FSOMA is pleased to share good news. Centers for Medicare and Medicaid Services (CMS) published its Proposal Decision for including acupuncture benefits, SPECIFICALLY to treat chronic low back pain (cLBP), which meets CMS guidelines, in those people eligible for Medicare and Medicaid. Please read the CMS Decision for full details – at least read the first few pages. 99% of the answers to your questions will be found there.
CMS has no direct way to include Licensed Acupuncturists under the list of approved Medicare providers. That requires separate action taken in Congress to open the Social Security Act and update the law. Congresswoman Judy Chu, of California has sponsored a bill during each session of Congress, for the past several years, to include Acupuncturists as Medicare providers; and she has done the same again this year. Her bill needs a lot of support and Florida could do more to help her find bill co-sponsors. \
CMS’s purpose in this decision is to provide acupuncture benefits and care to those who are Medicare/Medicaid eligible and in need of treatment for cLBP pain. This decision was made in a way that provides the most care to those in most need. It does not favor one provider type over another and since Acupuncturists are not currently Medicare providers, eligible acupuncturists must work under the direct supervision of MD, DO or NP. This most likely means that any Licensed Acupuncturist providing treatment for cLBP under Medicare will be either working in a physicians office or will have hired a MD, DO, or NP to supervise treatment of those patients in the L.Ac’s office. Other options likely exist, but these two seem most plausible.
So, no – as an acupuncturist you may not start treating Medicare patients and submitting claims to CMS with the expectation of being paid. That will not happen until Congress amends the existing law to recognize L.Ac’s as independent Medicare providers. Yesterday’s decision is a long-time coming – it’s not everything Acupuncturists want, so there is more we can do to elevate the profession.
Be well informed and passionate about this profession’s opportunities going forward. Pitch-in where you can…many hands make lighter work.
https://urldefense.proofpoint.com/v2/url?u=https-3A__www.cms.gov_newsroom_press-2Dreleases_cms-2Dfinalizes-2Ddecision-2Dcover-2Dacupuncture-2Dchronic-2Dlow-2Dback-2Dpain-2Dmedicare-2Dbeneficiaries&d=DwMFAg&c=L93KkjKsAC98uTvC4KvQDdTDRzAeWDDRmG6S3YXllH0&r=whttps://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295
Related News