What’s the AOA doing to combat insurer discrimination against OMM/NMM?

Friend of IP4PI Dr. Domenick Masiello shares correspondence with the AOA:

From: Domenick Masiello
Date: February 26, 2017
To: “Doss, Yolanda” <ydoss@osteopathic.org>
Cc: “Wooster, Laura” <lwooster@osteopathic.org>

Subject: Re: Issues in OMM/NMM

Well, I guess now I have to respond point by point. I am staring at my wall, looking at the 2 AOA board certifications that I have. One is Family Practice and osteopathic manipulative treatment and the other is a separate, different certification called Special proficiency in osteopathic manipulative medicine, C-SPOMM. So, Yolanda, there are actually 3 certificates flying around NOT two. Now we have a residency so there is also Neuromusculoskelatal medicine/OMM. the Special Proficiency is NOT a FP certification. I should know, I didn’t just speak to somebody with 20 years experience, I actually possess these certificates and have been in practice for 30 years! there is no gold standard, just confusion created by the AOA and its various certifying boards. I didn’t say that insurance carriers or hospitals recognized any DO claiming to be a specialist in OMM, I just said that some FPs advertise themselves as such, thereby adding to the confusion for the public.

Yolanda you did offer to help with Aetna over a year ago – it just would have been nice to hear back on the issue. You sort of kept that to yourself until recently about 9-10 months later. Aetna is not the only insurance company that doesn’t recognize our OMM specialty. I have had problems with Connecticare, Empire in NY, Oscar/magnacare in NY in addition to Aetna in NY and CT. In fact none of the exchanges in NY recognize OMM but they do have acupuncture and chiropractic listed in EVERY exchange! Recently I even tried Liberty Health Share, a Christian healthcare cost sharing provider. They would have me contact them for approval first before every visit and then submit treatments plans like a PT because they don’t know what I do.   You haven’t heard about other instances of this insurance problem because many DOs who do manipulation are not members of the AOA. Some doctors who completed their OMM residencies chose not to sit for the exam and many more have cash businesses as I did for the past 29 years. You also don’t have any outreach to folks like me so why would you hear from us. last summer I begged and pleaded for a specialty specific email blast for AOA members to no avail. You assume we will be contacted by our specialty boards but we are not and you assume that we will be contacted by our state societies but many of us are not members of those societies because they don’t serve our needs as traditional osteopaths.  recently, at a meeting of the Bergen County osteopathic Society in NJ, it was suggested that perhaps this less than ideal treatment of physicians board certified in OMM might be because of our minority status within our own profession. Most AOA members are FPs and they have the loudest voice and the rest of us are a minority within a minority profession. Also that the creation of a board certification for manipulation may have been experienced by the FPs as a threat to their insurance reimbursement. Ultimately, the point is not that you are working on it but how does this kind of thing happen in the first place? OMM should be your top priority because that is what makes us different despite our small numbers.

My point ultimately about the United Healthcare issue is that despite paying tens of thousands of dollars in dues over the years, I had to contact United Healthcare’s senior VP, Molly Knorr myself to find out that I needn’t send in any private health information. It was actually Monica Horton and not you who advised me to comply. My point is that why didn’t the AOA just contact United HealthCare directly as i did? The amount of time and energy that Monica spent emailing me could have been spent by just contacting the VP of United HealthCare. That was my point. And by the way – I didn’t lose those patients, they are still with me. In fact, one of them is the 3rd generation in a family that I have treated for these many years – that’s the power of osteopathy. Wouldn’t it be wonderful if the AOA would just market our profession to the world?

About the essential health benefits, you don’t say HOW it is going to limit OMT and you don’t say WHOSE opinion that was. If you had a specialty specific email system, you could poll us and maybe we could have some input. You keep forgetting that you work for the membership and that the AOA is NOT a private corporation. the lack of transparency, the lack of following best practices is very much related to the issues i mentioned above. Why is it necessary for the president elect, the president and the past president all to make hundreds of thousands of dollars per year when so little is spent on effective advertising?

I could go on and on but I have a life to attend to as well. Yolanda, as with most of my communications with you its the same. All is well, the AOA is doing fine, no worries. As a DO, I just don’t agree. To those on this thread who care to, just forward it on to others who might care and maybe some day it will make a difference.

Domenick J Masiello, DO, C-FP, C-SPOMM

The only thing necessary for the triumph of evil is for good men to do nothing. – Edmund Burke

On Thu, Feb 23, 2017 at 2:45 PM, Doss, Yolanda <ydoss@osteopathic.org> wrote:


Thank you again for looping me into this discussion.  As you mentioned I have actively been working on these issues, and I apologize for my delayed reply.

I’d like to begin by clarifying some of the statements made by Dr. Masiello – paragraph by paragraph.

First, there are only two primary board certifications in Osteopathic Manipulative Medicine (OMM):  (a) Family Practice/OMT (FP/OMT) (previously referred to as Family Practice /Special Proficiency in OMM); and (b)Neuromusculoskeletal Medicine/Osteopathic Manipulative Medicine (NMM/OMM).  The term Osteopathic Manipulative Medicine specifically relates to the discipline of Medicine as practiced by physicians and differentiates OMM the specialized manipulation and care provided by DOs from the services of Physical Therapists, Chiropractors and any other manual medicine provider.  Medicare (i.e., CMS) appropriately lists the specialty as OMM and it has assigned it the specialty code number 12.  In many instances, carriers will follow Medicare’s designations while also following their specific payment policy designs, such as the Resource Based Relative Value System (RBRVS) and the Relative Value Units (RVUs).   A physicians’ self-designation as an OMM specialist will not typically translate into a specialist designation by a hospital or insurance carrier for credentialing purposes if the physicians do not have one of two primary board certifications.  Before board certification became recognized as the “gold standard,” there were many OMM specialists in family practice who were not board certified.  I have personal experience in speaking with theses specialists who in many cases have more than 20 more years of dedicated OMM practice and I would count them as specialists.

Next, Dr. Masiello is correct in noting that I advised him I would research the issue of the incomplete National Uniform Claim Committee (NUCC) Taxonomy codes.  I began this process because Dr. Masiello reported that Medicare uses the NMM/OMM Taxonomy code along with a specialty description in the National Provider Identifier database. (The NUCC replaced the Uniform Claim Task Force in 1995. In 1996, the NUCC was formally named in the administrative simplification section of HIPAA.)   According to the Chair of the NUCC, ten years ago the NUCC  began contacting medical specialty boards for information regarding each specialty to create Taxonomy codes.   Unfortunately, the AOA was not contacted as part of this process and, consequently, the AOA’s certifications in OMM were not captured in the system because there is no parallel certification offered by the ABMS boards.  Although the OMM taxonomy code was not captured by NUCC, Dr. Masiello’s experience with Aetna has been the only instance reported to us of an insurance carrier denying credentialing because it did not have the Taxonomy definition.  As mentioned in other communications, AOA has been contacting Aetna and other insurance carriers proactively to avoid similar situations.  In the interim, we are pointing to the Medicare Taxonomy definition and Medicare OMM specialty code 12 which can be utilized for credentialing.   While Dr. Masiello is correct that there is no quick fix available, AOA is actively working to resolve this issue as quickly as possible and we have implemented other preemptive steps.  Fortunately, we are very familiar with these types of coding processes used by the AMA and similar entities involved in developing codes.

Regarding AOA communications about United Health Care, I strongly disagree with Dr. Masiello’s recollection.  The AOA’s position is always to provide members with detailed information and guidance regarding policies and practices.  We provide the pros and cons so that members can make informed decisions.   The guidance should assist members in making their own decisions.   Sometimes the options may be very limited, but we do not tell members what to do.   Specifically, in this case, we informed Dr. Masiello that he is not obligated to submit any information when he is not contracted with a carrier.  However, we also noted the potential downside consequences if he chose not to submit the information requested.  I based our comments on a past experience with a physician who asked the same question and was not sure what to do.  She spoke with her attorney, who advised her not to provide any information because she was not contracted with the carrier.  Subsequently, the carrier refused to reimburse the patient for any care provided by this physician.  The important point here is that the insurance carrier had leverage and in this case directed the patient to seek treatment from another physician.   While there is no rule that requires you or other physicians to send information, there is a risk that not complying may have a negative impact.   Here we were not telling Dr. Masiello what to do.  We simply provided a complete picture and encouraged you to seek additional information if you remained unclear because every carrier and region functions differently.  You contacted United Health Care to assist you in your decision, which can’t hurt.

Dr. Masiello then turns to the essential benefits question.  On this issue, Dr. Masiello continues to express a difference of opinion regarding a tactical judgment by the AOA Board.  A decision was made to not try to fit OMT into the essential benefits bucket, which might have limited the definition of OMT and would have limited payment for OMT services.   We, of course, respect Dr. Masiello’s right to disagree with the determination, it is not fair to suggest that the “essential benefits” issue was not considered by the AOA Board.

Lastly, I believe I have clarified that we are actively working on the NUCC issue and this process continues to move forward.

I hope you this information helpful and addressed some of the concerns expressed in these emails.   I am unable to address the AOA 990 or Treasurer reporting issues, but those are issues of AOA governance and do not impact the member-service issues Dr. Masiello raises.  I will defer comment on those questions to other staff.

Thank you for allowing me to respond, please do not hesitate to contact me if you have questions regarding any of this information.

From: Wooster, Laura
Sent: Wednesday, February 15, 2017 9:37 AM
To: ‘Domenick Masiello’
Subject: RE: Issues in OMM/NMM

Dr. Masiello and Dr. Robbins-

Thank you both for your replies on this issue—I wanted to combine both of your emails to make sure all on this thread are able to be fully looped in.

I’ve copied Yolanda Doss (who I had mentioned yesterday has handled much of the AOA’s work on this issue) on this email to ensure your questions and comments can be fully addressed by her.

Thank you!

Laura Wooster, MPH
Senior Vice President, Public Policy
American Osteopathic Association
(202) 349-8747 – Direct
(773) 968-6879 – Cell

From: Domenick Masiello
Sent: Tuesday, February 14, 2017 6:21 PM
To: Wooster, Laura; Koss, Richard
Subject: Re: Issues in OMM/NMM


This is not actually correct. My FP board certificate states, ” Family Practice and Osteopathic Manipulative  Treatment”; my board certification (a different AOA Board) in OMM states: Special Proficiency in Osteopathic Manipulative Medicine”. They are not the same. Some DOs who are family practitioners and do OMT will advertise themselves as OMM specialists. Are They?

The NUCC taxonony list for NMM/OMM is incomplete in that it does not contain the description or definition of the specialty. Don’t believe me, go to their website and try to find the description associated with 204D00000X – NMM/OMM.  This gross mistake by the AOA allows some insurance carriers to simply deny specialty recognition. It also means that OMM is NOT listed on the specialty menus of their patient portals. It also allows them to force DOs like me into a Family Practice designation. This can effect reimbursement but also obligates me to maintain admitting privileges and to maintain 24/7 coverage in order to join their networks (read your contacts!).

I had an issue with United Healthcare last year whereby they quoted the ACA to imply that I must provide them with data on my patients who have United’s coverage. The problem was, I was not nor am I now in their network. The AOA advised me to provide the information even though I technically didn’t need to. (that was my recollection). I challenged the VP of United toquote me chapter and verse where in the ACA does it state that an out of network doctor must comply. She replied that there was no such requirement and I needn’t comply. So much for AOA help.

The other thing that is missing is that the AOA dropped the ball (AGAIN) when it failed to have OMT included as an essential health benefit when the ACA created the exchanges. Acupuncture and chiropractic are listed in every state. OMT does not appear on the list from any state. Exchanges were put into place over 2 years ago.

Simply stating that the AOA is “working on it” is not enough. What is needed is to ask why are these oversights allowed to happen? Why is there virtually no advertising budget (as revealed by looking at their IRS Form 990)? We need transparency and true advocacy. We need an AOA that understands that osteopathy is not allopathic medicine with some manipulation thrown in.  We need a public treasurer’s report published yearly on the website so we can see for ourselves how money’s being spent or not spenty or oversent We are entitled to this. The AOA is NOT a private corporation. It exists to serve us, the membership.

Domenick J Masiello, DO C-FP, C-SPOMM


From: Hallie Robbins [mailto:integrehab@gmail.com]
Sent: Tuesday, February 14, 2017 5:38 PM
To: Richard Koss; Wooster, Laura
Subject: Re: Issues in OMM/NMM


Thanks for including others on this thread. In extending the consideration to other specialties with MD and DO credentials and affiliations therefore to MD or DO Board Certification, how does this affect the many DO’s who practice OMM and are physiatrists (PM&R) rather than FP?


Hallie Robbins, DO


On Tue, Feb 14, 2017 at 5:31 PM, Wooster, Laura <lwooster@osteopathic.org> wrote:

Dr. Koss-

Thank you for reaching out again. I will respond to each of the issues you identified.

First, for the first issue, the information provided in your previous email does identify a problem that exists, but it omits key details and somewhat mis-states the status of recognition of Osteopathic Manipulative Medicine (OMM).   Most importantly, if you look at the most recent “Crosswalk – Medicare Provider/Supplier to Healthcare Provider Taxonomy” released by the Centers for Medicare & Medicaid Services (CMS), you will see Medicare Specialty Code 12 identifies “Physician/Osteopathic Manual Medicine” as a provider/supplier type with two corresponding provider taxonomy codes.  The problem that has emerged relates to the recognition of OMM specialists who are certified by the American Osteopathic Board of Family Physicians (AOBFP), where there is not a separate taxonomy code for OMM within family practice.  We are finding that this may create challenges for OMM specialists with AOBFP board certification in gaining recognition from certain payors.

With Aetna, for example, the company includes a family practice OMM code and a Neuromusculoskeletal Medicine (NMM)/OMM code in its systems:

  1. 12001 – Family Practice/Special Proficiency in OMM
  2. 12002 – NMM/OMM

However, there is not a parallel taxonomy code available and, instead, Aetna relies solely on the CMS provider taxonomy code listings contained under Medicare Specialty Code 12 to recognize related provider specialties:

  1. 204D00000X – NMM/OMM
  2. 204C00000X – NMM, Sports Medicine

The AOA has been working to address these problems.  We are pulling together documentation from AOBFP, the American Osteopathic Board of Neuromusculoskeletal Medicine (AOBNMM) and the Bureau of Osteopathic Specialists (BOS) regarding a formal taxonomy for OMM within family practice.

Four activities are currently taking place to correct problems any physicians experience:

  1. We are working with certification staff from AOBFP and the AOBNMM to prepare the formal documentation needed to request a Healthcare Provider Taxonomy Code for OMM in family practice;
  2. We will be submitting new definitions for the two existing OMM taxonomy codes and the additive family practice code via the National Uniform Claim Committee (NUCC);
  3. We are identifying payors that may be relying solely on CMS’ provider taxonomy codes to ensure an interim pathway for specialty recognition exists for impacted physicians while the broader issue is being worked through; and
  4. In conjunction with the BOS and the Specialty Boards, we are examining whether or not there is a need to revise or request additional specialty codes for osteopathic physicians.

We are looking to correct this issue as quickly as possible and we will keep the AOA’s members informed of key developments.  The Health Care Provider Taxonomy code set that is maintained by the NUCC is updated on a bi-annual basis, with revisions becoming effective April 1 and October 1 of each calendar year.  The code list that will become effective on October 1, 2017 will be published in July 2017 and we are working expediently in hopes of completing the above-referenced activities so that the new OMM code is included in that set.

I have copied this email to Yolanda Doss from the AOA, who has done much of the work I just described above and has made significant progress on this issue.  I am also copying Sean Grande from the AOA, who has significant experience in payor relations and is working with payors on this, and a number of other issues, moving forward.

Second, with respect to the question raised in item #2 of your email, I believe that I previously addressed your concerns with the AOA’s efforts to improve payment for OMT in each of my responses in the email chain (pasted back in below your most recent email). These explanations include details of the AOA’s advocacy (both previous and ongoing) at the federal and state level to address this payment issue and increase access to OMT to more patients, especially in light of the current opioid epidemic and an increased awareness of the importance of appropriate pain management. I understand you are dissatisfied with the outcome of these efforts to date, but we hope you understand the nature of our advocacy. Our AOA President, Dr. Buser has provided strong leadership and personal engagement with all of these efforts, including meeting personally with CMS and regional carriers. Unfortunately, there is no “quick fix”, but we will continue to fight the battles on behalf of our members and the unique and important services they provide to their patients.

Thank you,

Laura C. Wooster, MPH
Senior Vice President, Public Policy
American Osteopathic Association
(202) 349-8747 – Direct
(773) 968-6879 – Cell

—–Original Message—–
From: Richard Koss
Sent: Tuesday, February 14, 2017 10:37 AM
To: Wooster, Laura

Subject: Issues in OMM/NMM

Dear Ms. Wooster,

I have not heard a response from you or the AOA people you forwarded my emails to. There are two very important issues concerning Osteopathy and our future.

  1. The fact that the AOA has not completed the process with the AMA to get NMM/OMM listed as a specialty so we can sign up with insurers (including federal programs) under our proper specialty listing.
  1. It is a legislated fact from the federal government that it will NOT pay for chronic or maintenance care of the musculoskeletal system.

This is discrimination against DO’s as the Neromusculoskeletal system is primary in health and life. All chronic disease is “maintenance ” care. Yet we can not treat chronic disease (especially chronic pain) with OMM.

Please as a member of the AOA and as a residency trained board certified specialist in NMM/OMM for over 27 years, respond to this email.

Please let me know what the AOA is doing with these two issues. Policies, plans, position statements.

If the AOA has no plans, please let me know this as well.

At least acknowledge that you received this email.

Thank you for your time.


Richard W. Koss, DO, CSPOMM, ACOFP

—–Original Message—–

From: Wooster, Laura
Sent: Wednesday, January 4, 2017 11:25 AM
To: Richard Koss
Cc: Schilligo, Nick; Kremke, Matthew

Subject: RE: Osteopathy

Dr. Koss-

Apologies for the delay in response, but I was out of the office on leave from the afternoon of Fri Dec 16 through the holidays, and only returning yesterday morning. In the meantime our attention on the Public Policy side has also been heavily commanded by the need to address recent and upcoming efforts by Congress and the incoming presidential Administration to repeal and reform health care.

With regards to payer audits and OMT coverage, the AOA has worked to address this on a number of different fronts, though I am confused by your statement below that “the recent letter writing campaign to save OMT in the northeast, and now with the opioid crises points to no one in the AOA protecting its members rights to practice their medical business”? The Save OMT campaign was entirely successful in preventing implementation of a Local Coverage Determination by a Medicare contractor that would have been disastrous for DOs providing OMT in 10 states. Is that not by definition the AOA protecting its members’ rights to practice their medical business?

The AOA’s Physician Services team regularly advocates on behalf of DOs who are undergoing audits by private payers on OMT—all the DO has to do is contact the AOA, and that team will work to combat payment denials, improper chart audit requests, and the like on their behalf with the payer. On a less granular level, the Physician Services department also meets on a proactive basis to educate payers on OMT, coding, and payment to ensure that their medical policies are more DO-friendly and to build relationships that can be leveraged when addressing specific audit issues on behalf of an AOA member. I’ve copied Mat Kremke, who oversees that team, and might be able to more specifically address your issue with Altegra Health.

Lastly, I also wanted to mention that the AOA has developed model legislation on osteopathic equivalency to introduce at the state level, and will begin to do so in the coming month. This legislation, if passed in states, would further protect the rights of DOs to practice the business of medicine (which is largely regulated at the state level) in a number of different ways, and could provide an opportunity to address issues on OMT payment and coverage at the insurance commissioner level. I’ve also copied Nick Schilligo, our Associate Vice President of State Government Affairs, who is overseeing this effort.

Thank you as always for your input!



Laura Wooster, MPH
Interim Senior Vice President, Public Policy
American Osteopathic Association
(202) 349-8747 – Direct
(773) 968-6879 – Cell

—–Original Message—–

From: Richard Koss
Sent: Thursday, December 15, 2016 5:21 PM
To: Wooster, Laura

Subject: Re: Osteopathy

Dear Laura,

Thank you for your response from the AOA. However I must take issue with the AOA’s handling of the coding, charting, and review process.

All of the letters, notes are about drugs and the opioid crises. That is well and good. I was on the task force in Texas when the push was for more morphine use in the control of pain. My lone DO voice was ignored then when I protested and said that this would be a huge problem. Pain as a vital sign is ridiculous. Pain doesn’t kill. Lack of pulse or elevated temperature will. The latest DO talks about discrimination…. The AOA people do not realize as a DO I am discriminated against all the time. Sometimes subtle, sometimes overtly as my OMT practice is marginalized, not paid for, and downright called out as not medical treatment. There is plenty of research and proof but it is not used in research or anything that will show that there are non drug treatments that are very effective.

What is the AOA’s position on chart reviews and audits by insurance companies.

What committee is supervising the auditors for quality assurance that the people auditing are qualified. That the audit criteria has been reviewed and approved by the AOA insuring its members that an audit will be fair and equitable to all.

That the auditors and review criteria is based on the proper definition and use of the modifier 25 especially in cases where OMT is used. That the auditors are qualified to review DO charts with a proven knowledge of the AOA glossary of terms. That in charts in question are reviewed by a DO knowledgeable in osteopathic knowledge and use of OMT, and not by non medical coders, nurses, or PA’s.

The recent history with Blue Cross in the North west as well as the recent letter writing campaign to save OMT in the northeast, and now with the opioid crises points to no one in the AOA protecting its members rights to practice their medical business.

I am starting the next audit request from Altegra Health who has contracted with Lifewise Blue Cross in Washington state. Who are these people, what are their credentials? who is doing the review? Who in the AOA oversees these people to assure us that the review will be fair? The review criteria should be written, published and distributed to the participating doctors who are being reviewed before the review and not after. Is the AOA asking for this information and disseminating it to their members so like me this moment feel like I am sending my chart notes into an arbitrary and capricious review.

I already know the AOA’s response sinc I have been in this situation several times before….

But I await your timely response.

Richard W. Koss, D.O.

—–Original Message—–

Hi Dr. Koss-

Appreciate hearing your input, thank you for reaching out!

The AOA’s Department of Public Policy has promoted osteopathic medicine and OMT in countless comment letters, communications, and meetings with federal and state policymakers as work was underway in these past two years to address the opioid epidemic. I’ve attached a few examples, but there are many, many more–happy to send additional examples, if you are interested.

Notably, in July when Director of the White House’s Office of National Drug Control and Policy, Michael Botticelli, spoke at the AOA’s House of Delegates, he specifically addressed OMT and its value as a nonpharmacological modality. He did this because the AOA had raised it with him and other White House and HHS officials in meetings leading up to the House of Delegates Town Hall, and he saw the value in OMT and increasing access to it for more patients. Previous to that, Surgeon General Murthy touched on OMT in his keynote address at OMED 2015–this too was made possible because of the AOA’s advocacy for OMT at the federal level.

At the state level, we continue to work with policymakers to ensure that pain patients have access to the care they need, including OMT. This is highlighted by the opioid prescribing best practices recently released by the West Virginia Attorney General. Partnering with the AG’s Office, the AOA, West Virginia Osteopathic Medical Association and West Virginia Board of Osteopathic Medical Examiners, were successful in promoting OMT as a nonpharmacological approach to treating pain. OMT is specifically mentioned as such, and this language will be introduced as a model to the National Association of Attorneys General in the coming year. In Ohio, the osteopathic medical profession was successful in including OMT as a nonpharmacological alternative to opioid-based treatment of pain. The AOA continues to partner with our state and specialty affiliates to promote OMT as states address the opioid epidemic. This includes recent efforts in Vermont and Rhode Island.

As I had mentioned to Kathie, this particular letter went out to nearly 200 provider groups for sign-on including allopathic and osteopathic physicians, nursing groups, social workers, addictions counselors, etc, since it’s intended to represent the nature spectrum of providers involved in prevention and treatment of opioid misuse and substance use disorders. It would therefore be counterproductive to mention OMT in it, as many of the other groups who we’d want to sign on have their own particular issues and messages in this space, and we would risk not having their support. This letter will only hold weight with members of Congress if they see numerous constituencies represented, and the end-goal of funding will benefit all stakeholders, including osteopathic physicians, and most importantly their patients.

Thank you again for your advocacy for osteopathy and the profession—happy to discuss further in a call if you’re interested.


Laura Wooster, MPH
Interim Senior Vice President, Public Policy
American Osteopathic Association
(202) 349-8747 – Direct
(773) 968-6879 – Cell

—–Original Message—–

From: Richard Koss

Sent: Saturday, November 19, 2016 7:14 AM

To: Wooster, Laura
Subject: Osteopathy

Thank you for your response.

Unfortunately I see things differently. Yes while there are many groups looking to sign onto this issue, this an issue to start to plant seeds of osteopathy and how we are different. Otherwise it will be like what is happening in our state where we have 2 licensing boards. The auditor just recently stated that since there is no difference between the two types of physicians there should not be two separate boards.

So when and how does the AOA distinguish our difference other than to brand ourselves as “We DO care?” And you Doctor “may do manipulation.?”

Because after 35 years in practice osteopathy is still unknown by other professionals, insurance companies, and public other than we are just like MD’s.


Sent from my iPhone

—–Original Message—–

From: Kathie Itter
Sent: Friday, November 18, 2016 6:42 PM
To: Wooster, Laura
Subject: RE: FOR SIGN-ON: Opioid funding letter to Congress


Why does the letter fail to mention that osteopathic physicians are uniquely qualified to treat pain without opioids?  D.O.s have an additional diagnostic and treatment modality in osteopathic manipulative medicine.  Osteopathic training, universally, places greater emphasis on listening, empathy and treating the whole person from the first day of medical school.  These are all valuable tools in treating patients with pain.


Kathie Itter
Executive Director
Washington Osteopathic Medical Association
PO Box 16486
Seattle, WA 98116-0486

—–Original Message—–

From: Fox, Leslie E. on Behalf Of Wooster, Laura

Sent: Friday, November 18, 2016 2:40 PM

To: Wooster, Laura <lwooster@osteopathic.org>
Subject: FOR SIGN-ON: Opioid funding letter to Congress

Good evening-

Similar to a letter that circulated in July and ended up being signed by close to 80 provider organizations, the attached letter to Congress is being circulated to provider groups for sign on urging members of Congress to allocate the maximum possible funding to address prevention, treatment, and recovery efforts for the opioid epidemic.

If you would like to sign your organization on, please email Ryan McBride by COB Monday, Nov 28 and provide your name, email address, and organization name (as you would like it to appear on the letter).

We recognize this fast turn-around may be challenging with the upcoming short week, but the Congressional timeline presents significant urgency.

Please let me know if you have any questions, and feel free to share with colleagues in other provider organizations so that we can ensure maximum impact and that all voices are heard.

Thank you,

Laura C. Wooster, MPH

Interim Senior Vice President, Public Policy
American Osteopathic Association
(202) 349-8747 – Direct
(773) 968-6879 – Cell

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