A proposed study from the Centers for Medicare and Medicaid Services (CMS) on acupuncture for chronic low back pain represents what the IHPC Partner for Health, American Society of Acupuncturists (ASA), called a massive step toward incorporation of acupuncture into national health care. The goal of the CMS work is to conduct studies in the age group covered by Medicare, in order to determine if the evidence for acupuncture’s effectiveness in this specific group is sufficient to include it under general Medicare coverage. Once the studies are completed, the data will be analyzed to determine whether to cover acupuncture for low back pain in this population.
While it is a step in the right direction and good news that acupuncture is being studied at this level, the ASA does have some concerns, according to David W. Miller, MD, L.Ac., chair of the group’s Board of Directors and a private practitioner at East-West Integrated Medicine in the Chicago area. “Our main concern is that licensed acupuncturists be explicitly included in the process, and that the service they provide be clearly recognized.” The association asked its members to provide comments to CMS by Aug. 15, asking that the section regarding “auxiliary providers” be changed to more clearly name “Licensed Acupuncturists or state equivalent.”
The group also asked members to request that the supervision required during the study period be done only by medical doctors. The current language states that other practitioners such as Physician’s Assistants, Nurse Practitioners, and Nurse Specialists can also provide supervision. The ASA does not see this as appropriate, given that these practitioners do not typically have the training required to supervise acupuncture practice, unless they themselves are also legally trained as licensed acupuncturists, Miller noted. Supervision by other licensure types does not have any legal precedent and does not add in any way to the safety or quality of the trials, the group said in a statement to members.
ASA cautioned members to remember in their comments that this is a groundbreaking moment for this type of study, and some error in concept is inevitable. In general, the acupuncture community is thrilled that CMS is moving in this direction. This type of access will allow millions of American seniors access to this effective, non-pharmacological option for pain control. This care may be a significant component in boosting quality of life for Medicare recipients, and decreasing our national opioid dependence.