John LaMonica, DC on Healthcare, and CA Certification
INTERVIEW
Interview with Immediate Past President of COCSA, John LaMonica, DC
The American Chiropractor
John LaMonica, DC, has continuously worked in the trenches as the President & Vice-President of the Congress of Chiropractic State Associations (COCSA) and as the current President of the New York Chiropractic Council, for the advancement and defense of the chiropractic profession. The American Chiropractor (TAC) caught up with Dr. John LaMonica (JL) for his thoughts on some of the most poignant issues that chiropractors are facing today, in this exclusive interview.
TAC: What are the states doing to assure that chiropractors in their state are able to legally practice within their scope as it is currently written?
JL: Most states are monitoring and assuring that all current statutes are being adhered to, and if any violations are discovered, they are taking action to make sure that the laws ar e enforced. The state organizations ar e also hard at work developing new legislation that will benefit chiropractic in their state. This would give chiropractic a better enviromnent in which to practice. One of the key benefits of COCSA is the states’ ability to communicate with each other in developing var ious legislation. It is extr emely helpful that states that currently have legislation are always willing to help those that are looking to enact similar' legislation.
TAC: Any thoughts on President Trump and his effect on health care?
JL: Healthcare is currently being hotly debated in Congress and at this time no one exactly knows the effect the new administration will have or what changes will be made. We are closely monitoring the situation and are ready to respond on both national and state association levels, as well as on a grass roots level. We believe that significant changes will be made; however, we also believe that certain provisions will also be retained in some form. These would include, but not be limited to, the preexisting condition clause, children being able to be kept on a parent’s insurance until 26 years old and the non-discrimination clause. We are cautiously optimistic that any reform to the healthcare system will be beneficial to both patients and providers.
TAC: How are the state associations responding to the possibility of the revocation of the Affordable Care Act?
JL: The state associations are aware that many changes will occur. States are monitoring the situation and feel it is best to review any concrete proposed changes before taking any ac-
tion. As stated above, many parts of the Affordable Care Act are targeted for change, but there ar e several sections that ar e popular' and will probably be maintained. It is best to understand all the proposed changes before a response is made. Whether the ACA is repealed in its entirety or significantly modified, the implementation of any change would take time. The states would have ample opportunity to properly evaluate any proposed changes and respond accordingly. Please be aware that if any significant information develops, the states are ready to respond immediately.
TAC: Any good news for chiropractors with regards to insurance and reimbursement?
JL: There have been several decisions made in the courts that have upheld patient and provider rights, and the courts have ruled against certain egregious actions that were affecting both patients and their providers. We are also looking forward to expanded inclusion in the VA and military, and are continuing the fight for reimbursement parity for all providers performing like or similar' services.
TAC: How do the state associations view the role of chiropractic assistants or technicians changing over the next 10 years?
JL: The discussion on certified chiropractic assistants has been ongoing for several year s. Some states have implemented certified chiropractic assistant programs, and as we ar e aware, the
FCLB has a program for certifying chiropractic assistants. A question with these programs is if implemented across the country, would all C A’s be mandated to take this course? A potential answer to this problem would be to have a certified clinical chiropractic assistant program for chiropractic assistants whose duties would include hands-on patient contact. Chiropractic assistants whose job description only contains administrative andJ or office duties and does not include hands-on patient contact would not be required to complete the program. A certified clinical chiropractic assistant would not be authorized to perform high-level duties that are fundamental to a DC’s license, i.e., adjusting and radiology. Another possibility would be to enact legislation in which Doctors of Chiropractic would be able to train their CAs to perform additional services in a limited capacity. The challenge here, of course, is that state laws vary significantly across the country. My personal belief is that no matter which direction it goes, the role of CAs in chiropractic offices across the country will become much more significant with increased responsibility.
TAC: Why is New York regarded as such a difficult place to practice?
JL: As one of the largest and most populated states in our nation, the expenditure on health care is astronomical. The reality is whenever expenditures are at such high levels, there will always be efforts to reduce costs. This, of course, led to significant legislation as well as insurance regulations, which greatly affected reimbursement not only to chiropractors, but
also to all healthcare providers in the state. Another aspect is that many laws related to health care do not support chiropractic as strongly as other professions. We are hard at work to correct these inequalities. As we are all aware, the cost of living in New York is one of the highest in the nation, which makes it very difficult for Doctors of Chiropractic to make the living they deserve, let alone, a new practitioner trying to start out and open a new office.
TAC: Could you share your thoughts on COCSA and the last two years of your administration, as well as where you see the leadership in the future?
JL: COCSA has become, what I feel, is the most significant organization in the profession due to the fact that it is the state organizations that drives what COCSA does. The state organizations are the direct connection to the practicing DC. Over the past several years, the leadership of COCSA has worked extremely hard to make the concerns of the states and their members the primary focus of what we do. It is the commitment of the entire board to continue and strengthen this relationship so that the voices and concerns of the practicing DC are paramount. I see COCSA as continuing to take the lead on coordinating the concerns of the entire profession through the state associations and their members.
TAC: Our sincere thanks to Dr. John LaMonica. If you would like to send an e-mail to Dr. LaMonica, you may e-mail him at [email protected] IESSI
