The Centers for Medicare & Medicaid Services has announced it will cover acupuncture treatment of chronic low back pain. According to a joint statement from the American Society of Acupuncturists and the National Certification Commission for Acupuncture and Oriental Medicine, "This unprecedented support of a licensure group who is not currently a part of Medicare, as well as the endorsement of our academic system, speaks to the care and trust they put in us, and the desire for Medicare beneficiaries to receive the best care possible."
CMS stipulates that it will cover up to 12 visits for LBP within a 90-day period under the following circumstances:
CMS will cover an additional eight acupuncture sessions if patients are shown to demonstrate improvement with treatment (20-treatment limit annually). In addition, "Treatment must be discontinued if the patient is not improving or is regressing."
CMS does not specifically list acupuncturists, but does mention "auxiliary personnel" who can provide (but not bill) treatment under appropriate supervision by a physician .. or a physician assistant / nurse who has also obtained a master's or doctoral degree from an ACAOM-accredited acupuncture institution. The ASA / NCCAOM statement explains:
"Provider types outside of Medicare are by CMS definition 'auxiliary personnel.' Auxiliary personnel must be supervised by Medicare providers. This is the maximal freedom that can be granted until the Social Security Act is amended to include LAcs, by an act of Congress. The power to do that does not lie with CMS, but with our profession."
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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