IMPORTANT INFORMATION ON THE NOVEL CORONAVIRUS (COVID-19)
As concerns about the spread of coronavirus mount and efforts to contain it escalate, Naturopathic Doctors should be aware of the latest advisories from public health agencies and credible organizations, and be prepared to report and/or advise
The AANP advises healthcare practitioners to follow public health guidelines, and standard preventive medicine protocols, including basic naturopathic and lifestyle protocols that can support the immune system and mitigate the risk of exposure
to infectious diseases.
We will continue to update this page as we receive more information and as things change.
ND Researchers Launch Registry for Your Covid-19 Case Studies
A team of Naturopathic research programs has created a registry to collect information on naturopathic approaches to providing supportive care during the pandemic. This registry can be completely anonymous without required reference to you or
your practice, and does not collect any protected health information (PHI) regarding patients/clients. If you have provided care, please consider submitting information to the registry! Read FAQ here.
The AANP Urges Physicians and Hospitals to Utilize IV Vitamin C to Combat the COVID-19 Pandemic
The American Association of Naturopathic Physicians urges our medical colleagues to incorporate this treatment from the naturopathic medicine toolkit immediately in an effort to save lives and reduce long-term morbidity. While we applaud the
use of IVC by a small number of hospitals in the U.S., it unfortunately remains a rarely utilized intervention, despite the potential to save lives and reduce the ventilation needs on critically ill patients.
The AANP Calls On Authorities to Engage Naturopathic Physicians
The American Association of Naturopathic Physicians calls on Federal, State and Local authorities to engage naturopathic doctors in emergency measures to supplement the healthcare workforce during this the Coronavirus Pandemic.
There are simple steps a clinic can take to help prevent the spread of viral infections, including having a plan to ensure that a person ill with any respiratory illness follows good cough etiquette and hand hygiene.
For patients who might be ill with a respiratory viral infection, clinics should also have a plan in place that addresses how to care for a patient before they arrive, during intake, and while the patient is being seen. As much as possible, clinics should focus on prescreening questions at the time of scheduling the appointment and telemedicine consults.
Click below for guidance for reaopening clinics, shared courtesy of Oregon Association of Naturopathic Physicians.
Instruct patients to call ahead — or inform the health care provider upon arrival — if they have symptoms including a cough, shortness of breath and fever. Ask the patient to wear a facemask to contain their cough, and place the patient
in an exam room as quickly as possible. Here are guidelines on when masks are appropriate and how to properly use them.
Consider screening patients for other germs that cause respiratory illness.
If a person with possible COVID-19 arrives unexpectedly, ask the patient to wear a mask and take them immediately to an exam room. Keep the exam room door closed.
If possible, schedule a person who may have COVID-19 as the last patient of the day.
If possible, suspected COVID-19 patients should be escorted into the building through an entrance that allows them to access an exam room without exposing others.
Collect all specimens and perform clinical interventions in the exam room if possible.
The exam room should be left empty for as long as possible after the patient has left; the room should be thoroughly cleaned and disinfected.
Patients who are under evaluation for COVID-19 may stay at home if they are not sick enough to be admitted, but will need a plan for who to contact if clinical symptoms worsen. See CDC guidance for home care.
If a patient does not have a clinical need to be sent to the emergency department or a hospital, do not send them there. You do not need to routinely notify the state authority when evaluating patients with respiratory illness. Discuss
a plan with the patient to seek appropriate medical care should symptoms worsen.
Protecting yourself and employees
Clinics play a vital role to keep their communities healthy. To do that, they need to take care of their providers. There are basic steps every employer should take to plan for the unexpected.
Those steps should include:
Ensure that your leave policies support employees who need to stay home when they are ill.
Instruct anyone who becomes sick with a fever and cough illness at work to go home immediately, and return only after they are free of symptoms for at least 24 hours (without the use of fever-reducing medicines or cough suppressants).
If your organization works with companies that provide contract or temporary employees, talk to those agencies about the importance of sick employees staying home, and encourage partners to develop flexible sick leave policies.
For employees who are sick with acute respiratory illness, do not require they provide a healthcare provider’s note to validate their illness or to return to work.
Create or update policies to allow employees to stay home to care for a sick family member or child who cannot go to school.
Plan for absenteeism by identifying essential functions and creating plans for continuity of operations.
Cross-train personnel to perform essential functions so the workplace can operate even if key staff are absent.
Consider what your business would require to maintain critical operations (identify alternative suppliers, prioritize customers, temporarily suspend some operations if needed).
The American Academy of Family Physicians has prepared a Checklist for Physician Offices for COVID-19.
How to Message Prevention and Symptom Treatment Options to the General Population:
The AANP has teamed with professionals in the integrative medicine, dietary supplement, and legal fields to analyze the sudden increase in regulatory activity around natural approaches to improving immune resiliency, and treating viral infections
and/or COVID-19. This resource provides information on the various laws at play, offers suggestions for providers to mitigate risk, and highlights where regulatory actions may cross the line into scope of practice - with the unintended
effect of limiting the ability of licensed providers to discuss important and appropriate non-pharmacological methods to mitigate COVID-19 and its symptoms.
Please read the Fact Sheet on Regulatory Agency Warning Letters (released June 5, 2020) for guidance on how to communicate your services to the public.
All healthcare providers should refrain from making health claims or proclamations about a "cure" or product that can "prevent" or successfully treat COVID-19. There are currently no nutrients, botanicals, vaccines, pills,
lozenges or other prescription or over the counter products available to prevent, treat or cure COVID-19 specifically. Web-based/email marketing that promote potentially false and misleading statements about prevention and cures of COVID-19
hamper efforts to safeguard public health and may create liability for healthcare providers making such claims. Click here to view a sample of an FDA warning.
Naturopathic clinics should decide whether to test patients for COVID-19 in your clinic, or refer to other clinics in your community. IF you decide to offer this service, it is absolutely imperative that you follow all safety precaution guidelines extremely carefully!
Due to limited testing capacity at this time, COVID-19 testing is not routinely available for patients presenting for care in the outpatient setting.
The following patients with COVID-19 symptoms are considered at highest priority for testing:
Employed in public safety occupation (e.g., law enforcement, fire fighter, EMS)
Part of an illness cluster in a facility or institution (e.g., healthcare, school, corrections, shelters)
With severe lower respiratory illness (hospitalized or fatal)
With worsening symptoms
Older than 60 years
With underlying medical conditions
Had contact with a suspect or lab-confirmed COVID-19 patient or had travel from an affected geographic area, within 14 days of their symptom onset
This provides $200 million in funding as part of the CARES Act, to help health care providers furnish connected care services to patients at their homes or mobile locations in response to the COVID-19 pandemic.
The COVID-19 Telehealth Program is open to eligible health care provider sites that treat patients, whether located in rural or non-rural areas or U.S. territories. The COVID-19 Telehealth Program is limited to nonprofit and
public eligible health care providers that fall within the categories of health care providers in section 254(h)(7)(B) of the 1996 Act: (1) post-secondary educational institutions offering health care instruction, teaching hospitals, and
medical schools; (2) community health centers or health centers providing health care to migrants; (3) local health departments or agencies; (4) community mental health centers; (5) not-for-profit hospitals; (6) rural health clinics; (7)
skilled nursing facilities; or (8) consortia of health care providers consisting of one or more entities falling into the first seven categories. See guidelines to apply for the FCC COVID-19 Telehealth Program.
Federal TeleHealth Guidelines and Resources
The CDC recommends using telemedicine technologies to not only protect your patients and clinic staff, but also to be able to continue providing healthcare services to your community. Here are some FREE resources.
DEA Clarifies Schedule II-V controlled substances may be prescribed by telemedicine without seeing patient during public health crisis, with certain conditions. PLEASE READ TEXT CAREFULLY
While federal guidelines require the use of both audio and visual in order to bill for telemedicine, some states have issued emergency orders further relaxing these standards to allow audio only. Please check with your state health department!
Also remember to ensure your patient’s privacy by reminding them to use headphones, meet in a private area, and to not share their login credentials.
HIPAA TeleHealth guidelines usually require the use of a HIPAA-compliant platfor for conducting TeleHealth, these requirements have currently been relaxed ONLY DURING THIS PUBLIC HEALTH EMERGENCY. Temporarily, HHS has indicated it is acceptable
to use non-HIPAA compliant forms of communication as long as they are person to person, not person to group (i.e., not FaceBook Live). While there are many paid platforms available, following are some free services:
State TeleHealth Guidelines and Resources (Note: The AANP cannot guarantee that all of the telehealth/telemedicine resources cited apply to NDs, or that they are up to date. If you have a more up to date resource than you see listed, please
send it to firstname.lastname@example.org.)
Vermont COVID-19 Licensing and Information (includes telemedicine). On March 25, 2020, a Vermont ND spoke with Lauren Laymen, staff
attorney at the Vermont OPR. Lauren confirmed that Vermont state law only requires that providers are Vermont-licensed to treat Vermont patients and that provider location is not pertinent. As such, telemedicine visits with Vermont
patients from a neighboring state fall within the Vermont scope of practice.
The legality of practicing Telemed is up to the states as the laws and emergency actions vary from state to state.
NCMIC's Telemedicine Policy. Assuming an ND is legal with the states in which the practice and the states where patients
are located, the NCMIC policy covers for Telemed.
Sprague Israel Giles/Arch Insurance Company provides coverage for telemedicine/telehealth services, and offers the following guidelines:
Services are considered rendered in the State where the patient/client resides, not where you are based.
If the State where services are rendered issues ND licenses, coverage will apply if you have an ND license in that State.
If the State where services are rendered does not issue ND Licenses, coverage will apply per the allowable scope of practice for that State for an unlicensed health practitioner.
Arch Insurance Company is waiving any and all additional costs associated with increasing telemedicine coverage on your policy to show telemedicine as a majority part of your operations. SIG needs to know what % of services you plan to
render via telemedicine for the foreseeable future, but it will NOT cost you anything more.
The carrier applies coverage according to updated legislation, and an emergency order granting out-of-state NDs access to telemedicine services for residents would count. If they get legal approval to provide services in a state without
first having to obtain an ND License in that State, SIG should be able to cover their services, per that State’s allowable scope. If it is a State that does NOT issue ND licenses, coverage as usual would apply per the legal scope for
an unlicensed provider in that State.
Aegis/MedPro: See Question 9 in MedPro's Covid-19 resource site, which states: “Will my coverage remain in force if I am temporarily practicing in a new state (whether care is provided in-person or remotely) in which I AM NOT authorized or licensed
to practice? Yes, if your practice in that new state is being conducted under an applicable federal or state waiver.”
*Note that the billing Q&A section in MedPro's sige is not applicable to ND’s. Aegis has negotiated a 12 pay plan for ND through AFCO and all customer service representatives have been advised to work with any borrowers calling asking
for accommodations. This includes waiving late fees and or extending cancellations when appropriate.
The CDC is urging people to have a 3 month supply of any prescriptions, and many insurers are waiving restrictions that prevent patients from refilling early. Providers should work with patients to have prescriptions refilled now in the event of shortages and/or additional social distancing mandates.
The global impact of the pandemic and extremely high demand for some products is definitely interrupting the supply of certain ingredients, especially for immune support products. In the face of supply challenges across the entire supplement
industry, AANP’s corporate partner Fullscript encourages providers to use their similar products tool to find brands or products that you may not have tried
before in case your trusted product may be unavailable.
We will add printed materials and resources from public health organizations and as provided to us by our community contributors. Contact email@example.com if you would like us to add a resource.
This spreadsheet to track expenses for the Paycheck Protection Program has been generously shared by Eva Sofia, ND, RD, LAc. Click here to access
FCC Reimbursement for Telehealth Expenses for Schools, Community Clinics and Rural Clinics
The FCC has a pool of money to reimburse ALL TELEHEALTH expenses for eligible healthcare providers to help provide telehealth services to patients at their homes or mobile locations in response to the COVID-19 pandemic. This can reimburse
your costs for equipment or services like Doxy.me, etc.
An eligible healthcare provider is defined as:
Post-secondary educational institutions offering health care instruction, teaching hospitals, and medical schools
Community health centers or health centers providing health care to migrants
New Financial Relief Resources (as of April 16, 2020)
Community Development Financial Institutions finance community businesses. You might be able to use locator to identify grants or loans to access for your practices. The organization that houses this locator, the Opportunity Finance Network,
is getting $125 million in capital from Google Fund for the CDFI's that are members of the Opportunity Finance Network to focus on businesses owned by women and people of color. Check to see if a CDFI near you has access to these resources.
Click here to access CDFI near you.
In the Bay Area in California, the "Opportunity Fund" has $50 million to help small businesses affected by COVID 19.
US Chamber of Commerce has The Save Small Business Fund which will provide $5,000 supplemental cash grants to help as many businesses as possible meet their most pressing needs—from rent and making payroll, to overall business operations. To qualify, applicants must employ between three and
20 people, be located in an economically vulnerable community, and have been harmed financially by the COVID-19 pandemic.
Grant applications will open on April 20, 2020. Grants will be awarded weekly on a rapid and rolling basis until all funds have been dispersed. To learn more about the Save Small Business Fund or apply for a grant, visit www.savesmallbusiness.com.
Congress Passes Historic COVID Aid, Relief and Economic Security Act (CARES)
On Wednesday, March 25, 2020, the U.S. Senate unanimously adopted a $2 trillion bipartisan agreement to address the needs of the American people and health care providers confronting the coronavirus pandemic. The House is expected to pass
it on Friday. It is the biggest economic rescue package in U.S. history. This comprehensive package provides new resources to address all aspects of the COVID-19 pandemic. Two provisions in particular will assist naturopathic physicians
impacted by the crisis.
On April 23rd, Congress passes additional COVID-19 stimulus funding to supplement the original CARES Act. Click here to see the comparison
of congressional response measures.
Direct Assistance to Physicians
$100 billion in direct assistance to physicians, hospitals and other health care workers for unreimbursed expenses and lost revenues due to reductions in other services as a result of the COVID-19 outbreak. Detailed guidance for eligibility
and submitting requests is forthcoming from the Department of Health and Human Services (HHS). AANP lobbyists are seeking clarification on how/if this will apply to NDs. Stay tuned for more info!
Small Business Stimulus
$360 billion in Small Business Administration grants and loans for small businesses, including physician practices. All naturopathic clinics would qualify for a variety of relief packages available to small businesses. Some of the provisions
As of April 15, the PPP has exhausted current funds and stopped processing applications.
Paycheck Protection Program: $350 billion of 100% government-guaranteed Small Business
Can be used for employee salaries, paid sick or medical leave, insurance premiums, and mortgage, rent and utility payments.
Interest rate cannot exceed 4%
Up to 8 weeks of average payroll and other costs will be forgiven if the business retains its employes and their salary levels.
Principal and interest is deferred for up to a year and all borrower fees waived.
Emergency Economic Injury Disaster Grants and Loans (EIDL): $10 billion in grants and loans to businesses that have been adversely impacted and need financial support.
Provides an advance grant of $10,000 (within 3 days of application) to small business and non-profits that apply.
The advance grant does not need to be repaid even if the application is subsequently denied by EIDL.
The grant may be used to provide paid sick leave to employees, maintain payroll, or pay business obligations and debts, including rent and mortgage.
Maximum EIDL loans are up to $2 million with interest rates up to 3.75%, as well as principal and interest deferment for up to 4 years.
Employer Payroll Tax Credits for employers whose (1) operations were fully or partially suspended due to a COVID-19 related shut-down order, or (2) gross receipts are down by more than 50%.
For 50% of wages paid by employers to employees during the crisis.
Credit is provided for the first $10,000 in compensation per employee from March 13, 2020 to December 31, 2020.
Click here to read a section by section explanation of the Small Business Stimulus Package. A simple application
process is supposed to be released by the end of next week that would allow business to apply and receive funds in the same day. The standards for eligibility will be proof of payroll costs and will be relaxed compared with 7(a) loans
issued during more typical times. While the SBA guarantees the loans, borrowers will apply through banks, credit unions and other lenders. Currently, 1800 private lenders are already approved to issue these loans. Inquiries at this
time should be directed to your bank or the Small Business Administration
What Stimulus Loan Should I Apply For and How? An excellent side by side comparison to help guide you on what assistance you should apply for from the CARES stimulus for small
business programs. Paycheck Protection Program Application.
Allows all student loan payments, principal, and interest to be deferred for six months through September 30, 2020, without penalty for all federally owned loans. Includes medical school student loans.
Navient has suspended payments and interest accrual on all U.S. Department of Education (ED) owned loans until September 30, 2020. You do NOT need to call Navient to opt in
to this, only call if you want to opt out and continue making payments.
For FFELP loans (prior to 2010) owned by Navient (but not owned by the Dept of Ed), Navient is offering up to three months of administrative forbearance to qualified FFELP borrowers who request it. This program brings your eligible
loans current and postpones payments for up to three months. During this time, you will not be responsible for making payments but please know interest will continue to accrue. At the end of this forbearance, unpaid interest will
not be capitalized (added to your outstanding principal balance). Please be aware that if this accrued interest is not paid and you postpone your payments in the future with a different forbearance or deferment then interest could
be capitalized (added to the outstanding principal balance) increasing your overall loan balance. You have to call and ask for this.
AANP webinars related to the COVID-19 and Business and Telemedicine Resources during this national emergency continue to be available to AANP members and non-members free of charge, but are now behind a login portal. You do not have to be
a member of the AANP to create a free guest profile, but these resources are only available to students and doctors in the naturopathic community.
Clinical Resources related to the COVID-19 during this national emergency continue to be available to AANP members and non-members free of charge, but are now behind a login portal. You do not have to be a member of the AANP to create a free
guest profile, but these resources are only available to students and doctors in the naturopathic community.