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.
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.