The 2020 short legislative session is already halfway over, and bills that have not had a hearing and a vote to move forward at this point are dead. The list of bills the OANP legislative committee has been tracking (upwards to 17 different bills) has been culled by more than half.
Currently there are only two bills that have a direct effect on NDs:
HB 4102 is an Oregon Medical Association (OMA) effort that OANP has been participating with them on, including providing our endorsement. The bill puts limits and requirements on health insurers in the area of prior authorizations and in step therapy. Step therapy is the treatments you must have prescribed before an insurer will cover an expensive medication. A familiar example from diabetes is the patient often has to "fail" metformin and at least one other drug in combination before they will authorize an extremely expensive GLP-2 agonist. If a patient has "proved" their way to that prescription, they can expect coverage to continue as long as they continue to have the same insurance plan. Currently if the patient changes insurers or plan, the insurance commonly requires the patient to start over - prove yet again that metformin and another medication "fail" for this patient. It’s a complicated bill, and a project to understand it in detail. OANP and a coalition of other organizations have joined together with OMA on this issue for the benefit of our patients.
SB 1561 is a hemp bill that has language adding NDs to those who can prescribe medical marijuana. The OANP legislative committee is watching the bill to see what the outcome will be. In the current context it benefits patients who desire access to less expensive material produced by others. OBNM has no prohibition on NDs counseling patients in its medical use, that is our status quo. In discussion it has been mentioned that question of medical marijuana prescribing by NDs doesn't get interesting again until it is legal at the federal level, and the move is to allow NDs to dispense various formulations from their office aimed at indications like sleep and pain management. Otherwise people have more than adequate access.
In keeping with our mission, the OANP legislative committee is to protect and promote the success of all naturopathic physicians in Oregon.
OANPs is already working on laying the groundwork for our legislative priority in 2021, where we continue our efforts for health insurance pay parity. This will continue to be our top priority based on the long-term association strategic plan until we have achieved that law and it is being enforced by the state of Oregon. In the time between now and the 2021 session we are working to build connections to allies among other provider groups with great success. Seeking to be engaged with the non-elected state government advocating for both the role of NDs and the greater good of the state through participation in the many committees that are ongoing and formed for special issues. We are also working hard to meet with every legislator, and develop positive relationships with everyone at the State Capitol.
Behind the scenes OANP continues to work on health insurance credentialing issues to remove barriers between NDs and the patients that desire their care under Medicaid and in private insurance. We will continue to keep OANP members apprised on this issue, as we realize how many patients are being impacted. The legislative committee has been working hard on a strategic list of hurdles we will overcome, and we are always open to hearing your thoughts.
As mentioned at our 2018 annual member meeting, we can never let our guard down in the area of protecting our licenses and scope of practice. Over the years OANP has had to defend the right of the profession to exist at all. Jim Massey, Joel Wallach and other NDs famously drove to Salem to defend against the removal of all ND licenses under a sunset law. A more recent attempt some years back was to abolish OBNM and have NDs no longer licensed, but required to register alongside tattoo artists. The currently unlicensed states include states that used to license NDs but they lost their ND licensing law through hostile legislative efforts. The work to defend the profession is never done! We could always use your support.
If you are interested in getting involved in legislative advocacy, we could always use your help!
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