a Speakers Bureau to work with media public services Develop NYSCA public policy resolutions The Center for Excellence Program will help you determine what an integrated practice may look like, and how to improve your practice procedures to become patient centered, more efficient and evidence influence. Chiropractic has a significant role in the health care arena, and our potential for growth is tremendous. The Center of Excellence will challenge our profession to establish cultural authority within the healthcare system. Chiropractic care should be a part of a mainstream healthcare interdisciplinary health team, with the doctor of chiropractic being the doctor of choice in providing conservative patient centered care that is most effective for neuromusculoskeletal spinal conditions.

Dr. Frank R. Cartica 05/10/1954 - 02/26/2005 It is with great sadness that we acknowledge the passing of NYSCA’s former member Dr. Frank R Cartica, D.C. of Yonkers, New York on Saturday February 26, 2005. He is survived by his wife Lois, and children Matthew, Jonathan, Genevieve, Jeremy Cartica and his mother Mary Cartica and brother of Kevin, Keith, James, John and Marybeth Muir. I am sure we will all agree that Dr. Cartica has done much for the Chiropractic profession and will be deeply missed. We ask that you keep his wife, children and family in your thoughts and prayers. Memorial Mass will be celebrated Thursday 11:00 AM at the Annunciation Church, 470 Westchester Avenue, Tuckahoe (Crestwood), NY 10707 - Tel. 914-779-4145. In lieu of flowers, memorial donations may be made to New York Fire Fighters Burn Center Foundation, 21 Asch Loop, Bronx, NY 10475.

NYSCA invites you, your family and friends to the GRAND OPENING of our BRAND NEW NYSCA Mall on the web were you can enjoy savings at nearly 800 quality on-line merchants while supporting the New York State Chiropractic Association! Nothing to join, no personal information to provide and if you have an existing account with any of the merchants, you can use that account — there is no need to re-register. It really is that simple. For each purchase you make at a participating merchant, a percentage goes to NYSCA. THIS HOLIDAY SEASON your online shopping can translate into dollars for NYSCA. Now you can shop online at Target, Omaha Steaks, Macy's, Expedia, Dell and nearly 800 other quality merchants. Your purchases in the NYSCA mall will generate income to the New York State Chiropractic Association which will be used to keep the membership dues low. To start your on-line shopping to ensure your purchases are properly credited to the NYSCA, Go to NYSCA Mall locate your desired merchant in the directory shop and save! That's it! Just the satisfaction of saving time and money while supporting us! It really is that simple. START YOUR HOLIDAYS SHOPPING TODAY Thank You and Happy Shopping!

ASHINGTON, D.C.—The brief respite from faster-growing health care costs sputtered in the first half of 2004 as health costs per privately insured American grew 7.5 percent—virtually the same rate as in 2003, according to a study released jointly today by the Center for Studying Health System Change (HSC) and the Employee Benefit Research Institute (EBRI). Health care spending growth slowed in both 2002 and 2003—after peaking at 10 percent in 2001—but outpaced growth in the U.S. economy by a considerable margin. That trend continued in the first half of 2004 with health care costs still growing at a faster rate (7.5%) than the unusually high 5.9 percent increase in per capita gross domestic product (GDP) during the same period. "Health care costs are likely to continue growing faster than workers' income for the foreseeable future, leading to more uninsured Americans and raising the stakes for policy makers to initiate cost-containment policies or accept the current trend of rapidly growing health costs and shrinking health coverage," said Paul B. Ginsburg, Ph.D., coauthor of the study and president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation. Research has shown that if health care costs rise at a significantly faster rate than incomes, more people become uninsured. In fact, the gap between trends in health care costs and incomes is the most important factor behind the long-term trend toward a smaller proportion of Americans with private insurance. "Even though health care cost increases have moderated compared to recent years, as long as they are increasing faster than wages and overall inflation, both public- and private-sector employers will continue to try to control those costs," said Dallas Salisbury, CEO of the Employee Benefit Research Institute, which underwrote the study. "That includes examining ways to shift costs to workers, and probably a movement toward account-based health plans." The study analyzes per capita spending on health care services—inpatient and outpatient hospital care, physician services and prescription drugs—commonly covered by private insurance. Per capita health care spending trends—also often referred to as cost trends—are important because they largely determine future health insurance premium trends. The study's findings are published jointly as an HSC Issue Brief and EBRI Notes titled Tracking Health Care Costs: Spending Growth Slowdown Stalls in First Half of 2004. The study is available online on both HSC’s and EBRI’s Web site. Growth in spending on hospital inpatient care slowed to 5.1 percent in the first half of 2004, down from 6.4 percent in the second half of 2003. While spending on outpatient hospital care held steady at 11.4 percent, outpatient care, nonetheless, remained the fastest growing category of health spending. Hospital utilization—inpatient and outpatient combined—continued to grow at a slow rate (0.8%) for the second year in a row, but hospital prices rose sharply—7.7 percent in the first half of 2004—and accounted for much of the hospital spending increase. The large jump in hospital prices is due in part to strong growth in wage rates for hospital workers, which have been driven up by a persistent worker shortage, particularly for nurses. Nonetheless, the most recent increase in hospital wage rates—4.5 percent in the first half of 2004—was considerably smaller than recent hospital price increases and has declined significantly from the peak wage rate increase of 6.3 percent in the second half of 2001. "Additional factors appear to be driving up hospital prices," said Bradley C. Strunk, an HSC health researcher and study coauthor. "One possibility is a sharp decline since 2001 in hospital Medicare margins—a situation that creates a strong incentive for hospitals to shift costs to private payers." The slowdown in hospital utilization growth may reflect an increase in health plans' utilization management activities as they selectively reinstate such tools as prior authorization requirements for some hospital services. The slow utilization growth in 2004 also may reflect continuing increases in patient cost sharing for hospital care. While prescription drugs receive much of the blame for rising health care costs, the reality is that the spending trend for prescription drugs has slowed markedly from the high growth rates in the late 1990s. During the first half of 2004, spending on prescription drugs per privately insured person grew 8.8 percent, slightly lower than the 9.6 percent increase in the second half of 2003. By comparison, spending on prescription drugs peaked at 19.5 percent in the second half of 1999—a time when drug spending accounted for a much larger share of the overall spending increase. During the first half of 2004, drug prices increased by 3.1 percent, largely unchanged from the 2.7 percent increase in the second half of 2003. The trend for prescription drug utilization also held steady, with drug utilization per person increasing 5.5 percent in the first half of 2004. By comparison, drug utilization grew by as much as 12.9 percent in the late 1990s. During the first half of 2004, spending on physician care grew by 5.7 percent—only slightly higher than the 5.4 percent increase in the second half of 2003. Roughly equal growth in price and utilization accounted for the increase. The price trend for physician care has not increased much in recent years—in stark contrast to the hospital price trend. ### ### The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation's changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc. *** *** Established in 1978, the Employee Benefit Research Institute (EBRI) is the only nonprofit, nonpartisan organization committed exclusively to data dissemination, policy research, and education on economic security and employee benefits. The Institute's mission is to advance the public's, the media's and policy makers' knowledge and understanding of employee benefits and their importance to our nation's economy. FURTHER INFORMATION, CONTACT: Alwyn Cassil, HSC: (202) 264-3484 Steve Blakely, EBRI: (202) 775-6341

Abstract With health care costs, and insurance premiums in particular, escalating rapidly, we may see the reintroduction of utilization management strategies associated with managed care, which seemed destined for oblivion only a short time ago. Results from a survey to assess Americans’ views of managed care cost containment strategies indicate mixed support: Despite an overall lack of confidence in managed care, Americans appear to be receptive to specific managed care practices. Those designing cost containment strategies must find a balance between imposing restrictions that moderate use and hold down costs and allowing consumers to retain some control over their own health care. Health Affairs, 10.1377/hlthaff.w4.516 Copyright © 2004 by Project HOPE Claudia Schur is a principal research scientist at NORC at the University of Chicago in Bethesda, Maryland. Marc Berk is vice president and senior fellow at NORC at the University of Chicago in Bethesda, Maryland. Jill Yegian is director of the Health Insurance Program at the California HealthCare Foundation in Oakland.

Eight NYSCA members have been selected by the New York State Department of Health to serve on the Department’s Medical Record Access Review Committee. Five members were selected to serve on a Downstate Committee and three (3) members were assigned to an Upstate Committee. The Committee members chosen by the Department are the following: ▪ Downstate Committee Members • Gary L. Haber, DC of Manhattan • Lloyd Kupferman, DC of Greenvale • Malcolm L. Levitin, DC, FACC of Rockville Centre • Donald Littlejohn, DC, of Chester and • Richard W. Scher, DC of Wantagh. ▪ Upstate Committee Members • Brian D. Justice, DC, DABCO of Rochester • Lynn B. Pownall, DC, DACNB of Jamestown, and • Richard J. Tesoriero, DC, DABCO of Oswego. The members of these committee will be convened by the Department when required to resolve disputed between chiropractic professionals and persons qualified to receive medical records. "Qualified person" pursuant to New York Public Health Law, Article I, Title II, § 18 Access to patient information, (1) Definitions means “any properly identified subject, or a guardian appointed pursuant to article eighty-one of the mental hygiene law, or a parent of an infant, or a guardian of an infant appointed pursuant to article seventeen of the surrogate’s court procedure act or other legally appointed guardian of an infant who may be entitled to request access to a clinical record pursuant to paragraph (c) of subdivision two of this section, or an attorney representing or acting on behalf of the subject or the subject’s estate.” Under Subsection (4) Medical record access review committees, the law provides, "The commissioner shall appoint medical record access review committees to hear appeals of the denial of access to patient information as provided in paragraph (e) of subdivision three of this section. Members of such committees shall be appointed by the commissioner from a list of nominees submitted by statewide associations of providers in the particular licensed profession involved; . . . . Such medical record access review committees shall consist of no less than three nor more than five licensed professionals. The commissioner shall promulgate rules and regulations necessary to effectuate the provisions of this subdivision." Under subsection (3) of the Public Health Law, providers may limit a qualified persons access to patient information for certain itemized reasons. The Committee members above will assist the Department resolve disputes between DCs and qualified persons requesting access to patients records.

The New York State Chiropractic Association's Fall Conference at the Fort William Henry Resort in Lake George, New York was a resounding success! The conference convened Friday afternoon, October 1 through mid-day Sunday, October 3 and offered doctors a Practice Enhancement Program (PEP) and roughly 33 credits of continuing education from a list of outstanding speakers, including a class on the HIPAA Security Rule, the next evolution in the HIPAA compliance series (enforcement of the Security Rule begins April 20, 2005). Saturday evening ended with an awards dinner cruise and social sponsored by McCarthy, Chechanover & Rosado, LLP Law Firm, aboard the Adirondac, a new cruise ship on scenic Lake George. The NYSCA extends is sincere appreciation to McCarthy, Chechanover & Rosado, LLP and the many other vendors who helped make the conference such a success including: OUM Chiropractor Program, American Specialty Health Networks, Harvey Professional Supply, Tri-State Diagnostics, Meditek, Inc., PMR Products, New York Chiropractic College, Islandia MRI/East Manhattan Diagnostic, Dale Professional Supply, Jack S. Beige & Associates, LLP, Scheine, Furey & Associates, LLP, NCMIC Chiropractic Solutions, McCarthy, Chechanover & Rosado, PRI Physicians’ Reciprocal Insurers, Bee Sure Distributors, Open MRI of DeWitt, D’Youville College, HUM Division of MLMIC, Harlan Health Products, and Empire Medicare Services. The next NYSCA convocation is scheduled for January 28, 29 and 30, 2005 at the fabulous Mohegan Sun Casino and Resort in Uncasville, Connecticut. We look forward to seeing you there! As the April 20, 2005 enforcement deadline approaches, doctors should start taking the necessary steps now to come into compliance with the HIPAA Security Rule. Plan on attending the January Mohegan Sun Conference now!

Dr. Dan Quatro, New York State Chiropractic Association (NYSCA) president wins a decisive victory in Tuesdays Republican Primary for the Monroe County 15th Legislative District. Quatro’s opponent was Webster Town Councilman James Carlevatti garnished 258 to Quatro’s 578 votes. “I never expected to win the primary by such a large margin, but we had the right message,” said Quatro. Dr. Quatro was appointed to the 15th District seat in July after the death of County Legislator Ray Santirocco. There is no time to sit back for County Legislator Dan Quatro and enjoy his victory as the November Election is less then two months away. His Democratic opponent in the November Election is Dolly Kujawa. Quatro will also run on the Independent and Conservative lines on the November ballot.

It is with great sadness that we acknowledge the passing of former NYSCA’s District 8 member Dr. Kenneth A. Falber who died on Wednesday, May 19, 2004. He was honored by the United States Military and his family at a private funeral. He served his country in the infantry during World War II and was decorated with three purple hearts and a silver cross. Dr. Falber practiced as a chiropractor and a hypnotherapist for 40 years at his Yonkers residence. He is survived by his loving and devoted wife, Roslyn, his children, grandchildren and great grandchild. He will be missed by the countless people whose lives he touched.