Tuesday, May 24, 2011

Massachusetts Bill to Mandate Acupuncture Coverage

Most all of us can agree we have been operating under the model of disease care, not health care, for the past several decades.  Prevention is the best medicine and acupuncture is one of several modalities that help individualizes make lifestyle choices to benefit their health and well-being. While passing national legislation as proposed in HD 1593 would be a boon to my practice (I would have to hire someone to run the office - yeah, an excuse for an annual Christmas party!),  mandating coverage for procedures not commonly used by the majority of the people bothers me on a personal (and self-insured) level.  Since KY is still fighting for "license" instead of "certification" and none of the large insurance companies will accept acupuncturists directly into their network, I do not see this state leaping on the bandwagon without an angel lobbyist trumpeting the cause. The argument is pretty compelling, in any event:

Acupuncture Insurance Legislation
● Under Massachusetts’ mandated universal healthcare and insurance system very few insurers
cover acupuncture services.
● Bill HD 1593 makes acupuncture services accessible to all families in every income bracket.
● Bill HD 1593 requires that all individual or group accident or health insurance policies, issued
by an insurer or non-profit health service corporation, provide benefits for services rendered by a
licensed acupuncturist in the state of Massachusetts.
● The consumer should have equal choice among all professionals licensed to practice acupuncture.
Acupuncture Training:
● Acupuncturists licensed in Massachusetts are regulated by the Board of Medicine .
Acupuncturists take a minimum of 2050 hours of training in acupuncture in addition to required
basic science and western biomedical courses. This is the equivalent of 3 to 4 years of study to
achieve an entry level degree of Master of Acupuncture and Oriental Medicine.

Cost-effectiveness of Acupuncture:
● According to a study in Washington state, the addition of mandated insurance coverage for
acupuncture and other complementary medicine did not significantly escalate healthcare costs.
● Costs actually decreased for acupuncture and complementary medicine users in high disease
burden groups due to a reduction of more expensive conventional care.
● The carpal tunnel syndrome study by Naeser et al. 2002 showed a significant cost savings with
the use of acupuncture compared to conventional treatment. A case of CTS medically treated
without surgery costs $5246 compared to $1000 for 15 laser acupuncture treatments at $65 per
treatment. This represents a saving of $4246 per patient with acupuncture treatment. The cost for
CTS surgery was $21,000 per patient and some patients were able to avoid surgery with 15 laser
acupuncture treatments totaling $1000.

Clinical Efficacy:
● In 1997 the NIH approved acupuncture as an adjunctive treatment for several conditions
including pain, nausea,asthma, carpal tunnel syndrome and paralysis from stroke.
● Over 500 positive clinical trials, measuring the efficacy of acupuncture, have been conducted in
the past three decades.
● There are 50 systematic reviews of acupuncture in the Cochrane databases. Overall, the trend has
been favorable, advocating the use of acupuncture in a clinical setting as an adjunct treatment
with conventional therapies, where suitable (Witt et al. 2006).
● Positive studies include acupuncture treatment for low back pain, neck pain, osteoarthritis of the
knee and hip, fibromyalgia, rheumatoid arthritis, TMJ, headaches, infertility, pain and nausea in
cancer patients.

Safety of Acupuncture:
● Acupuncture is a safe and cost-effective form of medicine that has been practiced and refined for
more than 2500 years. Acupuncture uses ultra-thin needles to balance and increase energy and
stimulate the nervous system to release brain chemicals for relaxation and well being.
● As of 2008 the Committee on Acupuncture shows 679 acupuncturists licensed in Massachusetts.
● From 2004-2008 the total number of complaints lodged against acupuncturists in Massachusetts
numbered 14, with 2 of those leading to disciplinary action and 2 to denial of license. This
reflects the general safety of the practice of acupuncture and this is true nationwide as well.
● Studies in Europe and Japan showed that less than 0.2% of all individuals treated with
acupuncture experienced adverse effects.

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