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.

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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

AOA Empire as a Regulatory Agency

Bob Maurer, D.O. writes:

To My Fellow Osteopathic Physicians: It is incredible how dysfunctional many of the AOA administrative departments have become. One of the biggest problem with the AOA is the empire that John Crosby built over the past ten years. It is an empire that the AOA directors do not recognize and do not know how to dismantle.

A prime example is the AOA administrative leader who told us that a lecture on the use of the new defibrillator was inappropriate for practicing osteopathic physicians.

The AOA has become a regulatory agency of its own, many times more dangerous than our own federal and state governments. It is overloaded with top level administrators, many of whom have the sole function of creating regulatory requirements that are detrimental to you and I and our fellow AOA members. Continue reading

No Replacement For The Osteopathic Approach To A Healthy State Of Wellness

Medicine At Its Finest  By Gina Reghetti, D.O.

I will focus on the Osteopathic Medicine Primary Care approach to attempt to explain the dismantlement  of  medicine.  It is my professional opinion that the Corporate developers of the Health Industries’ Electronic Automated Technologies believe that they have developed technology smart enough to replace the role of doctors in general, and specifically, the role of the Osteopathic Physicians from their noble profession of medicine.  Specifically, the focus will be on the total dismantlement, and removal of the Osteopathic Physicians and Surgeons from healthcare entirely; for no other reason other than the Osteopathic Medicine Primary Care approach works.

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Reconnecting the patient-physician relationship

Primary care, like osteopathic family medicine with OMM, is an amazing and diverse specialty. It takes time to listen, see and palpate a patient to help treat disease and maintain optimal health. The government, insurance industry, malpractice attorneys and hospitals have made this ideal practice impossible and nearly extinct. More than half of a DOs and their staffs time is taken up with government compliance measures and insurance red tape. The primary answer is reconnecting the patient-physician relationship without third parties in a direct primary care DPC model.

Best wishes for good health,
Craig M. Wax, DO
Family physician, Editorial Board of Medical Economics
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
http://wgls.rowan.edu/?feed=YOUR_HEALTH_MATTERS
Twitter @drcraigwax
Independent Physicians For Patient independence @IP4PI

Enough is Enough: AOA and IOM vs. Osteopathic Education

AOA quote:

The A​merican Osteopathic Association (AOA), the national professional membership organization for the nation’s more than 104,000 osteopathic physicians (DOs) and osteopathic medical students, applauds members of the Institute of Medicine’s Committee on the Governance and Financing of Graduate Medical Education (GME) for their work on the comprehensive report, Graduate Medical Education That Meets The Nation’s Health Needs. Specific acknowledgment goes out to Barbara Ross-Lee, DO, Vice President for Health Science and Medical Affairs, New York Institute of Technology, for representing the osteopathic medical profession.

Let me get this straight, the woman (Barbara Ross-Lee, DO) that single handedly took apart three osteopathic institutions and removed nearly all of the Osteopathic components of education that made them osteopathic at all including the faculty and the curriculum is being applauded for her leadership and representation of the Osteopathic community at the IOM? Regardless of the accolades, laurels and academic achievement she may have achieved, she does not represent me or Osteopathy in any way that has real meaning.

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What would happen if doctors say goodbye to the AOA?

Guest post from Gina Reghetti, D.O.

What would happen if doctors would no longer be members of the AOA? Here’s the power that they exert on us. Once we are no longer “Active” members with the AOA, they will immediately make our board certifications which are “Time-Limited,” go “Inactive.” I know that is illegal. It is a violation. Let’s stand united to seek justice.

I also believe that “Time-Dating” Certifications is illegal! Mandatory Membership is not a good idea; it’s control. Whenever one doesn’t have an option, then that puts individuals at risk due to loss of FREEDOMS. Continue reading