Federal Judge Ends Mandatory AOA Membership Tied to Board Certification

“A federal judge in Camden has granted final approval to an $84 million settlement of an antitrust class action against the American Osteopathic Association,” related to the tying of AOA membership to the ability to maintain specialty certification through Osteopathic Continuous Certification, reported the New Jersey Law Journal on December 4, 2018.

The lawfirm leading the case, Duane Morris, LLC, earlier reported on what is in the settlement:

In addition to agreeing to end its practice of conditioning AOA board certification on purchasing annual membership in the AOA, which was at the center of the lawsuit, the AOA has also agreed to provide a host of other economic benefits to the more than 45,000 class members, such as:

  • for three years reducing its annual dues by $90 and
  • waiving a $90 board certification fee;
  • for two years offering AOA members two free CME courses of up to 12 aggregate credits;
  • contributing not less than $2 million to an osteopathic awareness campaign;
  • eliminating distinctions between online and in-person CME for purposes of AOA membership;
  • lifetime board certification is restored for all those certified prior 1997;
  • committee of independent private practice physicians will be created to represent independent practice considerations to the AOA board; and
  • physicians will not lose membership in the AOA as a result of failing to meet the CME requirement, provided that the physicians meet the CME requirements for the state(s) in which they practice.

Weighed against the uncertainty and expense of protracted litigation, the valuable benefits the AOA has agreed to provide to resolve the claims against it demonstrate that the settlement is in the best interest of the class and sub-classes, as well as the AOA, stated Duane Morris.

https://www.duanemorris.com/pressreleases/osteopathic_physicians_class_action_settlement_0718.html

For a full copy of the settlement agreements, see:
https://www.duanemorris.com/site/static/AOA_joint_motion_for_certification_0718.pdf

For a full history of the suit, see:
https://www.duanemorris.com/site/osteopathclassaction.html

Here is the wording from the motion on the key items:

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The AOA is MIA as Insurers Marginalize Osteopathic Medicine

For more than a decade insurers have been implementing discriminatory policies that result in the automatic downcoding of claims filed by osteopathic physicians.

An official journal of the American Osteopathic Association recently published on this topic, but the osteopathic physicians on the front lines are asking the AOA to explain why it has been largely silent to this point and not taken meaningful action to stand up for the best interests of its members.

Here is a letter to the AOA Richard Koss, D.O. shared with IP4PI:

I hope you find the article in the recent DO magazine, dated November, 14, 2018, regarding the major insurers pushing back on the use of the modifier 25 as disturbing and discriminatory as I do.

What is the AAO’s policy, and plan to keep OMM specialists from being marginalized and discriminated out of existence? What is the economics committee doing to prevent this from happening? This has been going on for so long now (about 18 years) that there should be regular updates in all AAO communications about the membership’s ability to earn a living at their chosen profession. Where are these updates?

Yes I know that the AAO is under the AOA, but the AOA has no interest in protecting its members who practice OMM.

If you can’t get paid for your services than you do not exist. As OMM is being wiped off the payment rolls, the upcoming students and residents will have no way to pay back their loans, or make a living. So the existence of the AAO is also at stake here.

The beginnings of this trend started back in the 1950’s when the AOA leadership fought and pushed for full practice rights. That is to prescribe drugs and surgery. To do so they had to put OMM in the closet and denigrate it as a pseudoscience. This began the official death of Dr. Still’s Osteopathy. Now there are no Osteopathic hospitals, and all postgraduate programs are ACGME. Dr. Still is not even mentioned in the Academy Programs.

The AOA has known about the billing problems for 20 plus years and continues to be reactionary bending to the dictates of the AMA, and Federal Government, Insurance company mandates without any fight. This I can speak from personal experience. The modifier 25 issue has been going on for at least 18 years. Most recent in 2010 in Vancouver, Washington and Portland, Oregon. Then came the CMS illegal denial of the modifier 25 in the northeast in the last 2 years. Now this article in the DO……

I asked Mr. Goldman the head of the AOA PAC when he asked of PAC donations: “What is AOA policy and plan to support legislators and programs who support OMM?” His answer: “There is none.” The AOA has no plans or policies to keep OMM in its future business model (especially the “Branding advertisement”). Therefore it is up to the AAO to fight for our right to practice.

Please submit this communication to the board of trustees, governors, and I hope you publish this as an OP ED piece or letter to the editor of the AAO newsletters. To continue to be silent in this matter will condone the AOA’s current path.

Osteopathically,

Richard W. Koss, D.O., C-SPOMM, C-ACOFP

P.S. I hope I am not the only one who finds this disturbing. Is this even addressed in the “Five Year Plans” of the AAO? Because if it is not then we really are in trouble.

P.P.S. Of course the AOA is asleep at the wheel and has not done anything to help their members ability to make a living in their chosen profession. The AAO, our OMM specialty organization, also does not want to get involved. I pointed this out to both organizations on several occasions over the years and never gotten acknowledgement or communication on these issue, only “Crickets”. Thus I expect the same response to this letter.

Washington State Passes Bill Outlawing MOC for Licensure

Friend of IP4PI, Ken Lee, MD writes in:

There is some good news from WA state. The Legislature just passed with NO opposition in either house HB 2257 that outlaws MOC for MD /DO licensure. It is veto proof. It sits on the Governor’s desk and in my state of WA if he does not sign it in a few days it becomes law automatically. Click here for the bill. The next step would be to do the same for insurance payments, hospital privileges. Several years ago I had my state medical association adopt my resolution to ban MOC for MD licensure; the state medical licensing body agreed to this idea but it was never made into law until now.  Fight on ! The impossible only seems that way.

Remember when the AOA worked for their members?

Gina Reghetti, DO shares her response to the AOA’s email alert opposing the repeal of ObamaCare:

Dear Dr. Buser:

I am writing in response to your “Urgent Action” email that I received on July 22, 2017, regarding the repeal of the PPACA, which is attached below.

I do not agree with your position that if the PPACA is repealed it would “significantly jeopardize our heath care system.” Since you represent the AOA as its president, I feel that you are using your position to influence political agendas that are not in the best interest of American patients and their doctors.

I would hope that the AOA does not use doctors’ membership dues and board certification fees to support such agendas that do not support the Osteopathic Philosophy of independent, private, practice osteopathic doctors that deliver one-on-one direct, private care to their patients without government or third party intruders, and that stay true to the practice of Osteopathy, as Andrew Taylor Still, D.O., M.D., founded.

Your stance appears not to support the Free Markets in the USA, and direct pay practices which are far better solutions than a government controlled healthcare system.

I take great insult that the AOA, through your voice as president, uses osteopathic doctors’ hard earned money to push agendas that are not reflective of the American way, and I believe that it constitutes just another AOA federal violation.

I am also very concerned as to why the AOA cashed my ninety dollar check for my board certification dues, yet the website displays that my board certification is inactive for the public to view, when that is incorrect since my board certification is dated to expire in 2022; although it should be a lifetime certification. Worse yet, the message to the public is to indicate that if osteopathic doctors do not hold board certifications through the AOA then they are somehow less qualified to practice medicine. I find this to be very defaming, and I request that this serious issue be corrected immediately and removed from the public website.

I remember when the AOA worked for their osteopathic physicians and surgeons and supported Osteopathy, but over the many years that role does not appear to be so any longer. Rather the AOA uses their power to lobby, such agendas, that are against the osteopathic oath and training of osteopathic physicians and surgeons here in the USA.

The AOA does not correctly reflect the opinions of their doctors; especially, when emails as yours are sent. There is no room for Politics in Medicine!

I would highly recommend that you, and the AOA, cease immediately from sending emails out that reflect your political stance rather than the Osteopathic Profession’s.

I strongly oppose your views as do the majority of practicing physicians and surgeons across this great nation.

Let us keep the United States of America a free nation for all and let us keep the government out of peoples’ lives, and especially out of healthcare, since it will only do more harm than good.

I thank you for your understanding and immediate attention to this serious matter.

I look forward to hearing from you to inform me that my Inactive board status is corrected back to Active status as it should be.

Respectfully,

Gina Reghetti, D.O.
AOA #64509
Attached: Dr. Buser’s email below:

 

 

 

Advocacy Action Alert


Dear Colleagues:

As you may have heard, the Senate will soon vote to repeal the Patient Protection and Affordable Care Act (PPACA) without a legislative alternative. Should this vote be successful, it would significantly jeopardize our heath care system, and result in a loss of coverage and access to care for up to 32 million Americans, and the potential for significant increase in premium costs.

Senators Lisa Murkowski (R-AK), Susan Collins, (R-ME), and Shelley Moore Capito (R-WV) have expressed their opposition and concerns about this plan. It is critical for any health care legislative proposals to achieve a high-quality, patient-centered, and cost-efficient system that meets the needs of our patients. I urge you to contact your senator to express your support for her pragmatic approach to health care reform and her vocal opposition to repealing PPACA without a legislative alternative, in order to ensure our patients have the continued access to health care.
The time is now to write to your senator and support her pragmatic approach to health care to ensure that our aforementioned goals on transforming the health care system focus on our patients.

Boyd R. Buser, DO

AOA President

 *Wondering how the AOA has developed its position on health care reform and the AHCA to date? Watch our webinar that explains the process.

Anti-MOC Victories at Michigan State Medical Society House of Delegates

Friend of IP4PI Dr. Meg Edison writes in:

Michigan State Medical Society House of Delegates was last weekend, Martin Dubravec and I ran around like crazy, testifying in support of 4 anti-MOC resolutions and against a resolution to join the FSMB Compact. The outcome was very successful:

  1. The delegates reaffirmed strong opposition to the FSMB Compact (making me very happy, since it was my resolution from 2 years ago that we oppose the compact).
  2. We passed a resolution to engage legal counsel to investigate anti-trust violations against ABMS/insurers/hospitals in Michigan.
  3. We passed a resolution calling for an end to the direct-to-consumer advertising of the ABMS MOC product.
  4. We passed a resolution calling for public access to initial board certification status on ABMS websites.
  5. A resolution asking the AMA to amend their MOC policy to require informed consent from patients before conscripting them into ABMS MOC QI projects was referred to the board for more study, disappointing…but not surprising given how many academics are delegates. Ken Fisher was on the committee that heard this, he fought like mad and got it approved…but the delegates extracted it and referred it to the board on the house floor. Still, the conversation on the ethics of MOC & research was started.

I’ve attached the resolutions (see links embedded in list above) for your future reference if you’d like to share and pass similar resolutions in your state medical societies. I want to point out, it is a small handful of us (me, Martin Dubravec, Ken Fisher). There were no other docs testifying. We don’t need an army to make change…just a few can do this. Yes, it’s a pain to give up a few hours on Saturday, these meetings are confusing and intimidating, but find a friend, become delegates and make this happen.
-Meg

I’ll add a 6th victory that came from years of getting the right people involved in organized medicine and our House of Delegates…

6.) On the same page as the “Oppose IMLC” resolution attached below, the resolution 24-17 to “study single payer” was “amended” to remove all language on “single payer” and approved with broad language to study all alternative payment models…which includes DPC and other free market innovations. Just 3 years ago, this same body voted to approve single payer…we’ve come a long way.

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. Continue reading

I should not be mandated to PAY-to-Practice this great noble profession of Osteopathy.

IP4PI supporter Gina Reghetti, D.O. shares correspondence regarding continued attacks on the osteopathic profession.

Just a note to let you know that I received a letter today from the AOA, dated 1-9-2017 and signed by Jeffrey L. Weaver, O.D., yes, OD, not DO, an Optometrist who is the Vice President, Certifying Board Services, and from Eunice Lee, Associate Vice President, Client and Member Services, informing me that I have until February 1, 2017 to renew membership to keep my AOA board certification active. My board certification is wrongfully time-dated to expire in December 31st, 2022.

My scanner isn’t connecting to my PC wifi so I am unable to email the letter to you currently.

I called Jeffrey L. Weaver, O.D., this morning to confirm that he is not a DO, and I had a conversation with him for more than an hour regarding my views and concerns of the wrong agendas that the AOA has enforced on their doctors, such as re-certifications, and OCCs and membership dues connected to certifications. Continue reading