US Agency Upholds Discrimination Against Licensed Integrative Health Professions

Discrimination symbolIn the United States, a critical part of the 2010 federal healthcare reform for many in the integrative health and medicine movement was Section 2706: Non-Discrimination in Health Care. Urged b y a coalition that included licensed naturopathic doctors, chiropractors, acupuncturists, massage therapists, and others, Section 2706 was included in the law through the work of a now-retired former US Senator, Tom Harkin. Since passage, the federal regulator agencies, principally the US Department of Health and Human Services (HHS) has been dragging its feet. The drama is captured in Beltway Battle over Patients’ Rights to Integrative Medicine and Health.

The outline of the battle is this: Congress intended that these new categories of licensed practitioners should be covered under the law. The language was somewhat ambiguous. HHS officials filed a perspective that let insurers off the hook. Congress told HHS to “correct the FAQ to reflect the law and congressional intent.” HHS did not respond. Congress told HHS to do so by October 2014. HHS has not done so. Senator Harkin retired January 1, 2015. HHS has still not replied. This spring, Mike Jawer of the American Association of Naturopathic Physicians (AANP) asked a representative of Centers for Medicare & Medicaid Services (CMS) to clarify current activity on the issue. A team from the AANP had met with HHS in October of 2014 on the issue. He also asked if a CMS representative might meet with naturopathic doctors and students at an early May 2015 DC-FLI “lobby day” for the profession in Washington, DC.

The response came from Jim Mayhew, Director, Division of Regulations and Policy, Office of Oversight, Center for Consumer Information and Insurance Oversight of the CMS. He wrote to Jawer, “Many thanks for reaching out to us. Unfortunately, no one is available on May 4th for a meeting. Furthermore, we have nothing new to report since October in terms of publically available information. We’re continuing to work on issues related to section 2706 with our colleagues at Labor and Treasury and also with State regulators. Best regards, Jim Mayhew.” In short, HHS effectively told those following “non-discrimination in health care” (Section 2706) that HHS will not, anytime soon, abide by the law.

Comment: The World Health Organization views appropriate relationships of traditional medicine with regular medicine as critical for universal health care. Ironically, as is noted in this US report, Meeting the Nation’s Primary Care Needs (pictured), these licensed practitioners are already “first contact” providers for many. As such, they are already relieving the burden on the regular primary care system in the US system, playing a role in allowing care to be extended to others.

The parallel globally to this shunting aside of these licensed “complementary and integrative health practitioners” is with the entreaties from traditional medicine organizations in Asia and Africa and elsewhere who seek recognition and participation in research and regulatory activity. These US disciplines, like traditional medicine practitioners elsewhere, are usually accessed under the radar of regular medicine. Their value to the system is either not noted or discounted. It is a shame that the US is not showing leadership by fostering linkages rather than cutting them off.

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