The Patient Protection and Affordable Care Act (PPACA), commonly referred to as Obamacare, allows states to choose acupuncture as a required essential health benefit to be included in private insurance plans. The federal government is giving states a wide latitude in determining what are required health benefits in private insurance plans. The PPACA outlines the following as essential health benefits: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, pediatric services (including oral and vision care). The Health and Human Services department is charged with coming up with the specifics for these broad categories and has delegated that task to the states. As a result, California has a major decision pending that will affect acupuncture coverage for millions of people in the state. Two bills, one sponsored by Sen. Ed Hernandez and the other by Assemblyman Bill Monning, have been sent to Gov. Jerry Brown for approval. If the governor passes the legislation, acupuncture will become a standard benefit across private insurance plans.
Insurance companies are against acupuncture benefits? Guess again! California may require acupuncture to become a required insurance benefit by private insurers pending the outcome of the two new bills based on an insurance plan formulated by Kaiser Permanente. The Kaiser Permanent Small Group Agreement Plan 1637 Plan 3-N includes acupuncture for a co-pay of $30 per visit. Acupuncture is specifically cited in the Kaiser plan for use in chronic pain management and the control of nausea.
Significant support for the inclusion of acupuncture as an essential healthcare benefit comes from Congresswoman Judy Chu, Ph.D. Other supporters include: the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), Acupuncture Association of Colorado, Acupuncture Society of New York, Acupuncture Society of Virginia, American Traditional Chinese Medicine Society, North Carolina Association of Acupuncture and Oriental Medicine, New Jersey Association of Acupuncture and Oriental Medicine, New Mexico Society for Acupuncture and Asian Medicine, Oregon Association of Acupuncture and Oriental Medicine, South Carolina Oriental Medicine Association, Texas Association of Acupuncture and Oriental Medicine, Washington East Asian Medicine Association, Wisconsin Society of Certified Acupuncturists, Tennessee Acupuncture Council, California State Oriental Medical Association. Some of the schools taking an active stance toward supporting acupuncture inclusion in essential health benefits include: Oregon College of Oriental Medicine, Academy of Oriental Medicine at Austin, Finger Lakes School of Acupuncture & Oriental Medicine of New York Chiropractic College, Yo San University, Emperor’s College, Five Branches University, Pacific College of Oriental Medicine, Southwest Acupuncture College. The move to include acupuncture in healthcare benefits reflects a growing trend towards its popularity, backing by modern research, support from insurers as a cost-effective modality and a concerted effort made by community outreach.
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