One of the potential casualties of an expedited process to offset a California state budget shortfall of $3.3 billion may very well be state Medicare (Medi-Cal) payments for acupuncture treatment. This is particularly troubling, as California currently is the only state to offer Medicaid coverage for acupuncture treatments.
In his submitted 2008-2009 budget, released on Jan. 10, Governor Arnold Schwarzenegger proposed a 10 percent cut across the board, including: "Reductions of $10 million in 2007-2008 and $134 million in 2008-2009 by eliminating certain Medi-Cal optional benefits including incontinence creams and washes, acupuncture, adult dental, audiology, optometry, optical, chiropractic, podiatry, psychology and speech therapy."
To make matters even worse, these cuts may very well go into effect on March 1, due to the potential budget shortfall. Gov. Schwarzenegger has declared a fiscal state of emergency and called for a special session of state legislators to address the fiscal crisis immediately, pursuant to Proposition 58, passed by California voters in 2004. Proposition 58 requires that the state legislature and the governor enact a balanced budget within 45 days of the governor declaring a fiscal emergency. Until such time as the legislature passes a budget, it's prevented from acting on other bills or adjourning. On top of all this, Schwarzenegger predicts the budget shortfall could balloon to $14 billion for the next year unless the current deficit is reduced.
In an action alert dated Jan. 11, 2008 (one day after the governor's proposed budget was released), the California State Oriental Medicine Association (CSOMA) stated: "CSOMA is currently networking with other stakeholders who would be impacted by the proposed cuts to acupuncture and other health care services in Medi-Cal in order to develop an effective strategy for challenging the elimination of these services. We will provide further updates and Action Alerts as information becomes available."
CSOMA President Greg Sperber, DAOM, BMBS, LAc, elaborated on the effect of this budget crisis on acupuncturists. He started by emphasizing that since acupuncturists who see patients on Medi-Cal only get reimbursed $15 per treatment and can only supply those treatments every other week, the cuts "are not going to do much to trim the budget." As it is, Medi-Cal payments across the board are among the lowest in the nation, prompting fears that large numbers of physicians will refuse to take Medi-Cal because the payouts are so small.
Sperber went on to say that the inclusion of acupuncture under Medi-Cal is instead "important as a political beachhead," given that California currently is the only state that has such coverage. The hope was that California could serve as a model, not only for other states, but eventually for Medicare coverage at a federal level.
Currently, CSOMA is working on outreach with other AOM professional organizations to determine how best to respond. Unfortunately, given the accelerated timeline for passing the state budget, Sperber is afraid "CSOMA is not going to have enough time to respond effectively." See the contact information below if you are interested in letting the governor and the legislature know your opinion on these proposed cuts:
Governor Arnold Schwarzenegger Phone: (916) 445-2841 Fax: (916) 558-3160 Web Site: http://gov.ca.gov/interact
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Laser therapy has emerged as a powerful tool in the realm of traditional Chinese medicine (TCM). This new modality fits beautifully into the toolbox of the modern acupuncturist, as it can be used as a hybrid form of stimulation to acupuncture points, meridians, organs, nerves, and symptomatic areas in a new way that blends both moxa and energetic needle-like responses.
