SECTION 1.  Nominations of any qualified doctor of chiropractic (qualified being defined under Article V, Section 2.) shall be submitted to the existing officers of the A.C.S not later than July 1, of each election year.  All nominations must be submitted in writing by the nominator with the approval of the nominee.               

SECTION 2. QUALIFIED DEFINED:                           

• ITEM A. The nominee must be a member in good standing of the A.C.S.  
  
• ITEM B. The nominee must have practiced within the State of Alaska for at least one year.  The exception is at the time of charter.
• ITEM C. It must be evident to other members that the nominee contemplates continued residence throughout his term of office. 
• ITEM D. The nominee must have maintained a high level of professionalism.                           
• ITEM E. The nominee must consider time involved to fulfill the responsibilities of the position.
• ITEM F: The nominee for secretary must have a basic working knowledge  of the mechanics of correspondence.       
• ITEM G: The treasurer must have a familiarity with mathematics and bookkeeping procedures.
• ITEM H: The new elected officials shall meet individually and as a group for a time sufficient to insure a smooth transition of duties.

In fact, under the new law, CMS says that providers are required to refund patients “if the [patient] has inadvertently received out-of-network care due to inaccurate provider directory information.” In other words, providers will be limited to the discounted in-network reimbursement amount if they have not taken the required steps to make sure they are no longer listed in the in-network directory.  Additionally, insurers can remove a provider from their directory if the provider does not supply updated information.

As with the Good Faith Estimate law, this portion of the No Surprises Act DOES apply to chiropractic physicians. In fact, CMS states, “The No Surprises Act provider directory requirements apply to health care providers and health care facilities. The statute doesn’t exempt any categories of providers or facilities from this requirement. [emphasis added]”

It is important to note that the directory change requirements will apply to ALL insurers and insurance networks.

In short, if you are or have ever been in-network with any insurer, we are urging our chiropractic physicians to update their directory information with each of those insurers.

According to HHS:

“At a minimum, providers and health care facilities must submit provider directory information to a plan or issuer:

• When the provider or health care facility begins a network agreement with a plan or issuer with respect to certain coverage;
• When the provider or health care facility terminates a network agreement with a plan or issuer with respect to certain coverage;
• When there are material changes to the content of provider directory information of the provider or health care facility;
• At any other time (including upon the request of plan or issuer) determined appropriate by
• the provider, health care facility, or the Secretary of Health and Human Services (HHS).”

FOLLOW THE REQUIREMENTS AND SHIFT FINANCIAL RESPONSIBILITY TO INSURERS
It is very important to note that CMS clearly indicates that “under the No Surprises Act, the [provider] is permitted to require in the terms of a contract or contract termination that a plan or issuer remove the provider’s name from the directory at the time of termination of contract. Additionally, the [provider] is contractually permitted to require that the plan or issuer bear financial responsibility for providing inaccurate network status information to an enrollee. [emphasis added]” This means that you can require that the insurer cover the patient cost differences when you provide the appropriate information and the insurer does not make the updates.

The ACS strongly recommends that you follow the requirements of each of your networks (most importantly, many require the changes to be made online except in the most limited circumstances). When it is NOT possible to file the update online or follow their other requirements for one reason or another, providers should send updates via US Mail with return receipt requested along with a clear explanation why the provider could not file the change online or meet the insurers’ other requirements. 

PREMERA BLUE CROSS BLUE SHIELD OF ALASKA ANNOUNCEMENT

Premera Blue Cross Blue Shield of Alaska issued a notice in November, 2021.  Premera is required to verify the accuracy of your provider information in their directory at least every 90 days. They will ask to verify your data—name, address, specialty, telephone number, and digital contact—through attestations and change submissions every 90 days.

If your provider data can’t be verified 180 days after the last verification date, they will remove you in their online provider directory. Once the data is verified, you’ll be added back into the directory. All directory changes will occur within 2 business days of submittal.

The November notice indicated how they were  streamlining the verification process and moving to the BetterDoctor online portal from Quest Analytics.  Offices should have received more information from Quest Analytics/BetterDoctor in late 2021.  Verification through BetterDoctor began end of 2021. If you haven’t received information from Quest Analytics/BetterDoctor and you’d like to update your provider directory information now, you can email Premera BCBS of AK a completed provider update form (.pdf)

Spam Emails
You’ve all probably gotten spam email, whether it’s supposedly from a friend or close business associate begging for help, or from the proverbial “Nigerian Prince” who is promising you millions of dollars if you’ll forward him your banking numbers. But as spam becomes more and more sophisticated, it can be harder to spot, making cybersecurity a real concern for chiropractic practices across the state.

Some of our members have reported receiving emails from a doctor in ACS leadership, asking for help. One variation a few years ago had our then-President stuck in Puerto Rico with no money and no way out – except with help from the recipient. One common scam asks the email recipient to send $25 iTunes gift cards, or $50 pre-paid Visa cards.

And, these scam emails aren’t just annoying – they can be downright dangerous, as the sender tries to bypass your firewall and gain a foothold inside your practice by infecting a computer with spyware, ransomware, or other scheme that puts your security at risk, and in violation of HIPAA.

Spotting Potential Spam Emails

• Phishing emails and text messages often look like they’re from a person or organization you know and trust, but the email is not from their usual address.
• If the sender’s address has a bunch of numbers or a domain you don’t recognize (the part after the “@”), it’s probably spam.
• The language or grammar is “off” and full of spelling errors.
• The formatting or design is different from the usual emails received from that person/organization.
• The email tells an unbelievable story (like the aforementioned Puerto Rico story).
• They ask for financial or other personal information, or for you to sign in to “update your account.”

If you get one of these emails, never click on a link or load an image, as they are most likely a malicious link. Likewise, never open an attachment from a suspicious email, or hit reply. Delete the email as quickly as possible. You also may want to report the email as spam before deletion. If you’re not sure if it’s legit, contact the sender through another means (DO NOT hit “reply”).

If you receive a “phishy” email from the ACS or one of our doctors, be sure to follow the tips above. Nothing can infect your computer if you don’t click any links or respond.

Classified Ad Scams
If you’re running a classified ad, whether on the ACS website or your local paper, watch out for potential scam artists. The ACS office recently received word from someone running an ad through the ACS that they had someone call regarding their equipment for sale. They even sent a cashier’s check, but it was for $3,000 more than the asking price! They then asked the seller to return the overage with money orders, but the seller could keep a portion for the inconvenience.

This type of scam is unfortunately not that uncommon. Luckily, it raised some red flags with our seller, and they still have their equipment, and no funds were sent out. Here are some tips to avoid this kind of scam:

• Never accept a check for more than you are asking or for more than the item you are selling is worth.
• Cashier’s checks ARE NOT the same as cash. They are easy to counterfeit because every bank uses a unique design, ironically so that their checks cannot be easily counterfeited. But this means there is so much variation that it’s impossible to know every bank’s design.
• Verify the check for legitimacy by calling or visiting the back it is drawn from before cashing or depositing. If calling, do not use the number on the check, as it could be a set-up; instead, search the financial institution’s number online.
• If you do try to cash a fraudulent cashier’s check, you are responsible for the money you withdraw.

Here are some other useful tips to identify potential classified ad schemes:

• Avoid phishing situations. Do not provide more information than necessary. Be aware of what contact information you provide and what information people could obtain. Any unnecessary asks for personal information could put you at risk for identity theft.
• Avoid payment systems when links are sent to you in an email. Using the internet payment service through their actual website helps protect you from fraudulent claims.
• Try not to rush any transactions, especially if the buyer or seller wish to change the terms of the sale.
• It is generally better to avoid wiring funds to an unknown party. Wire transfers cannot be canceled at any time, unlike checks. Once the money is collected, it is gone.
• For more information on protecting yourself from classified ad scams, click here.

When it comes to online security, it is better to be safe than sorry. Having your general rule when online be “If it seems too good to be true, it probably is” is a good start, but vigilance is the key.