BHMK filed a class action lawsuit on behalf of naturopathic physicians and their patients. The lawsuit alleges that two insurance companies—Health Net Health Plan of Oregon, Inc., and American Specialty Health Group, Inc.—violated the Patient Protection and Affordable Care Act (“ACA”) by discriminating against naturopathic physicians.
The ACA mandates non-discriminatory health care with the goal of improving the quality, affordability, and accessibility of patient care. Specifically, insurance companies cannot discriminate against a health care provider acting within the scope of their state-issued license.
The State of Oregon has licensed naturopathic physicians since 1928 with a broad scope of practice that allows naturopathic physicians to serve as primary care providers, provide preventative services, prescribe pharmaceuticals, and order tests necessary to diagnose and treat illness.
The lawsuit alleges that Health Net and American Specialty Health violated the non-discrimination mandate by limiting patient access to naturopathic physicians licensed in Oregon. Those discriminatory practices include prohibiting reimbursement to naturopathic physicians for certain types of care, capping annual reimbursement amounts to naturopathic physicians, and paying naturopathic physicians less than other providers performing the same service.
The lawsuit seeks several remedies, including: (1) reimbursement to individuals who have been denied benefits under their health insurance plans; (2) repayment of profits retained by the insurance companies as a result of their discriminatory practices; (3) enforcement of non-discriminatory practices in the future; and (4) a declaratory judgment clarifying application of the ACA’s non-discrimination mandate.
