This is a letter from the Maricopa County Medical Society to its members.
Jonathan Weisbuch shared it along with his reply to the Society.

Dear Physician Member,

The purpose of this email is to bring your attention to Section 2706 of the
Patient Protection and Affordable Care Act (PPACA), titled
“NON-DISCRIMINATION IN HEALTH CARE” and to ask you to contact your
legislators regarding this issue. A copy of the language from the bill is
attached. This section of the law would prohibit insurance companies from
discriminating against any practitioners practicing within the guidelines
of their state licensing board. It effectively means that as of January
1, 2014, insurance companies cannot discriminate against covering services
for Naturopaths, Chiropractors, advanced care Nurses (e.g., NP’s, nurse
anesthetists who want to practice without physician supervision), midwives
(if there is a state licensing board), and any other alternative medicine
group with a state licensing board.

The concern is that, in addition to providing lower quality and sometimes
dangerous care, the provision will not only increase the cost of care by
paying these alternative providers, but can also result in patients needing
to seek further care to deal with adverse outcomes.

We are providing a link for you to use to contact your legislators. We are
also providing a sample letter that can be amended and copied and pasted,
for your convenience. Please replace the examples in the letter with
examples from your own practice. We are also asking that you forward this
to as many physicians as possible, both in and out of state. The hope is
that as many legislators from as many states as possible will receive
numerous letters to bring their attention to this subject.

For those seeking more information, below are some links to some articles
from alternative healthcare groups exemplifying their interpretation of the
law: (links were not included in this copy).

Jonathan’s reply:

Dr. Miriam Anand, President Elect
Maricopa County Medical Society
326 East Coronado
Phoenix, Arizona 85004

Dear Dr. Anand,

I have just read your Special Issue of the InforMed Letter, dated May 20,
2013; and I am surprised by its implications. Is our profession so elite
that we can take a position criticizing other providers of care, suggesting
that if the insurance industry compensates naturopaths, chiropractors,
nurse practitioners, and midwives, that the quality of care throughout the
state will decline and costs will rise? Anecdotal information against
other licensed professionals is insufficient to demonstrate that they are
harming patients. Do you have data to justify these claims? We all make
mistakes in our practice of medicine otherwise unnecessary injuries and
deaths would not occur in our hospitals; and the misdiagnoses and
inappropriate interventions, which harm our patients, would not occur.

In this period when the Affordable Care Act is being implemented, and
medical and hospital providers in Arizona are urging our legislators to
support the Governor’s efforts to expand Medicaid to provide every Arizona
citizen access to health insurance, is it appropriate for the Maricopa
Medical Society to be accusing other clinicians of providing inadequate
care? Should we not reach out to these other licensed professionals to
determine how we might expand and improve the care a million Arizonans will
demand in coming years? How can we justify asking our legislators to enact
a bill to eliminate the non-discrimination clause, Section 2706 of the ACA,
when the providers under this section are appropriately licensed by the
state? Does that imply we should demand our legislators to withdraw the
clinical licenses from the non-MD/DO practitioners in this state? Should
we tell our patients not to use the non-physician providers? Shall we
choose not to care for them when they do seek help from acupuncturists,
midwives, nurse practitioners, naturopaths or chiropractors? Are we
willing to stipulate that the regulations established by Arizona license
boards are insufficient to protect the health and safety of the citizens of
this state who seek the care of other licensed practitioners?

I think not. Now is the time to join with our fellow professionals now
serving Arizona citizens, many of whom are our patients, and integrate them
into a larger team of providers, working to improve the health of our
population, and meet the needs of the Affordable Care Act to serve all who
are without adequate coverage. Now is not the time to be declaring war on
other practitioners whom patients seek to relieve their aches, pains and
problems. Now is the time to do all we can to make the Affordable Care Act
a success.

With all respect,

Jonathan B. Weisbuch, MD. MPH

Former MCMS Board Member