Section: State and Federal Advocacy
The Benefits of Advocacy
As Naturopathic Medicine Week approaches, it's appropriate not only to tout the benefits your patients receive from naturopathic care but to consider the benefits that your professional association - AANP - returns to you as we advocate on your behalf with states and before Congress and the federal agencies.
Section 2706: AANP Holds Call with Federal Regulators
AANP Letter Circulates in House of Representatives
NDs and Patients File a Section 2706 Lawsuit in Oregon
Advocacy Updates - June 23, 2015
Despite strenuous efforts, HB 6707 - the Connecticut bill to obtain prescriptive authority for NDs - ran out of time to be considered (though there's a small chance for the legislature to consider it in a special session).
Students, NDs Collaborate on VA Initiative
In tandem with AANPs effort to have the Veterans Health Administration assign an employment code to licensed NDs, a group of Bastyr University students has created a Facebook page dedicated to raising public awareness of the value of NDs serving veterans.
AANP Takes Part in FDA "Listening Session" on Compounded Medications
Dr. Michael Cronin, AANP Board member and Chairman of the Integrative Medicine Consortium, represented both organizations at an April 30 "listening session" held by the FDA for stakeholders concerned about its rules on compounded medications.
DC FLI Breaks New Ground on Capitol Hill
Naturopathic physicians and students took to Capitol Hill en masse the first Monday in May, pressing for NDs to be included in Medicare and for Congress to prompt the Veterans Health Administration to assign NDs an employment code so they can work systematically for the VA. One hundred and fifty NDs and students held meetings in 270 House and Senate offices, a 50% increase in the number of offices visited since last year. The enthusiasm was palpable, with these visits introducing naturopathic medicine, in many cases, to new offices and new staff members on Capitol Hill – many of whom were clearly receptive to our profession’s pitch.
AANP Awards "Congressional Champion" to Sen. Kelly Ayotte
Dr. Kasra Pournadeali, president of the AANP, made the presentation to Senator Ayotte, highlighting her cosponsorship of our Naturopathic Medicine Week Resolution last summer. The Senator's support was crucial to the bill's unanimous passage by the full Senate in the fall.
AANP Stands Up for Homeopathic Medicines
AANP Board member Amy Rothenberg, ND, DHANP, provided expert testimony at a recent FDA hearing intended to assess whether or not the agency should change its regulatory approach to homeopathic products. “AANP believes that FDA's current approach is working well," Dr. Rothenberg commented. “The low cost of these medicines, as well as the consistent quality of product, make them appealing to both physician and patient. Over decades of use, we have not found problems or variability with quality of the homeopathic product, and no toxicity has been reported."
A Confluence of Rivers
As any of you who have followed AANP news know by now, Massachusetts has been working diligently to accomplish licensure. Sometimes I imagine you think we’re unreasonably patient, or incompetent, or both! But I want to tell you a few points about this work that might make you smile, or might just have you pull out your credit card to make a donation!
FDA to Hold Hearing on Homeopathic Products
AANP plans to submit comments to the FDA in response to the agency's recently-announced hearing on the regulatory framework for homeopathic products. The hearing will take place April 20 and 21.
State Associations in the Thick of Legislative Action
Numerous state associations are pushing forward with their licensure or scope expansion bills or have achieved outright victories lately in their legislatures. Here’s a quick roundup of activity in more than a dozen states
Open Up Your Advocacy Toolbox
Resources are everything for an ND. For a small profession, it pays not to reinvent the wheel when others have developed the information, arguments and templates you can use.
Colorado NDs Seek Ability to Treat Children
After intensive work with Children’s Hospital and the Colorado chapter of the American Academy of Pediatrics, the Colorado Association of Naturopathic Doctors (CoAND) is moving forward with legislation to enable NDs to treat children under the age of two. Its bill has passed the General Assembly and awaits action in the Senate.
State Activity on Licensure and Scope Expansion
This year is shaping up to be an extremely active one for state associations’ advocacy efforts. Licensure bills have been or will be introduced in 11 states.
How AANP Is Supporting State Advocacy Efforts
AANP speaks out for the ND profession in a variety of ways – one example is by attesting to naturopathic physicians’ extensive education and how it is vastly different from the education of traditional naturopaths.
AANP Seeks Revision to Insurance Model Act
The National Association of State Insurance Commissioners (NAIC) is updating its Managed Care Plan Network Adequacy Model Act, which has not been revised in 18 years. Most of the written comments so far have come from state insurance departments and from associations representing physicians, pharmacists, and insurance companies.
ND Licensing Aligns with Healthy State Rankings
An annual health ranking of the 50 states shows that 8 of the top 10 states and 13 of the top 20 states are those in where NDs are licensed.
Making a Federal Case for 2706 Coverage
Patients of NDs who are Federal employees and are enrolled by either of two health insurance plans – GEHA (Government Employees Health Association) or FedBlue – should be able to have the covered services of their NDs reimbursed through these plans. AANP needs someone to test the waters!
Compounded Medications
AANP is part of a coalition of health professionals asking Congress to examine the FDA’s implementation of the Drug Quality and Security Act – specifically, the agency’s unwavering stance that the law does not allow traditional compounding pharmacies to provide medications for office use.
The Year Past: Advocacy Accomplishments
2014 was a year of notable success for AANP and the naturopathic profession. NDs can look forward to continuing momentum in the New Year. Let us recount the triumphs of the past year.
Year One of the Affordable Care Act
The first year of Affordable Care Act (ACA) is coming to a close and NDs have a lot to be proud of in the way we’ve organized and lobbied for insurance coverage consistent with Section 2706 of the law.
AANP Educates the VA
Advocacy Priorities in 2015
The State and Federal Affairs Committee of AANP has affirmed five advocacy priorities for the organization in 2015.
Prime Your State Association for a Licensure Push in 2015
A number of state associations are laying the groundwork for a serious effort to achieve licensure for NDs next year. Since most state legislatures start up in January, now is the time to do that planning.
Section 2706: Steady Progress Made in the States
The 2706 Team at AANP has been meeting monthly since the 2013 DC-FLI and has good progress to report on its work toward insurance coverage for NDs in licensed states. Many of you are familiar with the non-discrimination provision of the Affordable Care Act, also known as Section 2706. This provision requires insurers to cover all licensed providers. However, powerful opponents to the law have blocked its enforcement so far by the federal Department of Health and Human Services. Most insurers and states did not even realize the provision existed before AANP outreach got underway.
Senator Harkin Endorses ND Licensure
Naturopathic physicians ought to be licensed in all 50 states! - So proclaimed Senator Tom Harkin (D-IA), speaking from the podium at a dinner in his honor in Washington, DC on September 29th.
AANP Defends Compounded Medications
AANP is collaborating with the International Association of Compounding Pharmacists (whose interests here parallel our own) as well as with the Integrative Medicine Consortium in developing a joint strategy.
A Seat at the Table of Health Reform
Vermont is redesigning health care. Our governor is committed to a single-payor health care system by 2017. Having test-piloted much of what ultimately got included in Obamacare, Vermont (like OR and WA and other states) is once again pioneering what I believe will ultimately become federal law. My goal in writing is to give the ND community a glimpse from inside the front lines of health care reform, and inspire more ND warriors to join a common cause.
FDA Developing Rules on Compounded Medications
The Food and Drug Administration (FDA), after a raft of comments submitted by AANP and numerous other organizations across the country, is holding a meeting of stakeholders to weigh concerns regarding the agency’s development of regulations implementing the Drug Quality and Security Act. AANP will be part of those discussions, as will the association representing compounding pharmacists.
Weighing In on Section 2706
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.
Connecticut NDs Gain a Modern Scope of Practice
The Connecticut Naturopathic Physicians Association (CNPA) has achieved a major success – a modernized scope of practice amending an antiquated licensure law that dates from 1922. The bill, which passed the House 144-0 and then the Senate, is set to be signed by Governor Malloy in the coming weeks.
Mikulski and Norton are Congressional Champions
In conjunction with the DC FLI, AANP presented awards to two Congressional Champions, Senator Barbara Mikulski (D-Maryland) and Congresswoman Eleanor Holmes Norton (Del-DC), who have introduced resolutions to establish Naturopathic Medicine Week two years running.
DC FLI Puts AANP in the Vanguard for Medicare Inclusion
This year’s DC FLI, AANP’s annual legislative conference, attracted NDs and students from 42 states who are committed to advancing awareness of naturopathic medicine on Capitol Hill. The primary goal was to acquaint lawmakers and their health staffers with the value of naturopathic medicine for seniors, who are often beset with a variety of chronic conditions. The federal Medicare system pays vast amounts for their symptoms to be controlled, often through prescription drugs that many seniors take concurrently. If NDs were included as primary care physicians in Medicare, however, seniors’ use of multiple medications would be reduced, with consequent health improvements for older Americans and reduced cost for the taxpayers who fund Medicare. This was the message that AANP members took to Capitol Hill.
AzNMA Scores Two Legislative Victories
Arizona Governor Jan Brewer has signed two bills into laws that the Arizona Naturopathic Medical Association had strongly advocated. One will allow naturopathic physicians to practice using telemedicine, and the other will allow naturopathic physicians to continue to prescribe Hydrocodone combination drugs after the expected federal reclassification of this substance later this year.
Delegate Susan Krebs Receives Legislative Champion Award from the American Association of Naturopathic Physicians
The American Association of Naturopathic Physicians (AANP) awarded Delegate Susan Krebs, of Carroll County, with their Legislative Champion Award at their annual legislative conference in recognition of her efforts over the past three years to gain licensure for Naturopathic Doctors in Maryland.
Advocating for ND Coverage Nationally
Teamwork is happening at the AANP! Interested doctors, students and administrators from all corners of our profession have been teaming up over the past year to advocate for ND inclusion in health plans under the Affordable Care Act (ACA). Known as the "2706 Team," we've been meeting in person at the DC FLI and the AANP Conference, as well as monthly by conference call to share resources and organize around making our case.
Licensure for NDs in Maryland – The Journey to Victory!
On April 14, 2014, Governor Martin O’Malley signed into law a bill allowing for the licensure of naturopathic doctors in the state of Maryland making Maryland the 18th licensed state for NDs in the U.S. The first licenses will be issued to NDs by March 1, 2016.
Making the Difference in Utah
Top 10 Reasons to Be Part of the DC FLI
A Don't-Miss Meeting of the Minds
What would it be like if naturopathic medicine were integrated into our culture, our healthcare options, our medical system in the way you’ve imagined it would be? I think for each of us, that likely looks a bit different, but perhaps we all envision a day where when asked what you do for work, you can answer, “I am a naturopathic physician,” and have people enthusiastically nod, knowing exactly what your training is and that you treated their mother, brother or friend with success. Whatever your vision is, getting involved is the way to make it happen.
State Licensure Advances
In 6 states, Pennsylvania, Maryland, Illinois, Iowa, Rhode Island, New York, and Massachusetts, legislative efforts are gaining steam to license NDs. In 3 other states, Connecticut, California, and Utah, ND associations are working to expand scope of practice. And in Idaho, an effort is progressing to renew ND licensure given that there is no board to oversee the profession. (NDs officially became licensed there in 2004 but new legislation is needed.)
AANP Speaks Up to FDA
A work group led by immediate past-president Michael Cronin, ND, identified dozens of ingredients that are essential for IV products and other compounded medications that demonstrably benefit patients. Last month, AANP weighed in on the safe and effective ‘office use’ of compounded products. Participating in the rulemaking process is essential since, in its proposed guidance, the FDA appears to be leaning towards elimination of office use – at least where drugs are obtained from smaller compounding pharmacies that opt to continue to be regulated by their state.
Make Your DC FLI Reservations
AANP’s spring legislative conference, the DC FLI, will be held April 26-28, and the headquarters hotel – the Hilton in Arlington, Virginia – is taking reservations.
AANP Comments to FDA
AANP has provided comment to the Food and Drug Administration on its proposed guidance that would greatly restrict the ability of physicians to administer compounded medications – including injectables and IV solutions – to patients in the office.
State and Federal Affairs Report
What an amazing year! Colorado passing regulation, the US Congress declaring Naturopathic Medicine Week and Washington getting Medicaid recognition are some of the highlighted successes we celebrate as a naturopathic community for 2013. As I prepare to transition from chairing the State and Federal Affairs Committee to a more specific focus on licensing and insurance coverage for NDs, I’d like to reflect on what we’ve accomplished together in the recent past, thank a number of phenomenal ND advocates, and lay out a vision for how you can utilize the AANP to create more victories in 2014 and beyond.
Patient Push on Section 2706
Section 2706 of the ACA states that health insurance plans cannot discriminate among services provided by licensed health care professionals. However, many states are neither observing nor enforcing this provision – and others are interpreting it to mean that ND services can be covered out-of-network rather than in-network.
Volunteers Needed for Working Group on Compounded Medications
AANP is seeking members to serve on a brand new working group with an immediate charge – helping the association develop comments on proposed FDA regulations on compounded drugs used by NDs. The timeframe is short as one set of comments is due Feb. 3 and two other sets are due March 4. A high priority for AANP is to retain the ability for NDs to offer safely compounded medications for office use, i.e., to be able to provide them to patients without an individual prescription.
Lobbying How To's from the Lobbyists! Plus DC FLI 2014
Anyone who has been to the FLI can tell you that it is an exciting opportunity to speak up for the profession by meeting directly with your elected representatives. Last spring, NDs convinced Members of Congress to sponsor a resolution creating Naturopathic Medicine Week and the very first Week celebrating the profession in the US came to fruition.
Have you visited AANP's State Advocacy Toolbox lately?
AANP's State Legislative Toolbox has been thoroughly updated and reorganized so you can find all manner of information to help with whatever issue, question or advocacy campaign you have in front of you.
Illinois Association of Naturopathic Physicians on the move
October State Affairs Update Plus a Report on Supplements and Health Care Costs
A new study indicates that nutritional supplements not only provide health benefits but significantly reduce health care costs because they help prevent illnesses that require medical treatment. The study, conducted by the research firm Frost & Sullivan and issued by the Council for Responsible Nutrition (CRN), analyzed the cost-benefit ratio for 8 regimens of supplement use, such as for diabetes, osteoporosis, age-related eye disease, and coronary heart disease. The results suggest that supplements taken at “preventive intake levels” by patients who are at high risk for these illnesses could save hundreds of millions of dollars.
Congress Recognizes Naturopathic Medicine
Including NDs in Health Insurance – the Affordable Care Act
Known as Section 2706, this provision was authored by Senator Tom Harkin (D-IA), who continues to champion its implementation. In fact, Sen. Harkin recently included language in the Department of Health and Human Services appropriations bill that clarifies the intent of Section 2706. This was necessary because “guidance” issued by HHS and the Labor Department muddied the waters.
The DC FLI: A Resounding Success
When all was said and done, the 10th DC FLI more than fulfilled its advocacy and educational goals. Participants gained essential experience into the political process, were invigorated by energetic speakers and highly relevant topics, came together as an advocacy force and just plain had fun. Keep an eye out for announcement of the 2014 event and plan to maximize our collective voice by adding yours!
Health Insurance Coverage Shall Not Discriminate
2013 is a critical year for naturopathic medicine. The Affordable Care Act has presented us with an unprecedented opportunity to propel naturopathic medicine forward-to grant access to naturopathic doctors to be covered under health insurance plans in all states in which we are licensed-but only if we are successful in educating state officials about how we fit in.
State Legislative Update
Many state associations are busily preparing for the 2013 state legislative session. On the most recent webinar of AANP’s State Legislative Alliance, six states reported on their plans for 2013. While these reports represent only a fraction of the activity planned for 2013, they demonstrate the thoughtfulness and sophistication of state leaders.
11 States To Introduce Licensure Legislation in January 2013