Why am I supporting H.R. 4803? What does Medicare mean to me? It means fulfillment of a deep obligation by me as a health care provider: that health care is a right, not a privilege.
I have lived this deeply my entire life. My mother was in the first class of patient advocates in the country out of Sarah Lawrence College. The first bumper sticker I remember on our car said, "Healthcare is a Right, Not a Privilege." My mother explained to all of us what that meant and the importance of every person having access to appropriate health care. That means the right remedy, at the right time, in the right context, delivered by the best and most able care provider who has been trained and vetted to provide that care.
We, as licensed / qualified acupuncturists, are the primary providers of the discipline named by CMS – acupuncture for the treatment of cLBP. We are the best trained, vetted, experienced and most qualified to provide acupuncture for chronic low back pain. The moment CMS came out with its decision to cover acupuncture for chronic low back pain, cLBP for Medicare beneficiaries, it opened the door for 66 million patients to receive our phenomenal care. We need to ensure they can receive that care from the provider of their choice.
We have patients who love and greatly benefit from the work we do. They want to continue with us as their care providers. I am advocating for patients over age 65 and others covered under Medicare, to ensure they have access to this evidenced-based, non-opioid treatment for chronic low back pain, cLBP, by those most experienced and qualified to do so.
Each of us has patients who call every day asking if we can bill their Medicare plan, as they have been informed by CMS that they have acupuncture coverage for cLBP. Each of us has patients who have expressed confusion and frustration when we have to tell them we can't bill Medicare under "original" (Part A, B) plans. We may be able to bill under a Medicare Advantage (Part C) plan that covers acupuncture by licensed / qualified acupuncturists. Our patients deserve consistent and reliable coverage, regardless of which plan they choose.
The ASA Advocacy Committee will be sharing a series of articles on H.R. 4803, "What H.R. 4803 Means to Me," in upcoming issues, looking at the impact on our patients, profession and practices. These pieces are meant to give a voice to different perspectives – and spark discussion and deeper conversations.
HR 4803 bill will codify licensed / qualified acupuncturists as providers under Medicare who can work and bill independently as "licensed / qualified acupuncturists." The language "licensed / qualified acupuncturists" is used through this article because that is the language used in the bill. Currently, Centers for Medicare and Medicaid Services (CMS) covers acupuncture for chronic low back pain/cLBP, but licensed / qualified acupuncturists cannot treat or bill Medicare patients because we are not recognized as providers currently under the Social Security Act, SSA. |
It matters to my patient Sam, who has worked his whole life; has recovered from bowel cancer; has chronic low back pain; and is looking to get treatment from the care provider he has a relationship with, and who has been expressly trained and vetted to provide this care. It matters to my patient Tia, who has worked her whole life and put into the system, and wants to receive the benefits she is entitled to receive, from the qualified provider she chooses.
It matters to Billy, whom I saw last week and was told he had acupuncture coverage by his insurance, given my name as someone who accepts his Medicare Advantage plan, and does not have actual coverage under that plan. We need to decrease confusion and increase access to care.
When we support H.R. 4803, we are ensuring that every Medicare recipient, whether we personally treat them or not, has access to the best educated and vetted licensed / qualified acupuncturist to provide their acupuncture care.
Amy Mager, public policy vice chair of the American Society of Acupuncturists and former chair of the Acupuncture Society of Massachusetts, has worked on legislation advocacy in Massachusetts and nationally.