The good news is Medicare has finally approved Acupuncture for coverage. The bad news is that they are just covering MDs, with little or no training, to perform the Acupuncture, or a Licensed Acupuncturist who bills through an MD.
Licensed Acupuncturists don’t just do Acupuncture. We are taught to view the body in a different way than conventional medicine. It is a way of viewing the interaction and dependence of the various organs and systems with each other. If an organ isn’t working correctly it will place a strain on other organs that have to attempt to compensate. And, if the body is running too hot or cold, to dry or damp, or if there is too little or too much energy the organs can be adversely affected. (Fatigue or agitation are examples of erratic energy.)
The basic theory of Traditional Chinese Medicine (TCM) takes at least a year to learn. This theory is a way of determining underlying causes of annoying symptoms, illness and disease and then treating the root cause. It also provides a road map for prevention of illness and disease by identifying and resolving harmful patterns and habits. Seemingly insignificant symptoms are clues that help determine underlying problems. Fix the cause and the symptoms go away.
If you like my articles and like the way I explain health and wellness it is due to my TCM background: knowledge and clinical experience.
To obtain a state license, and practice, a Licensed Acupuncturist is required to have four years of schooling, after college, and at least 800 hours of internship. We are trained in the theory of Traditional Chinese Medicine (TCM ), Chinese Herbology, Dietary Medicinal Therapy, Tui Na, (Chinese medicinal massage), as well as other medicinal techniques. Training varies a bit depending upon the school attended, but all schools must cover the basics. This gives us a powerful perspective and set of tools for dealing with the wide variety of health issues.
TCM schooling includes conventional Anatomy and Physiology. We are taught when to refer patients to an MD or emergency room for tests or treatment. In Oregon we are licensed by the Oregon Medical Board and held to the same rules and standards as other medical professionals.
Before practicing, Licensed Acupuncturists sit for board exams and must pass to obtain a license to practice. To be licensed also requires an FBI check, to rule out any criminal activity. Any criminal conviction means an automatic loss of license. To maintain a license, ongoing continued education is required. All this is the same as any other medical professional.
The point is, going to a weekend seminar, or reading a pamphlet on Acupuncture points, or even going to China for a few weeks to be ‘certified’ in Acupuncture is not the same as TCM training and qualification.
As for Licensed Acupuncturists billing through an MD, all Medicare is initially going to pay for is a minimal fee for Acupuncture ($36), not any of the other modalities we incorporate. Much less paying for the office visit.
As far as Licensed Acupuncturists billing through an MD: anyone who has ever received an insurance bill knows that everything that is done for a patient has to be itemized and billed separately. Then the insurance company determines what they do or do not want to pay for. This varies widely per company. It is confusing for patients and practitioners because no one can ever be sure of what will be paid. Billing takes so much time that either paying staff or a billing company is necessary. As little as Medicare is going to initially pay for Acupuncture, it doesn’t make it financially feasible for most MDs to pay their billing staff or billing company and pay a Licensed Acupuncturist for their services as well.
So, under the circumstances, why is it good news that Medicare has decided to cover Acupuncture? Because Medicare sets the standard for insurance companies. If Medicare covers something, all other insurance companies will do so as well. It is the first step. It means Acupuncture has finally been accepted as mainstream medicine. The appropriate compensation for office visits, Tui Na, nutritional and herbal consultations will follow.
Licensed Acupuncturists are in the same position now as Chiropractors were in the 70’s, fighting for credibility; an understanding of what we do and it’s value. We are going through the same challenges of obtaining reasonable compensation for our services as Chiropractors did then.
Auto insurance companies and workman’s comp have been paying Licensed Acupuncturists well for our services for decades. They know TCM helps people heal quickly, often when nothing else works.
The Veterans Administration is now hiring Licensed Acupuncturists because they have learned that TCM excels at treating, not just physical but emotional pain including Post-Traumatic Stress Syndrome (PTSD), anxiety, depression and related insomnia.
TCM has proven a powerful tool in the opioid crisis, by reducing the need for pain medications. Consequently, the Oregon Health Plan (OHP) has approved as many Acupuncture treatments as their members feel they need. It is also an effective tool for helping people get off of pain medication as well as treating addiction. The insurance company Oregon signed up with, for their OHP, initially paid very little for the Acupuncture but enough for many of us to still accept. After a year, Oregon’s insurance company started requiring so much paperwork, of all their practitioners, that it made it cost prohibitive for many of us to provide our services to OHP members. Especially Licensed Acupuncturists who were paid so little to begin with.
Once Medicare pays for the range of services provided by any licensed practitioner it sets a standard for minimum compensation by insurance companies. When this happens for Licensed Acupuncturists it will insure that this low cost and effective medicine is available to all.
What you can do to speed up the process is to contact your state and congressional representatives to demand that Licensed Acupuncturists be permitted to bill Medicare directly for all their services. Once that is accomplished it really will be good news for health care.
Health and Happiness,
Nancy Burton, L.Ac.
For consultations call: 541-646-1034