A Special Message to Patients of Naturopathic Doctors

  • Does your insurance plan not cover NDs?
  • Does it have an annual cap of $1,000, $1,500 or some other amount on services of all “alternative care providers?”
  • Do labs ordered by your ND apply to your annual cap?
  • Did you have to purchase more expensive insurance in order to get better coverage of your ND?

 

If you answered yes to any of these questions, your insurance plan may be operating illegally, and we need your help to bring them into compliance with the law!

 

The Affordable Care Act (ACA) contains a provision called “Section 2706 – Provider Non-Discrimination.” Insurance plans issued on or after January 1, 2014 are now prohibited from discriminating against providers like naturopathic physicians (and acupuncurists, chiropractors, etc) in either coverage in your plan benefits, or participation as an “in-network” provider.

 

If you are seeing your ND for a service or condition that your insurer would ordinarily cover if you were to see an MD or other provider, than your insurer must by law also now cover your ND – at a minimum as an out-of-network provider. This applies to ALL PLANS except for medicare.

 

What You Can Do TODAY to Help Bring Insurers Into Compliance!

 

Oregon’s Insurance Commissioner has requested that we file formal complaints any time a patient or doctor identifies a plan or insurer that seems to be discriminating against naturopathic doctors.

 

  1. File complaints at www.cbs.state.or.us/ins/consumer/tomake.html or call 1-888-877-4894 and select the Life & Health option
    1. Detail how your plan covers (or doesn’t) your naturopathic doctor with different limitations, restrictions, or caps than other doctors
    2. State that Section 2706 of the ACA prohibits this kind of provider discrimination
    3. Ask the Commissioner to ENFORCE THE LAW

 

Examples of discrimination might be (select any of the following or write in your own):

  • Not covering ND services at all, even as an out-of-network provider.
  • Applying a $1,000 or other annual cap for services that are identical to those of other providers not subject to this cap.
  • Applying labs and diagnostic imaging against a different “alternative care” cap instead of applying it to the plan’s normal deductible.
  • Refusing to pay for a pharmaceutical, lab, or diagnostic imaging where it would be covered when done by another provider.
  • Not covering mandated routine preventive screenings like mammograms, etc.
  • ND is in-network with insurer but some plans offered by insurer deny coverage of services by ND (i.e., you can see an ND in the Silver plan, but not the Bronze plan).
  • Reimbursement rates for same quality and performance of services done by an ND are substantially different for ND than for other providers.

 

  1. Go to http://www.CoverMyND.org to send a message to the Governor to ENFORCE THE LAW