Laws & Legislation

Letters to the Editor: More Thoughts About Medicare Recognition

Dear Editor:

I'd like to offer a comment regarding insurance compensation from Medicare inclusion. I am frustrated with insurance limitations. I do treat musculoskeletal issues and bill insurance for them. But I also treat people whose main symptoms are PTSD, insomnia, GI distress, major anxiety and depression, memory issues, gynecological issues, a combo of these, and more with great success!

Our tradition comes from that of a general practitioner who treats the whole person; yet we are only officially recognized and compensated for a very limited and reductionist view of what we can accomplish as providers. I understand our medicine is not totally understood through Western measures, and within the confines of insurance, it is Western measures for which we are recognized and compensated. There are inherent problematic issues with the Western model of clinical research regarding our medicine. I understand that treating the shen is way too "out there" for the tidy box the insurance rubric forces us to contort into.

But not being recognized as legitimate practitioners or compensated by insurance companies and Medicare for GI issues, psychoemotional issues, sleep disorders, gynecological issues, etc.? It truly makes me frustrated to play the game and celebrate something like this as a win, when the view of acupuncture is still so myopic in the face of the wholistic, whole-bodied medicine it is.

It's great we're getting more recognition by larger systems of compensation. It increases access to those who may not have considered this medicine without these dictating systems. And I recognize and appreciate those fighting for more recognition and greater access for all in need. It also is so reductionistic to be recognized for the treatment of only chronic low back pain – further confining our success.

I suppose I'm frustrated that "growing evidence" discounts the efficacy of our profession, and I struggle measuring everything by Western standards. We are doing a great job as a culture beginning to point to the inherent racism that is embedded within our American power systems. (I am writing from the U.S.) But this measurement by others of the worth of our profession just feels to me like an extension of bending to the greater (and monetizing) powers to validate our legitimacy. It feels like an extension of a colonialist mindset.

Honestly, it's hard for me to feel like celebrating this as a win. I would like to see the fight for recognition include all systems of the body. We are not practicing a reductionistic medicine!


Dear Editor:

Just read this article [October 2021; Introduction of Acupuncture for Our Seniors Act] and feel obligated to respond because it hits close to home at the moment.

I'm a New Jersey acupuncturist who joined a N.J. Medicaid plan at the beginning of the summer; one that to my surprise apparently had acupuncture benefits at the time. Initially, I wasn't even sure if I was going to get paid, so I just started treating patients and hoped for the best.

For a while, the network sent me a ton of patients and the claims were getting paid at a slightly less-than-average, but sufficient fee for my services (happy to be working), and I felt a successful security about being a busy and decently paid acupuncturist.

Fast forward to now and I've begun to realize that claims have started getting paid at only a fraction of the original rate (like one-third), and I have made a difficult decision to discontinue accepting this network's patients.

So what if Medicare goes through for acupuncturists, but pays a fraction of what we would typically expect for a treatment? Will we have accomplished anything? Most practitioners will probably decide not to endure the extra paperwork and lesser pay for these patients, as other professions have already decided.

Medicare will come off as heroes for a short while since they'll cover the first 15 minutes to say acupuncture is covered; seniors will now expect everyone to treat them; and practitioners will be left trying to explain why it's still not worth dealing with Medicare.

I was more hopeful of the new bill, but as of now, I'm entirely neutral on the matter. If we can get a decent fee schedule, then why not? If other insurances catch on to cover what Medicare covers, then why not? But if not, then what for?


Editor's Note: We understand you may have unanswered questions or concerns regarding H.R. 4803, the Acupuncture for Our Seniors Act of 2021; and/or would like to offer your support for the legislation. We encourage you to submit your comments to editorial@acupuncturetoday.com for potential publication in a future issue.

February 2022
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