The Nondiscrimination Provision Levels the Playing Field for Nonphysicians

There is a saying that if you are not at the table, you are probably on the menu. These days the table for health care providers is becoming very crowded with nonphysicians. Under a provision of the Patient Protection and Affordable Care Act (PPACA) it seems the intent is to expand the scope of nonphysicians, possibly in an attempt to increase access to care because so many more individuals are expected to have health care coverage. Section 5101 of the PPACA defines the national health care workforce to include all “doctors of chiropractic...licensed complementary and alternative medicine providers, integrative health practitioners...” Section 2706(a) (title XXVII of the Public Health Service Act) is the nondiscrimination in health care provision that takes effect next year and mandates that insurance companies cannot discriminate against any health care provider “with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.” Legitimizing the independent practice of medicine by nonphysicians is a major concern associated with this provision, particularly for dermatologists.