Medicare Status

What H.R. 4803 Means to Me and Our Profession

Nell Smircina, DAOM, LAc, Dipl. OM

When I first became interested in attending acupuncture school, I was under the impression I was making a responsible and stable move. I thought that because I was going to be attending the longest master's program available and would become a licensed health care provider, I would have some sort of way paved for me, or at least job security when I left school.

For all you other practitioners out there who found yourself falling into sole proprietorship and owning a business when you thought you signed up to be a clinician, I see you.

Looking back at my journey and the steps I had to take to be successful in practice, I shake my head. I can simultaneously be proud of my success given the way the industry is designed; and frustrated by the uphill battle many well-qualified practitioners face.

I am a businessperson and I thoroughly enjoy the business aspect of practicing. But what about the thousands of practitioners who have no interest in business and instead want to fully utilize the clinical skills they've cultivated over many years of training?

This is the second in a series of articles from the ASA Advocacy Committee on "H.R. 4803: What Medicare Means to Me," 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 will codify licensed / qualified acupuncturists as providers under Medicare who can work and bill independently as "licensed / qualified acupuncturists." 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.

What about the practitioners who fail not because of substandard clinical skills, but because they never were given an opportunity to treat as many patients as possible ... because no one even knew they were there? Is that on them? Did they not take out enough Google ads? Was the problem too few social media posts?

Perhaps acupuncturists never should have to rely so heavily on the ability to run a business to be successful. What if acupuncturists had opportunities to apply for jobs at any hospital in the U.S. because it was standard practice to have an acupuncturist on staff at any major medical institution?

What if we had residency programs that allowed for connections and potential job opportunities? What if acupuncture was in the standard of care and our profession was treated like others within the U.S. health care delivery system?

So, this is what H.R. 4803 means to me, but more importantly, to the profession. It means recognition in a system of health care. It means taking one step closer to being acknowledged as providers of medicine, rather than technicians of a modality. It means the ability to deliver a powerful medicine that should be accessible to millions of seniors in desperate need of healing.

Legitimacy is driven by access to care and patient utilization of a medicine. To be able to give the option of our care to as many people as possible, we need to be listed as providers in the Social Security Act.

Acupuncture has already been shown to be effective (if it wasn't, then why are there so many other professions fighting to use the needle?), but acupuncturists need to provide access to our care specifically; to give seniors the benefit of our full qualifications. This bill is simply a legislative vehicle to get our profession in a position by which access is expanded.

Being listed as a provider type in the Social Security Act will open doors for our profession that are currently shut. We have a unique opportunity to educate the public, help millions of seniors and move the profession forward.

For far too long, Medicare beneficiaries have had to bear the burden of paying out of pocket, which is a barrier to care. We've been trying to put the cart before the horse: to have everyone utilizing this medicine without recognizing these barriers to care. H.R. 4803 is a straightforward rectification of one of these issues – ensuring access by eliminating a barrier.

Have you done what you can as a member of our profession to increase access to acupuncture? Text ACUPUNCTURE to 52886 to get started today!

May 2022
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