Oregon-based Health Net is violating the Affordable Care Act by discriminating against naturopathic doctors and arbitrarily refusing to pay for covered services provided by these alternative providers, according to a lawsuit filed against the insurer.
The Oregon Association of Naturopathic Physicians (OANP) has sued Health Net on behalf of several naturopathic physicians and their patients. The lawsuit alleges that Health Net discriminates against licensed naturopathic physicians in Oregon by denying claims for services provided by naturopathic doctors that otherwise are covered when delivered by a traditional medical provider, the group's statement said.
"The impact of this discrimination is clear," OANP Board President Carrie Baldwin-Sayre said in the statement. "Until we have an impact judgment ruling, insurance carriers will continue to skirt the law, and patients and practitioners will be forced to pay the price."
In particular, OANP claims that Health Net didn't cover services within the scope of a naturopath's license, including diagnostic tests and imaging, and requires naturopathic doctors to complete a "medical necessity review." Plus, the group asserts that Health Net imposed an annual limit on reimbursable naturopath office visits, yet doesn't have a similar limit on traditional medical doctor visits.
The Affordable Care Act requires insurers to cover one annual physical per year before the deductible is met and without cost sharing. The problem, however, is that many insurers don't recognize naturopaths as primary care physicians even though the ACA prohibits insurers from discriminating against providers acting within the scope of their license, the Statesman-Journal reported.
Health Net spokesman Brad Kieffer told the Portland Business Journal that the insurer hasn't yet seen the complaint, and he couldn't comment on it.