Articles by JCS

ASH Chokehold

ASH CHOKEHOLD

 

APPEAL TO GEORGIA

DEPARTMENT OF INSURANCE

&

BOARD OF CHIROPRACTIC EXAMINERS

TO INVESTIGATE

AMERICAN SPECIALTY HEALTH

The chiropractic profession should learn a few valuable lessons from the social upheaval we now see with massive proponents of the First Amendment protesting against injustice, brutality, and institutional discrimination. Indeed, these three issues pertain to the medical war against our profession. But where are our protests? Do chiropractors have the backbone to speak out for their rights?

We’ve seen medical injustice historically led by the Jim Crow, MD, of medicine, Morris Fishbein, the AMA’s chief propagandist who had his boot on the necks of chiropractors for 25 years until 1949. During his reign of terror, over 15,000 times chiropractors were arrested for rendering what has proven to be the best in conservative spinal care, for teaching the Big Idea of neuroscience, and to encourage patients how to be healthy naturally. Such crimes, eh!

Meanwhile, the AMA has been doling out opioid drugs like Halloween candy, experimenting with radical back surgeries that continue unabated today, and was in bed with Big Tobacco until 1986. Whatever happened to “First, Do No Harm”? Okay, stop laughing!

The Medical Mussolini was replaced by the AMA’s Committee on Quackery and today we still see remnants of the AMA’s chokehold with institutional marginalization of DCs in Medicare/Medicaid, VA, TRICARE, BCBS, UHC and workers’ comp programs. Most of all, the AMA has created its vitriolic branding—“chirophobia”—the medical fake news that permeates everyone, just as racism has affected everyone to some degree.

However, the largest boot on our neck comes from by American Specialty Health, a managed care organization whose goal if to “squeeze care to expand profits.” According to its news release, ASH had a 94% overall revenue growth from 2014 ($255.90 million) through 2017 ($497.44 million). A private news article estimated ASH’s annual revenue at $854.9M.

From its website,

“ASH is one of the nation's leading specialty health benefit management companies currently administering benefit programs for over 46 million Americans and providing access to consumer-self pay programs for over 155 million people. "We're very pleased to see ASH once again recognized for our consistently high financial growth," said ASH co-founder, Chairman and CEO George DeVries.”

Of course this predator fails to mention the horrible PATIENT REVIEWS AT THE BETTER BUSINESS BUREAU (BBB)  and YELP REVIEWS OF ASH.

Here are just a few of 123 negative reviews on ASH by patients that I include in my report. I am certain every DC has disgusted patients who sound exactly the same:

  • 1.     OK, all my fellow chiropractors are right about ASH.  It is nothing but a scam.  If you have ASH for your chiropractic benefits, you might as well give up on getting the proper care from this company.  
  • 2.     I agree, there should be a ZERO STARS option. ASH is awful!! Not only do they deny claims without cause, they send out so much paperwork to the patient and the chiro office that they could've essentially just paid the claim. They don't give the patient the benefits that their insurance company says they have from their plan!! All of the horrible reviews I read are completely true from my own dealings. It's as if they have a template on how to treat the patients and practitioners as horribly as possible.
  • 3.     This is the WORST company I have ever had to deal with. I really try to be fair, but there is something extremely shady going on with this company.
  • 4.     I have had to endure working with this company for 10+ years. Believe the overwhelmingly negative reviews and disregard the canned ASH responses trying to get your personal information and ignoring the actual complaints.
  • 5.     No stars. Horrific transactions with provider services and contracting.
  • 6.     This corporate entity should be investigated for fraud.
  • 7.     All the comments are true. How this company is still in business is beyond finding out. They make it very difficult for the patient and the doctor. They restrict visits and say that I don't need any more treatments. My coverage says I have 30 but I could only use 5. The paperwork that these guys request from doctors is atrocious. Even though my doctor would send in the paperwork, they still wouldn't approve any more visits. I am in pain and there isn't anything I can do. From what I know their reimbursement rate to the doctors is mere peanuts as well.

Obviously, ASH epitomizes what is terribly wrong with for-profit healthcare with its chokehold on the necks of patients and DCs alike that defrauds patients of their contractual rights to obtain reasonable chiropractic care and other complementary therapies. By implementing exhaustive administrative with arbitrary “medical necessity” criteria barriers and curtailing proper care by fake EBM guidelines, ASH thereby drives patients away from chiropractic offices or forces them to risky and expensive medical spine care treatments (opioids, injections, surgery) that ASH is not responsible to cover.

ASH’s policy also flies in the face of the founder of EBM, David L. Sackett, MD, author of Evidence-based medicine: what it is and what it isn't, who warns, “Evidence-based medicine is not ‘cookbook’ medicine,” which characterizes ASH’s policy with its inordinately stringent “medical necessity” criteria and clinical guidelines that are not reasonable and, according to Dr. Sackett, results in “slavish, cookbook approaches to individual patient care."

A major method to cut costs and suppress clinical freedom occurs when ASH strongly discourages the use of spinal x-rays defending its policy on the unproven claim of the danger of “ionizing radiation”. However, many university department heads, chiropractic associations, technique instructors, and radiation experts disagree with ASH’s policy such as Jerry Cuttler, PhD, Nuclear Sciences and Engineering, past president of Canadian Nuclear Society, who said “There’s just no evidence of that.”

Jeff Randolph, Esq., in the New Jersey lawsuit said ASH’s violations “improperly denied medically necessary care, carried out deceptive business practices and impeded patients' access to health care.” The recent lawsuit (Horizon BCBS) also stated “cutting benefits appears to be the business model" of American Specialty Health.  Apparently, the court agreed and fined ASH $11.75 million for the same chokehold irregularities it continues to do to all chiropractors.

I urge you to study my Appeal to the Insurance Commissioner’s Office in order to learn the evidence to push-back on ASH’s chokehold of our incomes and right to practice classic comprehensive chiropractic care rather than its draconian version of “pop and pray” as they laugh all the way to the bank.

It would be great if our state and national chiropractic associations were to help in this fight to expand our market share, to guarantee the services patients pay for, and to protect our right to practice classic comprehensive care rather than the bastardized sub-optimal version we now see emanating from some regressive groups who want to take chiropractic back to the days before technology and clinical expertise.

It’s time to get off your Spinalator and act up by contacting your state association, your state Insurance Commissioner’s Office and your state Board of Chiropractic Examiners. Let’s hold ASH’s feet to the fire by SPEAKING TRUTH TO POWER.

Keep in mind democracy dies in darkness and silence is not golden.

Enjoy my lengthy but enlightening complaint against ASH:

APPEAL TO GEORGIA

DEPARTMENT OF INSURANCE

&

BOARD OF CHIROPRACTIC EXAMINERS

TO INVESTIGATE

AMERICAN SPECIALTY HEALTH

 

Let me know what you do!

Remember: #Chiropractors Matter!

JCS

 

 

 

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