May
2012

Oregon Association Of Naturopathic Physicians Newsletter


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Notes From The Office

Implementation of Coordinated Care Organizations Begins
by: Laura Farr l Executive Director, OANP


While the bill that includes non-discrimination language has passed the Legislature, the hard work has only yet begun! CCOs are scheduled to "be operational” by August 1, 2012. That means they’re scrambling as we speak to try to hammer out what "operational” means.
 
As I mentioned in many of my testimonies, the non-discrimination language is only a floor that sets a level of expectation that CCOs will use all licensed providers. But it does NOT mean that all CCOs will simply "open the door” to naturopathic physicians overnight.
 
Some entities creating CCOs will likely flaunt the non-discrimination language, drag their feet, or do the minimum to adhere to the letter of the law.
 
Some CCOs want to do the right thing and understand that the state needs all available providers, but are struggling with how to integrate entire professions that have historically been "on the outside.”

CCOs are decentralizing healthcare
 
Or to put it another way, the CCO model is "giving power (and money) directly into the hands of the communities who know what they need.”
 
Each CCO will have the discretion to decide what, how, and with whom it will network.
 
That means that we need to meet with each prospective CCO to convince them to include NDs – which means we need help from all of you!
 
OANP has been meeting with "anyone who will listen” in the tri-county area about the benefits of including naturopathic physicians, and we’ve been working with the Oregon Health Authority, the Governor’s office, and Oregon’s Congressional Delegation to remove some remaining barriers to NDs getting credentialed by CCOs.
 
We’d also like to thank our Eugene members for all the work they’re doing reaching out to the entities creating a Lane County CCO.
 
We’d also like to reach out to any other region that would like help networking with your local CCO. I can’t be everywhere around the state and at every meeting, but OANP can definitely provide you with ideas of who to contact, what to say, materials to share, and power points to present. Please contact me (laura@oanp.org) if you would like OANP to come talk to a group of your local doctors about all of these changes.
 
 



OANP Legislative Committee member Stephanie Kaplan, ND and Executive Director Laura Farr attend bill-signing with Governor Kitzhaber heralding non-discrimination language in CCO bill.





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.. Community News


OANP Needs Your Input to Help NDs Get the most out of Contracts and Rental Spaces
by: Adam Briggs l Membership Manager, OANP
 
This year, OANP Executive Director Laura Farr set out to determine what the "industry standard" is for contract terms within the ND community. She quickly realized that the contracts NDs negotiate with landlords or private MD, ND, or DC clinics vary widely. To make sure we are capturing a large enough sample size to truly reflect the market, OANP has decided to gather more information, and that is where you come in.
 
We are calling on NDs in Oregon to share with us the basic terms of of your contracts at your practice. We are looking for information like:
    • Is your contract flat rent, commission-based, or salaried
    • What facilities and services are included in your contract, for example - do you get a private office or shared, is billing and collections covered or extra, is malpractice and liability covered, do you have access to any support staff, etc.
    • Is a medicinary part of your contract and who manages it?
No project like this has been undertaken, but it is something that will allow for NDs to have a better idea of what to expect when starting or moving a practice, or simply when renegotiating an existing contract. Please take a few seconds just to email this information to me at membership@oanp.org.
 
And please also know that all contract terms shared will be kept completely confidential!
Thank you for your support!
 

Medicare Billing for NDs
by: Laura Farr l Executive Director, OANP
Patients increasingly are choosing naturopathic physicians for their primary care, and most local insurance companies cover naturopathic medicine to some degree. Some national and federal insurers, however, still do not cover naturopathic medicine, in large part because naturopathic doctors are not yet licensed in all 50 states.
 
Medicare does not cover or pay for services provided by a naturopathic doctor. However, some Medicare members MAY have secondary insurance that DOES cover your services, and the trick is to get the claim past Medicare so that it can be processed by the secondary.
 
To do this, Noridian Administrative Services, which processes claims for Medicare, recommends either requesting a "For Denial Letter” or a letter such as this one providing evidence that Medicare does not cover these services.
 
Providers can submit a copy of these letters along with the claim to a secondary insurance company (for example TriCare), which may cover naturopathic medicine.
 
For private insurers that do not cover naturopathic medicine, we recommend that the patient contact their Human Resources Department directly to request that they add coverage for naturopathic medicine in subsequent contract renewals.
 
For patients who are dually eligible for Medicare and Medicaid, providers should submit a DMAP505 HCFA form available from the state of Oregon here, along with a denial letter from medicare in order to bill the Oregon Health Plan as a secondary insurer. You will, of course, need to be credentialed as an OHP provider with the state of Oregon in order to do this.
 
It is our commitment to ensure that all patients have the ability to see the provider of their choice. If you have any questions about insurance coverage of naturopathic medicine, please don’t hesitate to contact us.
 
 
 
 
 
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Member & Supporter News

OANP Member Dr. Pamela Jeanne to release her new book "Healing Matters: Celebrating Women's Innate Healing Nature" later this Month.
by: Adam Briggsl Membership Manager, OANP

Dr. Jeanne, a long time member of and leader in the OANP, and practicing ND at Natural Medicine Works in Portland, released her first book "Healing Matters: Celebrating Women's Innate Healing Nature" on May 12th. In the book Dr. Jeanne focuses on a question she has been asking since medical school: "Why don’t we know the names, Hildegard of Bingen, Agnodice, and Trota of Salerno, as readily as we know the name, Hippocrates?" Dr. Jeanne takes on this question by examining the lack of feminine (or yin) energy in conventional healing. Jeanne traces the history of ‘yin’ medicine through the spiderwebs of the time, showing how women’s contributions have been hidden, erased, or repackaged to appear as if women had no place in the evolution of healing.
 
Jeanne shows that what we now call conventional medicine had its birthplace on the battlefield and that care is still commonly administered as if we are treating young, male, injured soldiers. Giving insights on how to view the history of women in medicine, plus solutions for restoring balance in the individual and the western healthcare system, Pamela Jeanne incorporates first-person narratives from the 21st century into each chapter, noting the growth of balance, offering ideas to own, and honoring women’s healing qualities. The book suggests the beginning of a new way to heal.
 
Dr. Jeanne's book is available now. Check out this link to buy it online.
 
 
Community Supporter Spotlight: Denise Burnham and Creative Compounds Pharmacy
By: Bridghid McMonagle l Board Member, OANP

Creative Compounds is a full service compounding pharmacy that has served the Pacific Northwest for over 14 years. With a state of the art compounding facility they formulate both sterile and non-sterile compounded medications to meet every patients’ needs.

Owner Denise Burnham, RPh, has extensive experience and background in research, patient care and consultations. The pharmacy specializes in therapies for hormone replacement, pain management, autism, weight management, pediatric patients and parenteral therapies. Creative Compounds has been PCAB (pharmacy compounding accreditation board) accredited since August 2010, furthering excellence in production, service, and quality standards.

As a PCAB accredited pharmacy, Creative Compounds has been deemed by an outside authority that a full quality assurance program and scientific methodology is used for every product. This process includes random potency and stability testing conducted by an independent lab. Creative Compounds is the only pharmacy in the Portland area that utilizes this rigorous program to insure the highest quality products for your patients. In addition to offering outstanding customer service with custom packaging and flavorings, Creative Compounds offers education outreach to patients and practitioners and the convenience of free mailing.

It has been wonderful working with Creative Compounds. I continually have patients tell me they have wonderful customer service and are very helpful. Their prices are competitive and they are happy to answer my questions. I highly recommend them as a compounding pharmacy.

 

OANP Member Kelly Marie Fitzpatrick, ND Appointed to CCO Rules Advisory Committee
By: Laura Farr l Executive Director, OANP

We are thrilled to report that one of our own has been appointed to the Rules Advisory Committee for the newly forming Coordinated Care Organizations. The "RAC" will be advising Oregon Health Authority staff on what kind of detail needs to be put into administrative rule to help clarify the law recently passed which autorizes creation of Coordinated Care Organizations for the Oregon Health Plan.

As the non-discrimination language that OANP helped pass is included in this rules process, her position as a advisory committee member will help us enormously in making sure that CCOs have clear parameters and expectations on how to include naturopathic physicians in the new system.

Of course, her seat is one of many at a table with many voices. But please congratulate Dr. Fitzpatrick and thank her profusely for the time she is committing to helping in this critical next step of the process!



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.. Continuing Education & Community Events

Tri-County Medicaid Collaborative Public Meetings
Washington County:
Monday May 14th 6-8 pm
Location: Public Services Building Auditorium, 115 N. 1st Ave. Hillsboro, Oregon 97124

Clackamas County:
Tuesday May 22nd 6-8 pm
Location: Clackamas Community College, Gregory Forum, 19600 Molalla Avenue, Oregon City, Oregon 97045
 
Both events are free and open to all members of the public.The collaborative is a unique, community-wide partnership to form a coordinated care organization to provide cost-effective, quality care for people on the Oregon Health Plan/Medicaid. In these meetings, the CCO will update you on their efforts to form a CCO serving the Clackamas, Washington and Multnomah County region. RSVPs are appreciated. If you are unable to attend, additional educational public meetings are being scheduled.
 
RSVP to: Sandra@tricountycollaborative.org or 503-416-8064

2012 NW Naturopathic Physicians Convention
May 17-20, 2012 (24 CE credits for Oregon, Washington, BC and California)
Info/Register: www.nwnpc.com
 
OANP Members Meeting
May 22, 2012 6:30-9 pm (2 CE Credits)
Dysfunction Junction: What’s the disruption? Clinical presentations of hormone imbalance with Sarah Wood, ND
Whether it's a woman presenting to your office with symptoms of menopause, an aging male experiencing symptoms of hormonal decline or a young woman seeking your expertise for addressing polycystic ovarian syndrome; supporting individuals suffering from hormonal imbalance is common practice. Successful treatment outcomes hinge on a firm understanding of the etiologies and contributing factors of hormone imbalance as well as adjunctive concepts and concerns surrounding imbalance. Join us as we take a clinical approach to hormone imbalance, delving into common hormonal presentations, key concepts pertaining to them, treatment considerations and case studies.
Info/Register: www.oanp.org
 
OANP Insulin Intensive Seminar
June 9-10, 2012 8 am-6 pm (17.25 hour CE total, 15 hours of pharmacy and 2.25 hours of general)
Saturday Sunday
7:30 Registration
7:30 Registration
8:00 History & Resources of Insulin
8:00 Alkaline Treatment of Type 1 Diabetes
8:40 Basics of Insulin Knowledge
8:45 Basal/Bolus Dosing of all Diabetes
9:30 Starting a Patient on Insulin
10:45 Break
10:00 Break
11:00 Diabetic Challenges
10:15 Different Insulins
11:45 Lunch
11:00 Insulin Basic Tools
12:45 Diabetic Keto Acidosis/HHS
12:00 Lunch 1:30 Treating Hypoglycemia
1:00 Insulin Accessories
2:15 The Sick Patient on Insulin
1:20 How to Inject Insulin
2:45 Break
1:40 How to Discuss Insulin with Patients
3:00 Exercise, Diabetes and Insulin
2:15 Break
3:30 Traveling and Insulin
2:30 Pumps and CGMS
4:00 Gestational Diabetes
3:15 Basal Dosing - DM2/LADA/T1DM
4:45 Break
4:15 Break
5:00 Pediatric Patient Insulin Issues
4:30 Emotional Aspects of Insulin Dependency
6:00 End
6:00 End

NCNM Annex
2719 SW Kelly Ave.Portland, Oregon 97201
Info/Register: www.oanp.org

OANP Member Meeting
June 26, 2012 6:30-9 pm (2 CE Credits)
HIPAA Compliance with Dr. Chris Apgar
Info/Register: registration will begin after May meeting

 
 
 
 
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.. Legislative Updates

OANP Hits Capitol Hill
by: Carrie Baldwin-Sayre, ND, Legislative Chair, OANP

The AANP couldn’t have chosen a more opportune time to hold its annual DC-FLI lobby day! As Oregon has been one of the first states in the nation to undertake the major healthcare transformations encouraged by the Affordable Care Act, it was a perfect time for the OANP to hit the hill and ask our delegation to support inclusion of NDs in Oregon’s new Coordinated Care Organizations (CCOs). OANP board members Carrie Baldwin-Sayre, ND and Rebecca Principe, ND3 joined Executive Director Laura Farr, NCNM representatives Marnie Loomis, ND and Melanie Henriksen, ND, private practice physician Meredith McClanen, ND, and almost a dozen Oregon-based students during the 3 day event. In addition to our Oregon representation, almost 150 NDs and ND students were represented from all over the country.
 
A little background
In order to implement Oregon’s CCO model, the Oregon Health Authority had to ask the federal government for special waivers for how it can use Medicaid and Medicare funds. Because of the overwhelming public demand to include naturopathic physicians in CCOs, the OHA requested as part of the overall waiver to expand the definition of eligibility to include NDs and other licensed providers.

What were we asking for?
Oregon’s waiver request (not just our piece, but in its entirety) has not yet been approved, so we met with Representative Walden as well as staff from each of Oregon’s Congressional offices asking for their support of the waiver generally, and specifically to write a letter to make sure that the request to include naturopathic physicians is honored. In addition to our state-specific request, we also joined in on the AANP’s request for Congressional help in getting NDs included in national health programs administered by Health and Human Services and the VA Department. It was thrilling to be with so many passionate colleagues, to be building these important bridges with our federal delegation, and to see first-hand the awareness and support from our senators and representatives we have created over time. Coming to the DC-FLI is something I would encourage everyone to consider both to build the profession and to re-energize your own commitment to what we bring everyday to healthcare!
 

OANP Executive Director Laura Farr (left) and Legislative Chair
Carrie Baldwin-Sayre outside Senator Merkley's office.


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News-bytes & Classified Ads

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Exam rooms, 1460 sqft. Reception area with built-in desk. Close to other health care professionals. Upper class neighborhood. On-site parking. First year $1460 plus triple-net, 3 yr lease to start. Call 503-932-0885 for more information.

 



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.. Clinical Research & Practice Information


Exploring the Relationship Between Androgens and Insulin
by: Labrix Clinical Services

A CDC report from 2009 estimates that 34.4% of Americans meet the criteria for metabolic syndrome and this prevalence increases with age. There are some slightly varying criteria for diagnosing metabolic syndrome depending on who is defining it, although most organizations, including the World HealthOrganization and the International Diabetes Federation, agree that blood sugar dysregulation, elevated blood pressure, elevated triglyceride levels, low HDL and abdominal adiposity are the primary determining factors. Additionally, we often see elevated androgen hormones including DHEA and testosterone in female patients, along with the symptoms that correlate with increases in these hormones including increased facial and body hair and or scalp hair loss.






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Oregon Association of Naturopathic Physicians
PO Box 5876
Portland, OR 97228
phone (503) 262-8586

STAFF
Laura Farr, Executive Director
laura@oanp.org

Adam Briggs, Member & Supporter Coordinator
membership@oanp.org