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How the COVID-19 pandemic created a "perfect storm" for opioid addiction

sent by Keith Miller, PCA Vice-President


The PCA working group for UPMC HP recently met with top representatives of UPMC HP and had a very productive call addressing the following important topics:

  • E/M denials- You may send appeals to
  • Pre-auths for children under 13
  • TMJ/ Fibromyalgia coverage
  • 98940-98942 billing on the same day as 98943
  • Routine Care definition
  • Tiering
  • Billing
  • Appeal times-FYI UPMC has 60 BUSINESS days to respond to appeals.

UPMC HP relayed some encouraging information to the working group, but final decisions have not been reached at this time. PCA continues to address these matters with UPMC HP and expects developments soon.

Dr. Justin Miller, a member of PCA’s UPMC HP Working Group summarized the discussion nicely: "This is a great example of your PCA dues making a positive difference.  Thank you to all involved with your countless hours researching and organizing to make a difference for our profession!"

If PCA members have questions or want more information, email PCA's UPMC HP working group chair, Dr. Darcie Anselment:


Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through December

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December 31, 2020.  The Consolidated Appropriations Act, 2021, extended the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.

Medicare Administrative Contractors will:
·       Release any previously held claims with dates of service on or after April 1
·       Reprocess any claims paid with the reduction applied

You don’t need to take any action

– Sent to PCA courtesy of Dr. Victor Rizzo


The Bureau of Occupational Affairs has learned of an increase in scams targeting health related licensees.

Scammers are purporting to be from the Bureau of Occupational Affairs board and working with the FBI or the DEA.  
More information can be found at the link below.
The board office would appreciate any assistance in getting this link out to the licensees.

Posture is Life: Influencing Longevity through Postural Correction – Power Point

By Pennsylvania Chiropractic Association | May 5, 2021

The below PowerPoint from the Foundation for Chiropractic Progress (F4CP) is for YOUR exclusive use as a PCA member and brought to you as a direct benefit of YOUR PCA membership.

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ABCA National Convention Registration!

By Pennsylvania Chiropractic Association | April 12, 2021

National Convention Registration Now Open!!Register Here!Students – $50Organizations/Affiliaties – $50Established Lifetime* – $125Non-Members (DC) – $375 

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Cures Act – April 5 Deadline

By Pennsylvania Chiropractic Association | April 12, 2021

What Associations AND DoctorsNeed to KNOW NOW! Watch the video to hear why this information is important for associations and your members! Marc Abla, Executive Director for the Illinois Chiropractic Society + Dr. Nick Payne, Executive Director for the Kentucky Association of Chiropractors update ChiroCongress members in easy to understand bites.

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U.S. Senate Passes Substitute Version Of H.R. 1868

By Pennsylvania Chiropractic Association | April 12, 2021

The House-passed version postponed the 2% Medicare sequestration cuts scheduled for April 1 – December 31, 2021. It also included protection from the 4% Medicare PAYGO sequestration cuts associated with the $1.9 trillion American Rescue Plan Act of 2021. U.S. Senate Passes SubstituteVersion Of H.R. 1868 On Thursday, March 25, 2021, by a 90-2 vote,…

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Doctors Of Chiropractic Often Think That DCs Are Unfairly Targeted By Insurers For Fraud And Abuse.

By Pennsylvania Chiropractic Association | April 12, 2021

Following is an informative and brief advisory (click on the article’s links, for Highmark’s observations and their plan) that demonstrates Highmark is targeting many more health professionals than DCs. HIGHMARK TARGETS HEALTH CARE FRAUD, WASTE, AND ABUSE ( – Sent to PCA courtesy of David J. Cutich, DC PCA Insurance Committee

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ACA and PCA Applaud Signing of Competitive Health Insurance Reform Act

By Pennsylvania Chiropractic Association | March 25, 2021

The American Chiropractic Association (ACA) and Pennsylvania Chiropractic Association (PCA) applaud Congress for passing legislation that will promote fair competition in health insurance markets with the removal of a 75-year-old exemption that allowed these companies to avoid federal antitrust laws. Daniel Schatzberg, DC, PCA President and Pennsylvania Delegate to the ACA’s House of Delegates, commented…

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ACA Encouraged by Expansion of Chiropractic Services to Military Exchanges

By Pennsylvania Chiropractic Association | February 12, 2021

Media Contact:Annette Bernat 812­-0226 FOR IMMEDIATE RELEASE: Feb. 12, 2021 Arlington, Va. – The American Chiropractic Association (ACA), a longtime advocate for increasing availability and coverage of chiropractic services in the military community, is encouraged by news that the Army and Air Force Exchange Service (AAFES) will offer chiropractic services at six U.S. locations beginning this year.…

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Brent Shealer, DC - Pittsburgh, PA 
"I just wanted to chime in quickly and give a  Special shout out to the PCA in this group. Simply put, join! Because of my membership I was recently able to reach out to leadership and get a problem resolved very quickly from the state BPOA when I was getting nowhere with them prior. Also, I've been able to stay on top of a lot of the nonsense that is happening with UPMC/AMI right now among other important issues in changes over the years.  For example, there also working on problems with how terrible Aetna is, meeting with Congressman trying to get equal pay for Chiro's that MD's get paid for the same service (EM codes for example), and still working on the problem with doc's having to direct supervise therapy and rehab.
 I see it said on here often, "does PCA know about this and" or "what is the PCA doing about this" regarding issues. Well, yeah, they do, and frankly for the cost of one adjustment a month ($50)  You can be a member and see your answer to those questions yourself, amongst many other discussion points while being informed. They can't solve every problem, but they do try and work hard on your behalf, member or not. So why not support them? A stronger State association, with more members, carries a lot more weight in matters. Thanks!"
Jeff Snyder, DC - Phoenixville, PA
"The PCA is an absolute for any doctor of chiropractic in the Commonwealth of PA. We know membership is essential in order to have strength in numbers when dealing with issues pertaining to practice and public health issues where we can make a huge impact. The PCA has our back and the backs of the consumer (no pun intended). As a practicing chiropractor, the membership fee is a NO BRAINER! Why would you, as a chiropractor, practice without the largest state association in your back pocket, on speed-dial, so you can manage the issues that come up day to day in practice.
The staff at the home office has never been better. Our executive vice president is cordial, respectful, and a true leader who has years of experience which has helped the association greatly over the past number of years.
I'm thankful for the PCA and what we as an association have accomplished to protect the rights of chiropractors to practice as well as protecting the health of individuals throughout our state."

Ed Kropf, DC - Pittsburgh, PA 

"As a PCA member over 31 years I have been a distant observer of Chiropractic in our state as well as the several factions of philosophy practiced here. As so far as the PCA is viewed, I feel the current system in place is providing the best communication with it's members. PCA has put into place several terrific members and administration that take on the problems from many fronts, report and attempt to correct/improve the position for the future of Chiropractic in our state.

Good job, you all are doing things so very much better, keep it up!!!"

Jeffrey Sklar, DC - Philadelphia, PA 
"In full disclosure, I have been a district director for the PCA for the last 2-3 years. However, I have been a member my entire career. The current leadership of the PCA has more passion and commitment toward protecting all PA chiropractors right to practice and patient accessibility than I have ever experienced. Whether you are a member or not, you have been benefiting from all the efforts of volunteer board members and PCA associates from lobbying to legal.
The level of responsiveness from any direct inquires to the Execs or affiliates(legal, political) has always been unparalleled with Ed Nielson as Executive Director. Whether you are a member or not, you have benefited from battles won by the PCA that may have never crossed your front steps.
The PCA has been a major contributor to my success in practicing in Pennsylvania. I am grateful to serve and more grateful to have such selfless colleagues that freely donate hours and hours of their time for our benefit as Pennsylvania DCs!"
Ladeluca Chiropractic
"The PCA helps chiropractors and I have found they are professional and very reliable. I can call them with specific questions and if they cannot answer then they refer me to the right person."

“I am a retired doctor, who was hit with a $17,000 recoupment request from a Pennsylvania health insurer, TWO years after I retired. As a retired-status member, I immediately contacted the Pennsylvania Chiropractic Association.  PCA’s  staff were responsive and very helpful, including referring me to Mr. Jason Martin, PCA’s General Counsel, for a free legal consultation.

After talking at some length with Mr. Martin, he assisted me with the audit and provided very solid advice. I followed his advice and I was able to resolve the audit with the health insurer without any payment on my part.   I am thrilled with the supportI was given by PCA staff and General Counsel Martin’s legal advice.

Thanks to my membership in PCA, I received very responsive and immediate support for my problem.  Most importantly, my membership in PCA saved me $17,000of my hard-earned money!  Thank you, PCA!”

Lori Kalie, DC - Lancaster, PA 

"I actually sold my practice. About two hours after you posted the ad, I got a call from a doctor who was interested. He officially took over today. I received quite a number of calls about the practice since the ad was up. The service you provide is valuable, and I just wanted to thank you and the PCA for offering this service."

Brian Meenan, DC - Pittsburgh, PA 

"I just started my own practice a couple of months ago. $600 is a bit steep but it is worth it! Charge me monthly, that’d be great."

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