Weighing In on Section 2706
Mike Jawer, AANP Director of Government & Public Affairs
Monday, June 16, 2014
by: Mike Jawer, AANP Director of Government & Public Affairs

Section: State and Federal Advocacy

Last week, AANP submitted comments to the US Department of Health and Human Services (HHS) concerning the intent and implementation of Section 2706, the nondiscrimination provision of the Affordable Care Act. Nine state associations – Arizona, California, DC, Hawaii, Maine, Minnesota, Oregon, Vermont, and Washington – also crafted and delivered their own comments to HHS. Together, we have provided extensive documentation of how the statute is not being followed, and reinforced our collective ‘ask’ that HHS revoke its existing guidance and publish clearer guidance that is faithful to congressional intent.
AANP’s comments are available for viewing in the State Advocacy Toolbox. If you would like to peruse any of the more than 700 comments that were submitted to HHS, click here.
In a nutshell, AANP’s comments:
  • Conveyed how NDs, as primary care physicians, perform many services defined as Essential Health Benefits in the Affordable Care Act.
  • Highlighted congressional and White House statements as well as a Circuit Court of Appeals case, all of which support the non-discrimination aims of Section 2706.
  • Explained that implementing Section 2706 consistent with legislative intent will not require insurers to cover any new services.
  • Provided examples of the statute’s inconsistent implementation in the states in which NDs are licensed as well as among different insurers within the same state.
  • Urged that HHS revoke its previously-issued problematic guidance and publish new guidance ensuring that the plain intent of Section 2706 is followed and that insurers do not discriminate against NDs in the states in which NDs are licensed. “Without such action,” AANP wrote, “private health insurers will continue the very types of discriminatory practices that the law aims to prevent.”

Since it will undoubtedly be many months before HHS decides on next steps, AANP and its 2706 Team have next steps of our own in the works. Materials are being prepared to help state associations approach insurers who are not complying with Section 2706. Additionally, the CoverMyND website is being retooled as a one-stop shop to enable patients to file complaints with their state insurance authority when ND services are not being covered in-network, or when those services are covered but in a way that discriminates against NDs versus MDs or DOs.
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