Billing / Fees / Insurance

AAOM, AAC Announce First Move to Expand Malpractice Insurance Coverage in 20 Years

Editorial Staff

The American Association of Oriental Medicine recently asked the American Acupuncture Council to undertake an initiative to obtain clarifying language from the insurance industry regarding the nature of malpractice coverage for acupuncturists who treat issues related to women's health. While acupuncture has been shown to be beneficial in treating a number of women's health issues, including improving fertility and correcting breech births, the insurance industry typically excludes coverage for "obstetrics and gynecology," without clarifying how this impacts on acupuncturists who treat women's issues with Eastern techniques. This has been a source of distress for some acupuncturists whose treatment could be construed as gynecological or obstetrical in nature.

To address this problem, the AAOM and AAC formed an OB/GYN Malpractice Coverage Committee. The committee included a broad range of participants from the profession, including Drew Henderson, LAc, Mark Evens, LAc, Martin Herbkersman, DAc, Claudia Citkovitz, LAc, Raven Lang, LAc (also a midwife), Chris Hughes, LAc, Kevin Ergil, LAc, Will Morris, OMD, LAc, and Michael Schroeder, an AAC representative. The committee started with an AAC policy statement that had existed for many years regarding what procedures were considered to be acupuncture and those considered obstetrics and gynecology.

From this starting point, the committee created and approved a consensus document, comprised in a question-and-answer format to cover these issues. In addition, the committee pioneered a three-tier coverage format so that acupuncturists who practice only acupuncture and do not engage in Western-style gynecology or the delivery of children would pay the lowest rates. Acupuncturists who employ some Western medical gynecology techniques would be considered class 2 providers and would pay additional rates; acupuncturists involved in labor and delivery would be eligible for coverage as a class 3 provider. This new system is believed to constitute the first time that an insurance program has been willing to cover these types of procedures when performed by an acupuncturist.

Dr. Morris, the new president of the AAOM, stated, "The AAOM/AAC Insurance Task Force, with representatives from Colorado, Georgia, South Carolina, California, New York, Oregon, and Florida, achieved consensus rapidly and effectively. This is another example of a successful and unified team approach to solving the concerns of our profession." Gene Bruno, LAc, the immediate past president of the AAOM, added, "It is very exciting that AAC is assisting the first major, positive change in coverage that has occurred in the last 20 years."

Ms. Citkovitz will be the first person actually covered under the new program. As of press time, she is involved in a research program at Lutheran Memorial Hospital in Brooklyn, New York. The program is funded by the National Institutes of Health, and will examine the use of acupuncture on pregnant women undergoing labor.

As of press time, the results of the committees' work are being forwarded to the AAOM Board of Directors and to the entire acupuncture profession for comment. Anyone wishing to comment or testify in person is encouraged to come to the AAOM public meeting to be held at the California State Oriental Medical Association's convention in San Francisco on April 30, 2005. Written comments can be sent to:

American Association of Oriental Medicine
ATTN: AAOM/AAC Insurance Task Force
PO Box 162340
Sacramento, CA 95816

E-mail comments can be sent to rchristensen@aaom.org. After all public comments have been considered, a final draft of the questions and answers will be adopted. This language will then be reflected in new policy wording that will benefit the entire profession.

Mr. Schroeder, vice president and general counsel of the AAC, and the council's representative to the committee, observed, "This is an example of what the acupuncture profession is capable of when it works together on a consensus basis. For the acupuncture profession to continue to progress and grow in new areas, insurance coverage has to be available in these areas. I believe that this will be the first of many expansions in the acupuncture practice and coverage."

March 2005
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