OANP Advocacy Moves Beyond Legislature
Monday, August 19, 2013
Posted by: Brook Schales
OANP Advocacy Moves
Phil Donovan and Ryan Fisher | NW Public Affairs
The OANP’s strategy to expanding insurance coverage of NDs has
been guided by a plan to ensure naturopathic physicians can treat:
Oregon’s Medicaid population,
Oregon’s public employee population, and ultimately
All Oregonians covered by private medical
With implementation of the Coordinated Care Organizations
last year, and the Affordable Care Act going into effect January 1, 2014, most
of OANP’s advocacy work is no longer in the legislative arena working to pass
laws. OANP, AANP and our coalition partners already successfully secured
provider non-discrimination language in relevant legislation.
Now our work turns to implementation and enforcement –
making sure that the details are done right, that agencies and insurers are
educated about the laws, and that appropriate action is taken if
and when the laws are broken.
So where are we on these fronts?
1) Oregon’s Medicaid
providers: Coordinated Care Organizations (CCOs)
Dr. Bruce Goldberg, director of the Oregon Health Authority
(OHA), has convened an Integrative Medicine committee to look at how different
types of providers can work with the Medicaid population. Doctors Sara Love,
Stephanie Kaplan and Carrie Baldwin-Sayre will be representing the OANP at this
roundtable to bring together providers with CCO leadership.
The OANP also continues our outreach efforts to local CCOs.
We are working with legislative champions such as Speaker Tina Kotek (D-North
Portland), Senator Chip Shields (D-North Portland) and Representative John
Lively (D-Springfield) to engage CCOs and encourage their credentialing of
naturopathic physicians to address the shortage of primary care physicians.
CareOregon – representing 4 CCOs in Portland, Yamhill and Jackson counties, and
the North Coast, has started credentialing NDs as PCPs. Trillium CCO in Lane
county has started accepting applications from NDs as specialists.
2) Public Employees
and the Public Employees Benefit Board (PEBB)
PEBB is putting out a request for proposals (RFP) to
contract with a new health insurance company for all public employees beginning
in 2015. The contract is currently held by Providence. To gain insight for the
RFP, the PEBB board surveyed its members to understand what improvements they
would like to see to the plan. OANP helped mobilize public employee patients of
NDs, who submitted comments across Oregon to the PEBB survey.
PEBB’s summary report of the survey holds several references that members
across Oregon "expressed a strong need for more alternative care coverage”
including access to doctors like NDs as primary care providers, and removal of
the current annual cap on all types of providers.
The OANP has met with members of the PEBB Board to highlight
that access to providers is an important component of the next PEBB contract
and that the Affordable Care Act (ACA) contains a non-discrimination clause
that the existing Providence contract would violate. A first draft of the RFP
contains a "network” provision and discussion about inclusion of "alternative
The OANP has also participated in Allies for Healthy Oregon
(AHO). This has put naturopathic physicians and public employee unions at a
common table. We are using this opportunity to grow our relationship with the
unions that want their members to receive care from the provider of their
3) Private Insurance
OANP has met several times with Oregon’s Insurance Division
to educate them about the provider non-discrimination provision in the
Affordable Care Act - referred to as "Section 2706.” Beginning January 1, 2014,
the ACA prohibits discrimination against a provider based on the type of provider
when the provider delivers covered services within the scope of their license.
The Oregon Insurance Commissioner disseminated strong clarifying language to
all insurers that they may not cover something when it’s done by one provider
if they won’t cover it for another provider. The Division also issued a "data
call” to understand how insurance companies will implement Section 2706 in
order to develop a useful implementation/enforcement plan.
Under Oregon law, insurance companies are required to
respond to the data call. We anticipate hard data from the Insurance Division in
the coming weeks.
Defending the ground we’ve gained:
While we try to maintain our focus on our priorities, other
issues invariably crop up each session, including:
The association representing acupuncturists introduced a
very broad "dry needling” bill that would have rescinded some treatment modalities
that have been available to naturopathic physicians for decades. The bill
attracted the opposition of a variety of health professions, and as a result of
our comments and theirs, the bill died in committee.
Student Loan Repayment
In 2011, the OANP changed the Oregon primary care loan
repayment program to include naturopathic physicians. This year, $4 million of
federal government dollars were allocated for loan repayment, but limitations
were placed on those funds by the federal agency that oversees those dollars.
The Center for Medicare and Medicaid Services (CMS) excluded naturopathic
physicians (and others) from a "prioritized list” of providers that the funds
can go to. While not technically being "ineligible,” NDs are so far down on the
prioritized list of eligible providers that effectively no ND would ever
qualify. We will be working to address this inequity in the upcoming year.
Your membership supports this kind of round the clock
advocacy work – and there is always more we can do! If you know of a friend who
isn’t an OANP member, help us continue this work by recruiting them to join