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advises insurers that this nondiscrimination provision allows them to exclude from participation whole categories of providers operating under a State license or certification.In addition, the FAQ advises insurers that section 2706 allows discrimination in the reimbursement rates based on broad ‘market considerations’ rather than the more limited exception cited in the law for performance and quality measures.
If the free market is going to determine coverage, why does the AHCA force insurers to cover CAM provider services?
(For an appalling look at how naturopaths diagnose and treat endocrine disorders, check out the latest post.) Under the ACA, preventive services must include pediatric and adult vaccinations.
Given the anti-vaccination stance of most naturopaths, it is a public health risk to advocate naturopaths as providers of preventive healthcare.
Unfortunately, one of those is Section 2706 of the ACA (42 U. It adds that it is not an “any willing provider” law and that varying reimbursement rates can be based on quality or performance measures, a subject we’ll return to in a moment.
I have argued that forcing insurers to cover providers they would not otherwise choose to include is at odds with the ACA’s emphasis on cost-effectiveness and evidence-based practice.
Of course, “performance or quality” data is notoriously lacking on CAM practices, leaving insurers in a precarious predicament: If this hard performance or quality data justifying the exclusion of CAM practitioners from providing covered services didn’t exist, would they be forced to pay up just because some state legislature had foolishly passed a licensing bill giving chiropractors, naturopaths or acupuncturists a broad scope of practice?