Support Natural Therapies

Support Natural Therapies

From Ralph Fucetola

The Institute, founded in 1998, provides a facility to promote health research in natural means. This Fundly crowdfunding program is intended to provide support for holistic practices and practitioners - www.InHeRe.org

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Update #3

16 days ago

Just posted this at the Institute web site.

Our first Crowdfunding project involves pending litigation that can construe the Affordable Care Act to forbid insurance carrier discrimination against holistic and integrative practitioners, permitting proper insurance coding for such therapies, and, from the standpoint of the Mission of the Institute, facilitating retrospective research into holistic and integrative modalities (through coding statistics.

Read more here: http://www.inhere.org/2018/11/06/making-health-insurers-follow-the-rules/

More Info

Our first project for this Fundly page is to support litigation pending in New Jersey involving several holistic practitioners who are being sued by a BlueCross/BlueShield plan (herein, BCBS) for "fraud" although the customers want the natural therapies that were offered. The insurer can afford the best legal representatives; the doctors and practitioners need your help. 

Please note: Ralph Fucetola JD, President of the Institute, is not the attorney for the Defendants and is retired from the formal practice of the law.

The dynamic young attorney representing the Defendants can set a precedent requiring insurers to honor the desires of their customers and allow holistic therapies that may benefit. 

The case may very well set a precedent defining the ACA's nondiscrimination prohibition as a powerful source of protection for holistic and integrative health care options.

Here are some of the points that may be raised by the defense:

1. BCBS's suit is primarily based on accusing Defendants of providing fraudulent healthcare services.

2. In fact, Defendants have never provided fraudulent services to patients

3. BCBS states that Defendants miscoding services

4. In fact, the codes used by Defendants to file claims were not used incorrectly.

5. An outside billing expert reviewed Defendant’s claims and found that their claims used the treating and supervising provider NPI numbers in the wrong slots.

6. This same expert will testify that no practice she has audited has understood how to correctly apply for and/or use NPI numbers and that training on the correct use of these number is rare, even for medical billers.

7. Horizon did not point to errors related to NPI number placement in its audit of AIM and Dr. Gardner in 2012. 

8. Instead, Horizon withheld payments to AIM shortly after submitting its audit results to Defendants.

9. Without giving AIM a chance to correct its billing errors, BCBS violated Defendants rights under New Jersey law: https://law.justia.com/codes/new-jersey/2009/title-17/section-17-29b/17-29b-4

10. Had BCBS gone back into AIM’s practice, it would have found that AIM purchased an electronic system to better tie patients notes to patient visits after the Horizon audit pointed out this weakness.

11. This action proves that Defendants took BCBS’s audit seriously and tried to comply with Horizon’s best practices.

12. However, BCBS quit paying claims after its audit and seems to have assumed that Defendants were committing fraud instead.

13. BCBS’s presumption of Defendants’ violation of the Fraud and Abuse Act under HIPPA law has financially damaged Defendants.

14. BCBS also seems to have attempted to damage Defendants reputation with patients by contacting them and intimating Defendant’s were involved in providing illegal treatments.

15. BCBS did not ask these patients if they were helped by Defendants’ treatments.

16. In fact, over the past 15 years, no patients have never complained of the care they received from Defendants and most will be willing to testify that the care they received from Defendants was superior to the care they receive from conventionally trained doctors.

17. BCBS claims that it does not cover Alternative Medicine. 

18. In fact, BCBS’s statement violates Section 2706 of the Affordable Care Act.

These important issues will not be heard by the court without sufficient funding.  The case of BCBS vs Jonuzi et al can set a powerful precedent supporting natural therapies... if you help by giving generously!

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Ralph Fucetola posted a new update:
16 days ago

Update #3

Just posted this at the Institute web site.

Our first Crowdfunding project involves pending litigation that can construe the Affordable Care Act to forbid insurance carrier discrimination against holistic and integrative practitioners, permitting proper insurance coding for such therapies, and, from the standpoint of the Mission of the Institute, facilitating retrospective research into holistic and integrative modalities (through coding statistics.

Read more here: http://www.inhere.org/2018/11/06/making-health-insurers-follow-the-rules/

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Ralph Fucetola posted a new update:
23 days ago

Update #2

We are having a great early response to this crowdfunding effort! Our article about it has been posted at:

www.RumorMillNews.com
www.OpenSourceTruth.com'
www.BolenReport.com

You can read it here:

http://www.opensourcetruth.com/stop-insurer-attacks-on-holistic-and-integrative-therapies/

And please, please, please share this Fundly link with everyone! https://fundly.com/support-natural-therapies

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Ralph Fucetola posted a new update:
about 1 month ago

Update #1

Thanks for our first donation! Thanks to The Bolen Report for posting this article: http://bolenreport.com/we-need-to-get-real-health-care-paid-for/

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