Proposed Medicare Acupuncture Coverage

Comment Period Ending Soon 

The Centers for Medicare and Medicaid Services (CMS) is moving forward with formal studies of acupuncture for low back pain. Link to Proposal 

The goal is to conduct clinical trials to determine if the evidence for acupuncture’s effectiveness warrants Medicare coverage, a critical step for the broader acceptance of acupuncture insurance billing.

CMS is currently soliciting public comments regarding their proposal.  Recently, Holistic Billing met directly with CMS staff and Dr. Joseph Chin Deputy Director of the Coverage and Analysis Group and Dr. Shari Ling, Deputy Chief Medical Officer, Center for Clinical Standards and Quality to voice our concerns with the proposal in its current form, chiefly the omission of licensed acupuncturists in the proposed clinical trials. LACs should be included explicitly in the studies. In our meeting with Dr. Chin and Dr. Ling, they were quite clear that the public comment portal is the best venue to shape the future of these trials. 

Currently, there are only 426 comments on the public comment portal. The comment period will close on August 15. The American Society of Acupuncturists (ASA) Board of Directors asks that you highlight several points below in your responses:

• Thank CMS for their consideration of this topic. (This represents a massive step towards the incorporation of acupuncture into national health care.)
• Ask that the section that includes “auxiliary providers” be changed to more clearly named “Licensed Acupuncturists or state equivalent.” The qualifications for auxiliary providers accurately describe this licensure group.
• • Make commentary directly about the laws in your state to highlight your required training, supervision (or lack thereof), and certification.
• Ask that the supervision required during the study portion be done only by an MD. Supervision by other licensure types does not have a precedent, nor does it add in any way to the safety or quality of the trials. (Note: supervision, in general, is only under comment for the trial phase, this does not apply to general practice. It is likely that, for CMS, supervision by an MD will be required for the study period.)
• • Make commentary directly about the laws in your state regarding supervision of practice. Who can practice in your state? Do you have a supervision requirement

Also, ASA provides a letter template should you wish to incorporate their verbiage or formatting. Letter Template Regardless of where you stand on Medicare covering acupuncture treatments, government decisions affecting acupuncture must include the input of licensed acupuncturists. The comment period will close by August 15; this is your opportunity to be heard. 

Are you interested in learning more about insurance billing and coding from a company specializing in billing insurance for acupuncture? Here are some additional tips!

All the best, 

Antonio Arias, MBA, CHBME

Reposted from Holistic Billing Services