The Affordable Care Act and Acupuncture

The Affordable Care Act (ACA) attempted to create wider access to health care services for patients in America and reframed some of the guidelines that insurance companies and other payers must oblige when evaluating coverage of services by acupuncturists and other alternative medical providers. Section 2706 of the ACA, also known as “Nondiscrimination in Health Care,” aimed to create professional parity for state-licensed providers like acupuncturists who render services within their legal scope of practice. By mandating coverage of these services and eligibility for reimbursement for treatment of health conditions covered in an insurance plan, state-licensed heath care professionals can no longer be excluded from insurance plans on the basis of their profession.  Section 2706, however, does not create parity in terms of reimbursement rates, which creates a loophole for insurers that concerns many acupuncturists. Also, in states where professional licensing of some alternative medical providers is not in place, coverage may still be denied for services that may be covered elsewhere. It is clear that the nondiscrimination provision is a start to addressing egalitarian recognition for some alternative health care professionals, but there is still much to address to ensure interpretation of this provision is not tailored to the needs of insurers instead of to patients and related providers. Section 3502 of the ACA, also was an attempt to legitimize acupuncture and other alternative medical services through its mention of establishing interdisciplinary community heath teams that may include licensed professionals offering complementary and alternative medicine (CAM), a.k.a. complementary integrative health (CIH). This language opened the discussion of inclusion of CIH services in essential health benefits but, again, more attention will be needed to see implementation of CIH as a mainstay in the common delivery of health care in America. Regardless, these provisions do favor the recognition and use of acupuncture and other services, which have been historically marginalized in the insurance marketplace. This is surely a positive start to mainstream integration.

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