MICHAEL BRADY January 21, 2020 06:53 PM
Medicare will cover acupuncture services for beneficiaries with
chronic low back pain, the CMS said on Tuesday.
People enrolled in Medicare will be able to
receive up to 12 acupuncture treatments during a 90-day period if they have
non-specific lower back pain that lasts 12 weeks or more, but not if it's not
associated with surgery or pregnancy. They will be eligible for eight more
sessions if their symptoms improve, but Medicare won't cover more than 20
sessions each year.
The Trump administration said that it reviewed
scientific evidence and the coverage policies of private payers to reach its
decision.
"Expanding options for pain treatment is a
key piece of the Trump administration's strategy for defeating our country's opioid
crisis," HHS Secretary Alex Azar said. "Medicare beneficiaries will
now have a new option at their disposal to help them deal with chronic low back
pain, which is a common and sometimes debilitating condition."
Congress and the administration have sought to expand coverage
for non-opioid pain management treatments to reduce the healthcare
system's reliance on opioids to treat pain and cut down on substance use
disorder.
Acupuncture providers and some patient advocates have
pushed for private and public payers to cover acupuncture services, which they
say offer patients relief from pain without the risky side effects of opioids.
Payers and many providers have raised concerns
about the effectiveness of acupuncture as a viable therapy. The evidence that
acupuncture is an effective treatment for chronic lower back pain isn't
especially strong, especially because many of the studies on acupuncture are
relatively low quality. But it's also a low-risk treatment option that could
help some seniors.
Commercial insurers have had problems figuring
out how to pay for acupuncture treatment because there is no standardized
licensing and treatment practices vary.
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