Source: Bastyr News Article June 2010
The recently passed health reform legislation is primarily designed to expand health coverage to 32 million Americans who are currently uninsured.
Notably for the natural health arts and sciences field, however, the legislation also introduces important funding and provisions that could progressively upgrade the nation's current health care model to a more proactive, wellness-oriented system.
In recent years acupuncture and Oriental medicine (AOM) has emerged as a dynamic research field in the U.S., with numerous Western medical studies demonstrating acupuncture's effectiveness in treating everything from depression in pregnancy to low back pain.
On the clinical side, more Americans than ever are including acupuncture as part of their health care. According to the most recent survey by the National Center for Complementary and Alternative Medicine, 3.1 million American adults reported acupuncture use in 2007 as compared to 2.1 million in 2002.
Despite its clinical value and growing popularity, however, most insurers have historically shied from covering acupuncture for anything more than a limited number of visits for very specific conditions - if at all. That's now changing with passage of the HR 3590 health care reform package.
How? Most importantly, the legislation:
• Recognizes the health care field in the U.S. as inclusive of licensed complementary and alternative medicine providers and integrative health practitioners (acupuncturists are licensed in 44 states).
• Introduces non-discrimination language, which prohibits third-party payers from self-determining reimbursement strictly based on the licensed status of a provider (e.g.a dentist, acupuncturist, naturopathic doctor, etc.).
"This means insurers must not only include state licensed acupuncturists in their coverage, but also reimburse them based on a standardized rate (called a Current Procedural Terminology code, or CPT code) regardless of whether acupuncture itself is covered in the plan," says Terry Courtney, MPH, LAc, dean of Bastyr's School of Acupuncture and Oriental Medicine.
This change also means acupuncturists cannot be turned down for reimbursement simply because they are acupuncturists. This is the "non-discrimination" aspect of the health reform package, Courtney says.
When can AOM practitioners and the general public expect these changes to take effect? Once additional regulatory language is written, Courtney says. The health reform legislation is really the framework (or underlying structure) on which the regulatory language (or operational aspect of health care reform) will be built.
Thus, Courtney says while all insurance plans will soon include acupuncturist benefits, what the actual scope of coverage and rates of reimbursement will look like "remain to be seen.
(Acknowledgment to William Reddy, LAc, for his insights on HR 3590.)
