AMERICAN NATUROPATHIC RESEARCH INSTITUTE
NATUROPATHIC ONCOLOGY RESEARCH INSTITUTE
1250 E. Baseline Rd., Suite 205
Tempe, AZ 85283
JOINT MEETING OF THE
AMERICAN NATUROPATHIC RESEARCH INSTITUTE (ANRI)
NATUROPATHIC ONCOLOGY RESEARCH INSTITUTE (NORI)
INSTITUTIONAL REVIEW BOARD (IRB)
November 4, 2011
MINUTES AND MEETING NOTES
In accordance with the requirements of the United States Code of Federal Regulations, Title 45, Part 46, the eighth regular quarterly meeting, of the American Naturopathic Research Institute (ANRI) and the Naturopathic Oncology Research Institute (NORI) and the Institutional Review Board(IRB) was called to order at 12:45 p.m., November 4, 2011 at 1250 E. Baseline Rd., Suite 205, meeting in Suite 203, Tempe, AZ 85283.
The following members were in attendance (alphabetically by last name):
Turshá Hamilton, NMD
Colleen Huber, NMD
Thomas Jemison, NMD
Kenneth Lashutka, NMD
Paul Stallone, NMD
Phranq Tamburri, NMD (who arrived just as the first meeting was ending, then participated in a second mini-meeting.)
Others who have attended previous meetings or wish to attend future ones are cordially invited to join us for future meetings.
COMPARISON OF NATUROPATHIC AND ALLOPATHIC MEDICAL EDUCATION
The AANP became aware of a letter sent by the American Association of Family Physicians (AAFP) sent to members of Congress, alleging inadequate medical education of naturopathic physicians, as an argument for not licensing naturopaths nationally to be primary care physicians.
Dr. Huber asked the group if ANRI should respond to this letter publicly, informing all the recipients of that letter that naturopathic medical education includes twice as many courses in medical school and more than twice as many classroom hours as conventional medical education, with board exams in all disciplines of conventional medicine as well as traditional naturopathic modalities.
Dr. Stallone responded that we should not bother to respond to that letter, and that it would be a waste of time, considering that Arizona naturopathic physicians are well-established as primary care physicians. Nobody offered an opposing argument to this viewpoint.
WEBSITE CONTENT: NATUROPATHIC STANDARDS.ORG
Dr. Huber asked if anybody would like to make any changes to the content of our website, www.NaturopathicStandards.org. Nobody had any suggested changes.
AFFORDABLE CARE ACT – HOW WOULD IT AFFECT OUR PATIENTS?
Dr. Huber asked how the 2010 Affordable Care Act, specifically the individual mandate to go into effect in 2014 would affect our patients. Dr. Stallone suggested that it would help our patients and ultimately naturopathic medicine, in that insurance consumers would eventually demand that their premium dollars pay for their choice of medicine, rather than some other kind of medicine (namely allopathic) which they may have no interest in, especially if the purchase of health insurance becomes compulsory.
GETTING HEALTH INSURANCE REIMBURSEMENT FOR OUR PATIENTS
Josh Quitmeyer, who works for Dr. Huber, presented a summary of the work he has been doing on getting health insurance reimbursement for naturopathic patients. He described the database that he designed and the use of CPT codes that he submits through a third-party insurance billing company that bills for their services only after patient reimbursement (at 5% of the reimbursed amount).
Josh is happy to share this information with any naturopath or their staff. Josh may be reached at Dr. Huber’s office, 480-839-2800.
Josh can also build a customized database, in his free time, for other naturopathic offices. Let him know if you would like this help.
Josh mentioned that we are even submitting to Medicare, even though those claims are almost certain to be denied.
Dr. Stallone pointed out that it is good that Medicare gets these claims, because patient outrage at lack of reimbursement may eventually provoke Medicare reimbursement of naturopathic medicine. Also, Dr. Stallone clarified that although “secondary insurance” won’t cover anything not covered by Medicare, there is often “supplemental insurance,” which does, or can, reimburse what Medicare does not cover.
Dr. Stallone also pointed out that naturopaths must include start and stop times of procedures which have CPT codes that are delimited by time periods, such as various codes for IVs.
Dr. Stallone also cautioned that sometimes insurance companies send letters to providers demanding a refund of an amount that they have already reimbursed.
Dr. Huber responded that it is important for all providers to stand firm against such tactics by insurance companies, and described her own previous experiences resisting such demands. Part of the following letter was drafted by a MD for use in his own practice when insurance companies demand refunds of previous reimbursed amounts. This letter, sent by Certified Mail, has worked well also for Dr. Huber’s practice and has vanquished all such demands so far:
Your reimbursement in the amount of $2,048.70 was forwarded to the patient the same day it was received, in accordance with our clinic’s policy. The patient was covered under your policy. She has cashed the check. The patient has paid in full at time of service, in accordance with our clinic’s policy, which is why we forwarded your reimbursement payment to the patient.
Your company is therefore not in a position to demand payment of the above-mentioned amount, and your request is again denied, in accordance with our letter of March 17, 2011, informing you of the same outcome.
The patient’s payment may also fall under the jurisdiction of Federal laws and regulations, which protect a member’s right to appeal a denied benefit payment.
We will wait to take any further action until we receive notice of a Federal Court Order resulting from your member’s possible lawsuit against your company.
Our clinic’s No Refund Policy is firm without exception. Your company will not receive any refund from our clinic. Any attempt on your part to undertake collections will be prosecuted by our clinic’s attorneys as a fraudulent collection, to the fullest extent of the law.
DR. TAMBURRI’S SURPRISE APPEARANCE
At the end of the ANRI / NORI meeting, as most people were leaving, Dr. Tamburri arrived, hurrying over after a busy morning at his clinic.
A fascinating discussion and debate then ensued, regarding the gold standard of currency, the Austrian School of Economics, the recent real estate bubble and those who predicted it, fixed vs. variable mortgage interest rates, the Occupy Wall Street movement, the bank bailouts, a comparison between the liberties of citizens and the liberties of corporations, tariffs, the history of tariffs in the U.S., libertarian vs Republican vs Democratic politics, the two-party system vs a three-party system in general and the upcoming Republican primaries.
Of course, this was far removed from ANRI / NORI, so we got back on a relevant subject (briefly) discussing how prostate cancer patients tend to be railroaded toward surgery, in the conventional fear-based medical system. That is, a PCP sees a rising PSA, and refers to a urologist. The urologist sees any one of a number of ambiguous or worrisome indicators and steers the patient towards crippling treatments and procedures (surgery, Lupron, etc.) The irony was noted how fear-based medicine can steer a man toward mutilation and away from much safer treatments.
NEXT BOARD MEETING: Friday, February 10, 2012 at noon, at the usual place, the clinic of Drs. Huber, Lashutka and Jemison, in Tempe. Chipotle’s will be served, unless objections surface before then.
Dr. Huber continues to offer for her clinic to provide lunch for the meetings at no cost to the membership, in order to save up the usual $10 dues per quarter per person to pay the $400 fee for the eventual incorporation of the non-profit.
POSSIBLE AGENDA ITEMS FOR FEBRUARY 10, 2012 BOARD MEETING
Dr. Lashutka mentioned that one role of ANRI / NORI is to hear about research done by its members and guests, including case series and other studies.
Dr. Stallone emphasized that there are other naturopaths who would come for these meetings if we focused more on a Grand Rounds type of format, sharing information on case histories, and treatment methods that have worked for us. Tumor boards are an example of what can happen at these meetings.
Dr. Huber requested that we proceed with that in a mutually respectful way that does not demand all information from the most experienced physicians among us, in a barrage of rapid-fire questions, but rather allows each of us to volunteer information as we see fit, with some role for questions and answers.
What happens when the AZ vaccine exemption form isn’t enough to get out of a vaccine?
Some time ago one of our patients registered at ASU and was told that the medical exemption form that I had signed was not enough, and they badgered him into getting a flu shot and a tetanus shot. This was a perfectly healthy, fit, strong, young landscaper. Predictably, after the shots he got the flu, first time in his life, and his health has not been as good since. How about if ANRI sponsors a Vaccine Research Program, and makes a letter on our ANRI letterhead, which doesn’t exist yet, that says, “the abovementioned person is strictly NOT to receive any immunizations outside of our research program, and the program ensures that all the participant’s immunization needs have been met.” Or something like that.
Search for an Executive Director.
Colleen Huber, NMD
Secretary, ANRI / NORI