MEDICARE LEGISLATION NEEDS YOUR ACTION NOW

By Diane Shandor, L.Ac.

I have in my practice a new client, Dan (not his real name).  Dan is 67 years old, a vet, and a great new client.  Dan has consistent back pain.  He came to me by referral from his chiropractor.  At the end of his first session Dan asked, “Does Medicare cover acupuncture yet?”  When I said I was sorry but it didn't, he indicated he was willing to pay directly for his treatments, especially if we could keep them to every other week.  Given his chronic pain, I'd like to be treating Dan every week.  I could consider discounting my fee for Dan.  However, I'd like to also look at the bigger picture.  There are millions of Dan’s out there who could really benefit from acupuncture treatment.  Many of them could not even afford half an acupuncturist’s usual fees. 

There are some pros and cons for acupuncturists regarding HR 646, The Federal Acupuncture Coverage Act.  On the positive side, the Act would enable 45.3 million people who receive Medicare coverage due to age or disabilities to access acupuncture as part of their Medicare benefits.  It would also allow Federal Employees to access acupuncture as part of their benefits.  For acupuncturists it’s a huge new market of folks that would likely lead to other possibilities for the profession, including work in hospitals. 

However, as we know, being a Medicare provider is more complicated than seeing clients who pay cash out of pocket.  Fees are set by Medicare.  We can't be sure at this time what the exact amount of payment would be for acupuncturists.  Currently, paper forms can be sent in.  But according to experts, that is being phased out so that submissions by 2015 would have to be electronic.  Not all acupuncturists will want to enroll as Medicare providers.  (It is important to note that providers can de-enroll if they try the system and it doesn't work for them.)   

I think we owe it to ourselves to each investigate the possible legislation by reading materials available, talking to other health providers who have been through this process, thinking about it, and if we are supportive, taking action now!  In January 2009 Congressman Maurice Hinchey (D-NY) introduced HR 646.  This fall is a critical time.  Since there is so much legislative energy going into healthcare, it is possible that acupuncture could gain this new status as part of the larger reform. 

Acupuncturists who support the possibility of this coverage need to be actively engaged.  Representatives in Congress need to hear that their constituents want HR 646 passed in the House and a similar bill introduced in the US Senate.

There are several ways to actively encourage participation.  www.aaaomonline.org  has a web page full of information.  This includes templates for letters to congress and the president.  AAAOM encourages us to ask our patients who have benefited from acupuncture to write and call their congress .  Just go to the site and click on RallyCongress.

"To read more about these significant findings on increased use of acupuncture, Tai chi, and Qi gong, please go to http://nccam.nih.gov/news/2009/073009.htm , which provides access to the newly released National Health Statistics Reports (NHSR), (Number 18, July 30, 2009) as well as the earlier, NHSR (Number 12, December 10, 2008)."

The Annals of Internal Medicine reports that Tripterygium wilfordii Hook F (TxHF) extract offers better symptom relief than sulfasalazine in patients with rheumatoid arthritis.  The herb is also known as lei gong teng or Thunder God Vine.  It is used in TCM to treat inflammatory conditions.  U.S. researchers randomized some 120 adults with active rheumatoid arthritis to receive the extract of 180 mg, or sulfasalazine (2 g daily) for 24 weeks.  Participants were allowed to use stable prednisone dosing (up to 7.5 mg/day) but not disease-modifying antirheumatic drugs," reports Physician's First Watch.  "In intent-to-treat analyses, significantly more patients assigned to TwHF versus sulfasalazine achieved at least a 20% improvement in arthritis symptoms (65% vs. 33%).  In analyses limited to the roughly 50% of patients who completed the study, results were similar. Adverse events did not occur between the two groups.  The authors write that three of TwHF's metabolites--triptolide, tripdiolide and triptonide--account for its anti-inflammatory and immuno-suppressive effects."
 

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