Does Obamacare Allow Health Insurance Plans to Cover Alternative Medicine? – YES

“[T]he section of the Affordable Care Act (Section 2706) that relates to participation in health insurance by licensed health care providers is very clear. It states that an insurer ‘shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.’ There’s not a lot of ambiguity there. If a naturopathic physician is excluded from participating in insurance just because she’s a naturopathic physician, that’s not permissible. That’s the clear meaning of the law, and we know from numerous discussions with Sen. Tom Harkin, the sponsor of the provision, that that’s exactly what was intended.

Unfortunately, anybody who’s familiar with how laws get implemented knows that it’s never that straightforward. In the case of the Affordable Care Act, things really get messy because each state is responsible for deciding how to implement the law. As a result, no two states are implementing the law in the same way.”

“The nondiscrimination provision disallows health plans from ‘discriminating with respect to participation under the plan or coverage against any healthcare provider who is acting within the scope of that provider’s license or certification under applicable State law.’ Sec 2706 safeguards patient access to non-MD/DO state licensed or state certified providers, including (but not limited to) chiropractors, naturopathic physicians, acupuncturists, massage therapists, osteopaths, optometrists, nurse practitioners and licensed or direct entry midwives and podiatrists, as long as they are licensed by the state and can treat the condition within that provider’s scope of practice. The health insurer can still address provider network quality and adequacy under this provision.”

“One clause of the health law in particular — Section 2706 — is widely discussed in the alternative medicine community because it requires that insurance companies ‘shall not discriminate’ against any health provider with a state-recognized license. That means a licensed chiropractor treating a patient for back pain, for instance, must be reimbursed the same as medical doctors. In addition, nods to alternative medicine are threaded through other parts of the law in sections on wellness, prevention and research…

The Patient-Centered Outcomes Research Institute, created by the health law, is funding studies on alternative medicine treatments to determine their effectiveness…

Some states, like Washington, are ahead of the rest of the country in embracing alternative practitioners. The Bastyr University system, where Guiltinan works, treats 35,000 patients a year with naturopathic medicine. Sixty percent of the patients billed insurance companies for coverage.”

“Licensed Naturopathic physicians provide services that are important to millions of Americans, and nothing in the Affordable Care Act prevents insurance companies from including licensed Naturopathic physicians in their network of providers, or from covering services that licensed Naturopathic physicians provide.

The Affordable Care Act requires non-grandfathered health plans in the individual and small group markets to cover the essential health benefits package, which includes 10 general categories of items and services described in the statute that are equal in scope to a typical employer health plan. The benefits must be substantially equal to the essential health benefits covered by the state benchmark plan…

Plans may also offer additional benefits. Therefore, even if the state benchmark plan does not cover services provided by a licensed Naturopathic physician, qualified health plans may choose to cover those services.”

“It’s important to note some limitations in how the health care law is treating alternative medicine in practice, rather than in theory…

Most importantly, the most sweeping of the half dozen provisions – the changes to reimbursement policy prompted by Section 2706 – hasn’t yet turned into a boon for alternative-medicine practitioners. In states like California, Hawaii, Montana and Rhode Island, lawmakers have offered bills that would enshrine the language of Section 2706. But they have not become law yet… Meanwhile, the federal Department of Health and Human Services has thrown cold water on advocates’ most sweeping visions. Perhaps influenced by pushback from traditional medical disciplines, HHS issued guidance that says, in part, ‘This provision (2706) does not require plans or issuers to accept all types of providers into a network.’ [F]or now, the HHS guidance seems to be having a chilling effect on the expansion of alternative-medicine coverage… The law does provide a leg up for alternative therapies (although it’s unclear whether homeopathy and aromatherapy would ultimately benefit). In practice, though, it’s important not to oversell the impact.”

“The Patient Protection and Affordable Care Act (ACA), a.k.a. Obamacare… has generated considerable interest and controversy. A more recent focal point for critics is the law’s inclusion of complementary and alternative medicine (CAM) practitioners in its definition of ‘health professionals.’ This is the first time a federal health-care law has singled out CAM providers as integral members of the ‘health care workforce.’ Section 2706 requires that insurers ‘shall not discriminate’ against licensed or certified health-care providers. This section could be interpreted as requiring insurers to reimburse CAM services.”