Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

July 17th, 2019 - Wyn Staheli, Director of Research
Categories:   Acupuncture|Alternative   Chiropractic   Physical Medicine|Physical Therapy   Billing   Medicare  
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On July 15, 2019, CMS released a decision memo regarding a national coverage analysis for Acupuncture for Chronic Low Back Pain. CMS intends to cover acupuncture for CMS beneficiaries who are experiencing chronic low back pain. Coverage only extends to patients who are enrolled in a clinical trial sponsored by the National Institutes of Health (NIH) or a CMS-approved study. These clinical trials are in response to the opioid crisis. 

HHS Secretary Alex Azar stated, “Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to treat the very real problem of chronic pain, and this proposal would provide patients with new options while expanding our scientific understanding of alternative approaches to pain.”

To further sweeten the deal for healthcare providers, according to the CMS press release, 

“The NIH recently issued a Funding Opportunity Announcement for interested parties to apply to conduct an efficient, large-scale pragmatic trial to evaluate the impact of, and strategies to best implement, acupuncture treatment of older adults (65 years and older) with chronic low back pain. The announcement can be found here: https://grants.nih.gov/grants/guide/rfa-files/RFA-AT-19-005.html.”

The official comment page states that they are seeking the following (emphasis added):

“… comments that include scientific evidence and discuss appropriate clinicians and training requirements to provide acupuncture that improves health outcomes. In addition, for commenters recommending Coverage with Evidence Development, we are interested in comments related to appropriate outcomes and study designs.”

This is an excellent opportunity to help establish the efficacy of acupuncture. Comments are being accepted through August 14, 2019. Please keep in mind that comments should be limited to acupuncture for the treatment of chronic LBP only at this time.

There is only a limited time available to comment so we strongly encourage all interested parties to help CMS with their coverage determinations. We feel that there are many chiropractic and other professional organizations which could help create good study designs.

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