CMS public comment call out for coverage of acupuncture for low back pain

Medicare, Medicaid, insurance coverage, major hospital insurance entities, federal health care coverage policy, health care policy

CMS and acupuncture coverage for LBP

The U.S. Center for Medicare and Medicaid Services (CMS), whose coverage policies are intertwined in hospital and medical center systems, has announced a call for public comment on the topic:  “acupuncture coverage for low back pain”.

To my knowledge, this is the first time in history the CMS has ever announced a public comment call for anything related to coverage of acupuncture services.  Tell your hospital sponsors and advocates.  If CMS reimbursed for acupuncture and other integrative health therapies, that would be a major milestone.

CMS is under the U.S. Department of Health and Human Services (HHS).  HHS is an enormous department that also contains the National Institutes of Health (NIH) and the Agency for Healthcare Research and Quality (AHRQ)

In the announcement, they state, 

“In response to the U.S. opioid crisis, HHS is focused on preventing opioid use disorder and providing more evidence-based non-pharmacologic treatment options for chronic pain. The [AHRQ, CMS, and NIH] are collaborating in this effort.”  In June 2018, AHRQ “published a systematic review of noninvasive, nonpharmacological treatment for chronic pain.”  “This review included assessment of several nonpharmacological interventions, including exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation for [chronic low back pain] CLBP. “

Link to the June 2018 AHRQ paper:  https://effectivehealthcare.ahrq.gov/sites/default/files/cer-209-evidence-summary-non-pharma-chronic-pain.pdf

Then, the CMS announcement says:

“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 NIH grant announcement is here:  https://grants.nih.gov/grants/guide/rfa-files/RFA-AT-19-005.html.

“CMS is opening this national coverage analysis (NCA) to complete a thorough review of the evidence to determine if acupuncture for CLBP is reasonable and necessary under the Medicare program.  CMS is soliciting public comment on this topic.  We are particularly interested in 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.  While CMS has conducted previous national coverage analyses on acupuncture, the scope of this current review is limited to acupuncture for chronic low back pain.”

Go to the announcement to submit your comments.  

Public comment period ends 2.14.2019

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