Oregon Association Of Naturopathic Physicians Newsletter

Notes From The Office

Extremely Urgent Alert: Your OHP Open Card patients may be denied access to care by NDs
by: Laura Farr l Executive Director, OANP

November 1st will be a big day for thousands of OHP Open Card patients. It isthe day that they will be enrolled in the new CCOs. It may also be the day thatthey lose access to their naturopathic physician.
Currently, Open Card patients may see an ND for primary care. Those NDs are credentialed by DMAP (in the Oregon Health Authority) as eligible providers.When the Open Card patients get transferred to the CCO, if you are not credentialed with the CCO, you will no longer be able to bill OHP/DMAP for your services. However, none of the 13 operational CCOs have begun credentialing Naturopathic Doctors as of this writing.
Needless to say, for many patients, this will be a tremendously and needlessly traumatic transition.
What OANP is doing:
1. We have requested the OHA convene a meeting with the CCOs and representatives of our profession to immediately work through any credentialing questions that may be preventing them from credentialing NDs. 

2. We have requested that the OHA consider allowing Open Card patients who see NDs to remain on the Open Card until continuity of care has been addressed.

3. We are ramping up to do a grassroots and media campaign to educate the public on these barriers to care within CCOs despite the efforts of the legislature to prevent such barriers.

What you can do: 
1. Go to our advocacy page to contact your regional CCO to ask how you can get credentialed in order to to ensure patient continuity of care. If they will not credential you, ask if patients can access you as an out-of-network provider or specialist.

2. DOCUMENT every conversation, email, and response you get from the CCO. They may refuse to credential you. They may not respond to you.We may be pleasantly surprised in some cases. But we need good information to coordinate our efforts to address this situation, and to inform our long-term legal strategy. Please send us that documentation!

3. Communicate what’s happening with your patients. OANP will be providing you with patient handout materials so your patients can understand how this situation will impact their access to care.
This is a time to move into action! Nothing is more important in the next month than making sure that the patients who choose a naturopathic primary care provider do not slip down the cracks of healthcare transformation!
... ..

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.. Community News

Oregon Health Authority looking for Naturopathic Physicians to join the State Emergency Registry of Volunteers.
by: Adam Briggs l Membership Manager, OANP
Dr. Eric Gebbie, of the Oregon Health Authority, is calling on Naturopathic Physicians to join the State Emergency Registry of Volunteers in Oregon. Known as SERV-OR, this program is run by the Oregon Health Authority. It is a great avenue for licensed healthcare professionals who may want to volunteer their services to help those in need during community disasters and public health emergencies.
September is National Preparedness Month, and Eric Gebbie is specifically reaching out to the ND community, because there are currently less than 10 NDs registered with SERV-OR. Gebbie emphasized that NDs "...have important skills, credentials and compassion that could be of great service to people affected by disasters."
For more information on SERV-OR, visit their website at SERV-OR.org.
Member Alert - Avoid Scams from the "Ashford Network"
by: Adam Briggs l Membership Manager, OANP
A company calling itself the Ashford Network has been approaching NDs via email and phone, and offering them a chance to do an interview on their podcast. The main issue with their offer is that they charge a fee of $2,500 to be on a podcast that does not have anywhere close to a substantial following. If you hear anything from them, do not agree to it, and please be wary of anyone soliciting advertising.
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Member & Supporter News
Multnomah Family Care Center recently credentialed as a Tier 3 Patient Centered Primary Care Home (PCPCH)
by: Dr. Sara Love l OANP Member

Sara Love, ND and Kirsten Carr, MD of Multnomah Family Care Center were recently honored with Tier 3 status as a Patient Centered Primary Care Home (PCPCH). The PCPCH is a part of the Oregon Health Authority and has the goal of seeing that patients in Oregon are established in primary care homes and treated according to standards set by the PCPCH committee on which OANP Board Member Dr. Carrie Baldwin-Sayre serves. The primary care home model emphasized preventive medicine and PCPCH clinics are paid monthly per qualified patient with incentives for keeping patients out of emergency rooms and surgery.
The PCPCH model is excellent for naturopathic doctors who wish to practice primary care medicine in Oregon. It allows us to truly use our medicine in a way that we were trained. Click here for more information about PCPCH.
Billing Medicare Update
By: Adam Briggs l Membership Manager OANP

In our May 2012 Newsletter, we highlighted how patients that have secondary insurance in addition to Medicare may have the possibility to bill naturopathic services to their secondary insurance. After that article was published, the process for getting a Medicare denial letter has changed.

Under the new process, the patient must fill out this form (with assistance from their ND), and send it with a HCVA to Medicare, Medicare will then send an EOB denying coverage. This EOB is then sent to the secondary insurance with a new HCVA billed to their secondary insurance. It is important to make sure the patient's secondary insurance offers coverage for NDs before beginning this process.

OANP Supporting Representative Tina Kotek

By: Carrie Baldwin-Sayre, ND

On Wednesday, September 26, the OANP was thrilled to host a fundraising reception for Tina Kotek, Oregon House Representative from District 44 (N/NE Portland). This was the first political fundraiser OANP has hosted in more than 20 years, and we were thrilled to actually have more people attend than even RSVP'd! The result? More than $4,000 in donations to Representative Kotek's campaign, and a strong showing of thanks for the support that Representative Kotek has given naturopathic medicine. 

As you may know, Representative Kotek was instrumental in winning the battle to expand the ND formulary (HB 327), and she fought hard for our inclusion in the primary care workforce. In 2010, she successfully championed for inclusion of NDs in the primary care loan repayment program (HB 3639), and she was a champion for inserting the non-discrimination language in the bill to authorize creation of the Coordinated Care Organizations in 2012. She works tirelessly behind the scenes, in those closed-door meetings where the public has no voice. 

Thank you again to everyone who came to the reception, and to all of you who donated. It was an excellent opportunity to share stories with Tina of how NDs help patients, and of the difficulties and barriers our patients experience with insurance barriers to naturopathic medicine. It was very clear that Representative Kotek not only understands our issues, but will continue to be a voice for naturopathic medicine in the future!


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Integrative Therapeutics

.. Continuing Education & Community Events
OANP 2012 Pharmacy and Ethics Seminar
December1-2, Waterfront Marriott, Portland, OR

This event offers 10 hours of pharmacy and 2 hours of ethics CE. Any CE obtained in December but not needed for license renewal in that year may be carried over to the next year's renewal. Pharmacy & ethics CE not needed for those requirements may also be used as General CE.
Systemic Enzyme Therapy: The Next Frontier in Healthy Aging and Inflammation Complimentary Seroyal Webinar – 1.5 hrs
Thursday, October 11, 2012 8:00 PM – 9:30 PM EST | 5:00 PM – 6:30 PM PST r

Systemic Enzyme Therapy was for a long time regarded as a purely empirical treatment method. Due to the rapid development of immunology, biochemistry and molecular biology, Systemic Enzyme Therapy (SET) has undergone significant developments. It has been shown that behind the empirically supported clinical results are a complex set of regulatory processes, which previously were unknown. Today, scientists have a better understanding with respect to mechanisms by which SET, long considered Europe’s natural alternative to pharmaceutical NSAID’s, achieves superior clinical results for pain, acute and chronic inflammation, and immune support. 
Enzymes play a critical role in the body and are involved in a tremendous number of metabolic processes. Scientists suspect there may be as many as 15,000 enzymes at work in our bodies on a daily basis. System Enzyme Therapy is one of the most studied natural therapies in history, and long considered a traditional mainstay in physician treatment programs across Central and Eastern Europe.
Chronic (silent) inflammation is increasingly being viewed as the central mediator of disease progression and/or in the manifestation of symptoms in diseases as varied as cardiovascular and autoimmune diseases, chronic fatigue and chronic pain syndromes, metabolic syndrome and more. Resolution of the chronic inflammatory condition lies at the heart of all attempts to treat and prevent these diseases. Please join Dr. Miller to learn more.

Integrative Approaches to Pediatrics
October 26-28, 2012 Institute of Women’s Health an Integrative Medicine Portland, OR

Come join us for a fabulous 2.5 days of lectures by experts in pediatrics, pediatric endocrinologyand natural medicines. CME hours: Total of 15.25 hours with 13.0 hours of general CME and 3.25 hours of pharmacy.
Topics include:
-What’s new in the Pediatric Literature
-Pediatric Allergies: Holistic management beyond gluten and dairy elimination
-Autism spectrum disorders- an integrative approach
-Top 5 problems in Pediatric Endocrinology
-Type 1 Diabetes in children
-Endocrinology and Integrative Solutions
-Vulvo-vaginal disorders in young girls
-Principles of Parenting Interventions
-Omega-3s and Child development and behaviors
-Botanical medicines and protocols in a Pediatric Practice
-Urgent care issues in Pediatrics
-Clinical Pearls from a Naturopathic Pediatric Practice
Featured Speakers: Mary Bove, N.D., Tamara Cullen, N.D., Matthew Baral, N.D. ,Aimee Shunney,N.D., Alena Guggenheim, M.D., Karin Selva, M.D., Aarin Benson, N.D.and Tori Hudson, N.D.
Orthopedic Study Group of Naturopathic Physicians Presents: An Interactive Shoulder (& More) Workshop with Tom Ravin, MD
Saturday, October 6th 8:00 - 3:30 (registration at 7:30) Oxford Suites Hotel Gladstone, OR

Topics to Include: Shoulder Anatomy, History, Referred Pain Patterns, Physical Exam, Landmark Palpation, Injection Models. Highlights of the Anterior Knee, Interosseous Membrane, Ankle and Foot. Special Topics: Tendinosis and Biotensegrity Proliferants. To Register, contact Dr. Joanne Gordon drgordon@naturalhw.com or 503-722-7776
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.. Legislative Updates

In Focus and In the News
by: Laura Farr | Executive Director, OANP 

OANP is single-mindedly focused on getting CCOs to recognize naturopathic doctors in order to provide continuity of care to patients currently seeing NDs, and access to care for patients who may not currently have it.

Baby steps are how you learn to walk…

While we have a seriously urgent problem with the transition of Open Card patients into the CCOs, we are also seeing some glimmers of progress.

· Trillium CCO is in on-going conversations with the Lane County NDs about how NDs can work within the CCO

· Oregon’s Health CO-OP – a new insurance carrier which is accountable to members (aka, the public) – has heard the public demand and is interested in working with OANP to figure out how to provide patients with access to naturopathic physicians.

· CCOs have been told by the Oregon Health Authority that they need to figure out how to comply with the non-discrimination language. That doesn’t seem like a big deal, but it’s progress.

· FamilyCare, Inc has agreed to credential Multnomah Family Care Center, an integrated clinic with MDs and NDs. For now, they say that they will only credential NDs who work alongside MDs. Baby steps…

In the News:

The media is starting to pick up on public demand for naturopathic medicine and the lack of response from CCO’s in providing access to care for those people who prefer to see a naturopathic doctor.

Executive Director Laura Culberson Farr was quoted in two recent articles explaining how some Oregon Health Plan patients will needlessly be losing access to their primary care provider in this transition to Coordinated Care Organizations.

Bloomberg BNA – is an industry journal read by health industry executives, attorneys, Congressional staff in DC, etc.

The Lund Report – is Oregon’s most widely-read health industry journal. 
Stay tuned, pay attention, and check back frequently on OANP's Advocacy Page.

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US Biotek

News-bytes & Classified Ads

2 NDs for Hire
I am looking to hire an ND for both the Bend and Redmond clinics. The position could be part time (1-2 days/ week) and only for a short interim as I look for someone full time. The short term part time position would be on a contractual basis while the full time position will be a salaried position with benefits. If you or anyone you know might be interested please contact me, Payson Flattery, ND, at paysonflattery@gmail.com
Medical Office for Lease in West Linn, OR
Exam rooms, 1460 sq ft. 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.
Career Opportunity for ND, ND/LAc
Dr. Noel Peterson is looking for an associate to join our practice at The Center for Traditional Medicine,PC, in Lake Oswego, Oregon. We are seeking to employ an experienced practitioner with passion, charisma, a strong work ethic, and commitment. Newly renovated and stunningly beautiful., our 4000 SF clinic is located on the Willamette River, in downtown Lake Oswego. Since 1978, CTM has excelled as a multi-discipline natural medical team dedicated to empowering our clients to create optimal health through education, inspiration, and natural therapy. We are fully staffed and excel in customer service.
Requirements: Oregon license, motivated and experienced in naturopathic and alternative cancer therapy, patient care and management, entrepreneur's spirit, affinity to Oregon, finds humor in and/or opportunity in everything she/he experiences.
For more information, Contact Noel Peterson ND, DAAPM noelpeterson1@comcast.net  www.MyCTM.org


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Lloyd Center Pharmacy

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.. Clinical Research & Practice Information

How to Bill Like a Lawyer - Coding tips and other techniques to get paid for your time
by: Shirley Grace | Physicianspractice.com 
Last week you examined a patient and took a history. After ruling out this or that, you began to suspect the worst. So you sent him off for the appropriate tests. The qualifications fit for a 99213, so that’s how you coded the visit. Today, the results are back: cancer. The patient returns and you relay the bad news. It’s a difficult visit. Lots of listening to someone whose body has let him down. You support your patient, impart critical information, reassure him that there’s hope, and discuss treatment options. Several members of the patient’s family are there, too, and they have questions. You spend 45 minutes on this counseling.How on earth do you code that? You performed no physical exam. You took no additional history. You made no medical decisions. These are, of course, the base criteria for E&M coding; more or less activity in each category can bump the code up or down a notch. But what you did for this patient has real value — and it took more of your time than most visits. Lawyers charge by the hour. Why can’t you? Or can you? Yes you can, sometimes...

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

Laura Farr, Executive Director

Membership Coordinator