Thank you with my heartfelt gratitude to everyone who attended the March convention. It was truly inspiring to witness 460 doctors, representing half the number of DCs in Nebraska, participating in this event! These conventions hold immense significance for the health of chiropractic in our state.

While the continuing education hours are invaluable, the personal interactions among our doctors, the relationships fostered and sustained, and the mentoring that takes place in the hallways during break are perhaps even more pivotal. In my view, these moments we share together represent one of the most vital aspects of the NCPA's mission- advancing the profession.

This is also a great opportunity to express my appreciation to the dedicated NCPA staff for their outstanding work in organizing these conventions, and to express gratitude to SecureCare for their financial support which enables the exceptional quality of our events. The high standard of excellence we maintain has become an expectation, yet it stands in contrast to what we observe in other states.

During this convention, we touched upon the benefits of being an NCPA member, and it is important to reiterate that conversation here. The NCPA acts as your advocate and keeps you well-informed. From the state to the federal level, political entities exert influence over every part of your practice. We collaborate with national organizations to champion chiropractic care and cultivate a favorable environment for our doctors. We diligently review every bill that traverses the Nebraska Legislature and champion your interests when necessary. We monitor federal rules and regulations, from HIPAA to healthcare regulations to general business matters, and work to keep you abreast of what is needed to maintain compliance. Moreover, we continuously promote chiropractic care statewide, striving to enhance awareness and understanding of our profession. We endeavor to advocate for our doctors on insurance matters not covered by SecureCare, and we offer assistance with questions, concerns, and any other support needed.

Personally, I consider an NCPA membership to be an exceptional value as the organization safeguards chiropractic care and my interests, allowing me to focus more on my practice. The NCPA is committed to improving communication regarding all achievements and endeavors, ensuring members are fully informed of the efforts being made to uphold Nebraska's status as one of the premier practice environments in the United States. During convention, it was highlighted that the average age of newly licensed DCs is now 45 years old. This underscores the fact that chiropractors from across the country are drawn to the advantages Nebraska offers.

Therefore, I encourage you to actively participate in NCPA activities, keep an eye out for our communications, and do not hesitate to reach out to our staff, your district representative, or myself if needed. We are all here to serve you and uphold the great state of chiropractic care in Nebraska!

Please feel free to contact me at MedicareNebraska@ncpa.net any time if you have questions.

At the core of the Nebraska Chiropractic Physicians Association (NCPA) lies a deep-rooted mission: to protect, promote, and advance the role of the chiropractic profession in Nebraska. Driven by a deep-seated belief in chiropractic's innate power, we aim to establish chiropractic as a cornerstone of health and wellness in Nebraska. Our vision—to make chiropractic the first choice for all Nebraskans—is ambitious but achievable with collective action, strategic collaborations, and a community-oriented approach.

Cultivating strategic collaborations is important to realizing this vision. Our collaborations with healthcare and community organizations, such as the Nebraska Medical Association, the American Physical Therapy Association in Nebraska, the Nebraska Hospital Association, the Nebraska School Activities Association, and the Nebraska Safety Council, play a crucial role in integrating chiropractic care with the broader healthcare community and the people of Nebraska. These collaborations are essential for weaving chiropractic care into Nebraska's broader healthcare narrative, amplifying our message across the state.

How can you contribute to our shared vision? Volunteer for events like the NSAA championships and the Lincoln and Monument Marathons. Volunteering demonstrates chiropractic care's benefits and promotes community relationships, propelling us toward making chiropractic the first choice for health and wellness in Nebraska.

The path to realizing our vision is paved with dedication, collaboration, and community engagement. As a member of the NCPA, you are a steward of a powerful mission and a visionary goal. By actively participating in strategic collaborations, you contribute to the advancement of our profession and directly impact the health and well-being of our fellow Nebraskans.

Let us unite to protect, promote, and advance chiropractic care. Together, we can transform our vision into reality and make chiropractic the first choice in care for all Nebraskans. 

The March SecureCare participating provider meeting was dominated with discussion regarding the recent focus on utilization of CMT codes. Thank you to everyone for the professional dialogue during the meeting. For those who were not at the meeting, this article provides an update and further context on the topic.

First and foremost, SecureCare’s mission remains unchanged. Our focus is on the protection of conservative care providers and improving relationships with our insurance company partners. In order for SecureCare to accomplish these goals, we must have a legitimate and effective network management process to ensure only medically necessary care is billed to insurance companies. When we find questionable care delivery patterns, we are obligated to perform medical record reviews to document aberrant billing patterns. If we find that care delivery or billing practices do not meet standards of care or insurance company medical policy, then corrective action is required. A hallmark of SecureCare’s process is that our focus is solely on outlier activity. This means the vast majority of providers continue to care for patients without undue burdens, such as prior authorization.

The recent issue with CMT utilization is a good example of why every business must continually evolve and adapt to the ever-changing business environment. Newly developed technologies now allow us to better understand how the network is performing and to isolate and respond to issues quickly. It is essential that we incorporate new capabilities into our workflow to remain competitive in the marketplace.

We understand that the recent issue arose quickly for all involved. SecureCare responded with immediate action so we could maintain our long-standing partnership with Blue Cross Blue Shield of Nebraska. We performed independent analysis of the concerns raised, and ultimately, agree that SecureCare’s current process of “average cost per patient” needs to be strengthened to adequately address pockets of obvious revenue maximization within the larger network that were previously undetected.  

We want to emphasize that each patient should receive 100% of the care they require. It is critical to remember that clinically appropriate care is not the same as billable medically necessary care. We found that in some cases, clinically appropriate care is transformed into a business model that can produce lucrative results for some providers, but that the care does not always meet standards of documentation, standard of care or insurance company medical policy.

There has been a lot of discussion regarding how SecureCare will manage these new elements of network oversight moving forward. As with all components of a business process, ours will evolve and be refined over time. It is not our intention to limit care or dictate specific percentages of frequency of billing codes. We have provided guidance and suggestions regarding coding frequency to help guide providers as they assess their individual practice and patient populations. Now that this issue is visible, we expect that over time the network as a whole will stabilize around appropriate values. We understand that some clinics will have higher frequencies and that some will have lower frequencies for certain codes. This is understandable and expected.  



Again, thank you for your support and understanding as we navigate this new issue. We received significant good feedback and input from many of you, which is greatly appreciated. We also welcome questions and challenges to our approach. Your input is vital to helping us achieve a better future for all stakeholders.

Great News for Nebraska Providers!

SecureCare is pleased to announce that effective July 1, 2024, you will receive an approximate 2% overall increase in reimbursement rates from Blue Cross and Blue Shield of Nebraska (BCBSNE) on your most frequently billed CPT codes.

On June 01, 2024, you will locate the new BCBSNE rates in Luviel Health under the heading NEtwork Blue 2024-2025 and SelectBlue 2024-2025. 

Our relationship with BCBSNE continues to grow despite recent challenges. This rate adjustment illustrates their commitment to our partnership and supports the value of chiropractic care.

In the near future, please review the updated rates and do not hesitate to contact us with any questions at providerservices@securecarecorp.com.

The 2024 NCPA Spring Convention was the highest attended convention to date for the association with over 460 doctors in attendance. The second highest was the 100-Year Anniversary Spring Convention held in 2015. We had many special guests, including two-time Husker National Champion and Superbowl Champion, Tony Veland and Dr. Carl Cleveland III, President of Cleveland Chiropractic College in Kansas City.

It was a privilege to have world-class speakers to present the latest in research and adjusting techniques, including Dr. Heidi Haavik, Dr. Tim Bertelsman, and Dr. Steve Agocs. Additionally, the personal injury panel discussion presented by Mandy Gruhlkey, Esq., Dr. Scott Misek, and Dr. Brad Stauffer provided relevant information about best practices for serving these clients in your practice.

Special thanks to Cleveland Chiropractic College for sponsoring our Exhibitor Reception on Friday. Also, on Friday, there were over 140 guests who attended Bowling Night at Spare Time Omaha, which was filled with bowling, games, and laser tag at a state-of-the-art facility.

Saturday's NCPA General Membership Meeting recognized our 2024 Lifetime Member Award Recipients, Dr. Rand Petersen, Dr. Jeffrey Rub (both pictured below), Dr. Po Pomajzl, and Dr. John Sempek. Congratulations to all for achieving this honor!

We look forward to the August convention which will be held August 15-18, 2024, at the CHI Health Center Omaha. Stay tuned for the details to be announced in June.

There hasn't been much legislative activity recently so there isn't much PAC news to report. However, we are headed into election season later this year, and although it looks like our state and federal PAC balances are strong, those funds will dry up very quickly if we don't get more recurring monthly donors along with some bigger one-time payments. 

It may seem that you constantly get asked to give money, but we all underestimate how strong chiropractic is in Nebraska, as well as how quickly that can change if the wrong legislators who have an axe to grind with chiropractic get enough power. Look how fast and out of nowhere the recent BCBS issue sprung up on us. 

We need to always be proactive because being reactive can be too late! If practice has been a struggle, please consider even giving just $5-$10 a month because it all adds up. But, if practicing chiropractic has been good to you over the years, then $100 a month is only two adjustments. If all of the 600+ NCPA members gave $100 a month, that would be $60,000 for the PAC, which would give us a really loud voice at the political table.

To the people who are monthly donors, thank you for playing your part in safe guarding the chiropractic profession in Nebraska. It's the people like you that selflessly give that keep our profession as protected as possible.

If you have any questions at all about the PAC, please don't hesitate to reach me at drwhite@sarpychiro.com.

First, some good news! The latest appropriation bill to go through Congress appears to have restored some of the Medicare cuts that we saw this year. While it will not quite take us back to where we were last year, it appears to have gotten us closer. At this time, we are seeing changes to reimbursement but have not yet seen a new fee schedule posted and are not sure if these changes will be retroactive to January 1, 2024. If they are retroactive, those claims will be reprocessed automatically.

While we realize everyone’s frustrations with the lack of increase, and actually decreasing, reimbursement for Medicare that carries over into the commercial sector. Rest assured these frustrations are not limited to chiropractic. Others in healthcare, particularly other physicians, are seeing the exact same treatment. The AMA has finally started an aggressive campaign to improve reimbursement and we can only hope that in time it is successful. This will be an uphill fight until it becomes an issue for patients, which is believed to be starting to happen. We are working to show those issues to CMS, with the hope that it will spur some action.

We are also aware that there is a new Medicare Advantage plan sold by Medica that requires pre-authorization for CMT codes. We are aware of the issue; it is being addressed. After reaching out to Medica with no response, a complaint was filed with CMS asking them to review this issue. The case has been presented that these pre-authorizations are inconsistent with the intended use of pre-authorizations in such plans. Updates regarding the progress of this project will be sent when they are available.

Thanks to you all for your quality notes and taking good care of your patients! Feel free to reach out to me at MedicareNebraska@ncpa.net if you need help or have questions.

Starting January 1, 2024, Molina was added as one of the Medicaid Managed Care Organizations for the State of Nebraska, taking over the position previously held by Nebraska Blue.

Molina will be paying for treatment on the basis of medical necessity and CPT codes for manipulation of the spine will be paid with no prior authorization.

They will also be paying for the first twelve PT codes without prior authorization and then any following that prior authorization will be required. The twelve PT treatments without prior authorization is not per provider but total treatments for the patient. It is good to consult with your patient to see if they are also seeking care in other locations as well. They will have a total of 60 combined PT services allowed per year for adults 21 and over and there are no limits for those patients under the age of 21. They will have the prior authorization tool on their website for providers to have access to for this process. 

Our last Board of Chiropractic (BOC) meeting was held on April 3, 2024, at the Nebraska State Office Building.

Board Membership: The current board members are:

Scott Misek, DC – Board Chairman

Heather Henrichs, DC – Vice Chair

Brian Stevens, DC – Secretary

David Henske – Public Member

Regulations Update: After making draft changes to our chiropractic regulations, the regulations are now advancing through the promulgation process. Most recently, they have completed the legal review stage.

FCLB Update: Dr. Misek and Dr. Henrichs will be attending the 97^th annual FCLB Annual Educational Conference to be held in May in Phoenix, Arizona.   

Next Meeting: The next quarterly BOC meeting is scheduled for Wednesday, June 5, 2024, at 9:00 AM at the Nebraska State Office Building. As always, the public is always invited to attend our meetings. 

The Nebraska State Board of Health (BOH) met on Monday, March 11, 2024, at the State Office Building in Lincoln. We welcomed a new member, Dr. J. Paul Cook, a private practice family physician from Omaha. Vacancies in the 17-member board remain for the positions of mental health practitioner, physical therapist, osteopathic physician, one public member, and veterinarian. All Board of Health positions are appointed by the Governor.

The main item of business was suggested changes in the Credentialing Review process. Credentialing Review is the process whereby any health profession requesting an expansion of its scope of practice applies for approval through the BOH, prior to introduction of legislation in the unicameral. This gives all stakeholders an opportunity to evaluate and discuss the proposed scope changes.

A sub-committee of the Credentialing Review Committee (one of the four standing committees on the Board) submitted a long list of recommended changes to the full Board. I served as a member of the sub-committee, along with Dr. Russell Crotty, the optometrist member from Auburn; Dan Vehle, a public member from Omaha; and Dan Rosenthal, the professional engineer member from Lincoln. During the discussion, input from various health professions was also accepted. This included such groups as the optometrists, CRNA’s, and the Nebraska Medical Association. Dr. Nick Payne was also present, representing the NCPA. The recommended changes were adopted by the full Board and will be forwarded to the legislative branch of DHHS for further evaluation and consideration for legislative introduction. At the same time, a working group of all professions spearheaded by the NMA will be submitting its recommended changes.

I recently attended a Board of Athletic Trainers meeting. Due to recent statutory and regulatory updates, AT’s now have the ability to administer dry needling, albuterol inhalers, and epi-pens. I serve as a Board liaison to the boards of chiropractic, athletic training, and physical therapy. I also serve as liaison to the NMA group discussing the credentialing review process.

The next BOH meeting is scheduled for June 10, 2024. Should you have any comments or questions regarding the BOH, my email is dougvanderbroek@gmail.com.

2024 has been off to a great start! So far, outside our own social media efforts, we ran a two-week Google display ad campaign in February, which had a great response to drive traffic to the NCPA website. Additionally, we continue to be featured once a month on the heavily viewed weekly Trivia Tuesday posts on the Nebraska School Activities Association X page. Click here to explore their X page.

We had the privilege of sponsoring the Brain Injury Alliance of Nebraska Annual Conference on March 14 & 15, 2024. This inspiring event supports those who have experienced traumatic brain injuries, their caregivers and statewide health care providers. Our exhibitor booth allowed us to share how chiropractic care can assist these patients throughout recovery and beyond.

ACA ENGAGE 2024

Members of the American Chiropractic Association (ACA) gathered in Washington, D.C., in January for their annual meeting, ACA Engage. As always, it was a great opportunity for doctors of chiropractic and students from across the country to reconnect and catch up personally and professionally. It was also a pivotal time for our Medicare legislation – the Chiropractic Medicare Coverage Modernization Act (H.R. 1610/S. 799) – and everyone who visited Capitol Hill during Engage 2024 went with added intensity, knowing that the time for getting the bill across the finish line is approaching fast. Dr. Eric Benson and I visited with Senator Fisher and with aides for Senator Sasse and these meetings were productive. I am proud to say with the help of many individuals in Nebraska that all our House of Representative members are co-sponsors of this legislation. There are now over 150 co-sponsors of this legislation, split fairly evenly on both sides of the aisle.

ACA Yearly Award Winners

• Quinn James, DC, of St. Peters, Mo., received ACA’s highest honor, the Chiropractor of the Year Award, honoring his advocacy on behalf of the chiropractic profession and the patients he serves. As ACA’s Missouri delegate and chair of the ACA Legislative Committee, Dr. James stands out for his ability to rally support for pro-chiropractic legislation on the federal and state level.

Other award winners included:

• Mark Bronson, DC, DIANM, of Fort Worth, Texas, received the Humanitarian of the Year Award.
• Eric Roseen, DC, MSc, PhD(c), of Boston, Mass., received the George B. McClelland Researcher of the Year Award, recognizing an individual for developing, refining and/or expanding the body of knowledge in chiropractic.
• William Lauretti, DC, of Seneca Falls, N.Y., received the Academician of the Year Award.
• Quinn James, DC, of St. Peters, Mo., and Alli Totzke-Hitzeroth, DC, of Montpelier, Va., received the Delegate and Alternate Delegate of the Year Awards, respectively. Both awards recognize members of the ACA House of Delegates who have demonstrated exceptional service, achievement and/or leadership. Dr. James is the first-ever recipient of both the Chiropractor of the Year and Delegate of the Year award in the same year.
• Caitlin Walter, DC, of Great Falls, Mont., received the Flynn-Lynch Award, which recognizes an outstanding member with no more than five years of experience serving in the House of Delegates.

New Leadership Elected

After elections by the ACA House of Delegates and Board of Governors (BoG), ACA installed new leadership. Leo Bronston, DC, MAppSc, of Onalaska, Wis., was elected president of the association, and Marcus Nynas, DC, of Billings, Mont., was re-elected vice president for the 2024-2025 term.

Dr. Bronston, who runs a private practice, has been a member of the ACA board since 2019. He is chair of the ACA Health Policy and Advocacy Committee and has been ACA’s representative to the American

Medical Association’s CPT® Health Care Professionals Advisory Committee (HCPAC) for more than a decade. Dr. Bronston was also recently appointed to serve on AMA’s CPT Editorial Panel.

Kris Anderson, DC, MS, of Grand Forks, N.D., and Adrian Stratton, MBA, PRP, CP, of New York, N.Y. are joining the BoG for the first time. Dr. Anderson, who works at a Federally Qualified Community Health center (FQHC) in addition to running a private practice, serves as vice chair of the ACA Health Policy and Advocacy Committee. He is also an advisor to the AMA’s RVS Update Committee (RUC) HCPAC. Mr. Stratton is a general management executive and partner at GAACC, a global-focused management consultancy. He is a registered and certified parliamentarian and has published and lectured extensively on parliamentary topics.

Continuing terms on the BoG over the next year are Eric Benson, DC, FIAMA, FICC, of Grand Island, Neb., and Maithy B. Ta, DC, of Kansas City, Mo.

Looking Forward to a Great Year

With the new member services portal in operation, the momentum generated at the annual meeting, and the boost in cosponsors for the Medicare bill, ACA has made a strong start in 2024. Members are moving forward, leading the profession in the most constructive and far-reaching ways. ACA is committed to being a positive and unifying force for the practice of modern chiropractic. For updates on ACA initiatives throughout the year, visit www.acatoday.org, read ACA Connects weekly and follow us on social media.

National Practice Expenses Survey Will Include Chiropractors

ACA is joining more than 170 healthcare groups in support of a national study to collect data that will be used to accurately determine physician practice expenses. Information collected through the Physician Practice Information (PPI) Survey will help policymakers to better understand the costs associated with modern physician practices and to support physician payment advocacy.

ACA Launches Fellowship to Prepare Future Health Policy Experts

ACA has launched a Health Policy Fellowship to educate doctors of chiropractic about health policy, coding and other complex issues and to prepare them to advocate on behalf of the chiropractic profession in the future.

Chiropractors Appointed to National Quality Forum Advisory Positions

Three doctors of chiropractic, all members of the American Chiropractic Association, have been appointed to serve on three separate advisory councils of the National Quality Forum (NQF), a non-profit, nonpartisan organization working to improve healthcare outcomes, safety, equity, and affordability. 

The following members have joined since Fall 2023:

Ryan Anson, DC

Melanie Bayne, Student

Jacee Christian, Student

Stephanie Clarke, Student

Brett Classen, DC

Aaron Cooksley, DC

James Daro III, Student

Trenton Evans, Student

Britton Goldsmith, DC

Andrew Grossnickle, Student

Isaac Kremlacek, Student

Natalia Linn, Student

Gregory Miller, DC

Brandon Pankers, Student

Cara-Celeste Parot, DC

Nathan Schanuth, DC

Ashley Sepulveda, DC

Paige Shestak, Student

Hope Upoff, Student

Derrick Vander Linden, DC

Andrew Webster, DC

Nolan Wiese, Student

Justin Young, Student

Garrett Zajicek, DC

FALL 2024

August 15-18, 2024

CHI Health Center Omaha

Omaha, Nebraska

SPRING 2025

March 20-23, 2025

Omaha Marriott Downtown

Omaha, Nebraska

FALL 2025

August 8-10, 2025

Younes Conference Center Kearney, Nebraska