Medicare Is Considering Approving Acupuncture for Low Back Problems. Does It Have a Place in Workers’ Compensation Claims?

This week, the Centers for Medicare & Medicaid Services (CMS) proposed to cover acupuncture for Medicare patients with chronic low back pain who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies.  To read the proposed decision, visit the CMS website here.

Acupuncture is not currently covered by Medicare.  According to CMS, the evidence supporting the use of acupuncture has grown in recent years, but questions remain about its efficacy.  CMS has been working with the National Institutes of Health (NIH) as part of the Opioids Workgroup and Evidence Generation Workgroup to launch studies on acupuncture for the treatment of chronic low back pain in adults 65 years of age and older.

According to CMS Principal Deputy Administrator of Operations and Policy Kimberly Brandt, chronic low back pain is the leading reason for prescription of opioids.  According to Brandt, “(t)oday’s proposed decision would provide Medicare patients who suffer from chronic low back pain with access to a nonpharmacologic treatment option and could help reduce reliance on prescription opioids.”

For many, the thought of acupuncture conjures up visions of a smoky backroom with incense and odd statutes on the wall.  According to this article from the National Institutes of Health, Acupuncture is part of a family of procedures that originated in China. According to traditional Chinese medicine, the body contains a delicate balance of 2 opposing and inseparable forces: yin and yang. Yin represents the cold, slow or passive principle. Yang represents the hot, excited or active principle. Health is achieved through balancing the 2. Disease comes from an imbalance that leads to a blockage in the flow of qi—the vital energy or life force thought to regulate your spiritual, emotional, mental and physical health. Acupuncture is intended to remove blockages in the flow of qi and restore and maintain health.

I’m sure some of you are thinking: “why would I approve something like that?”  However, the National Safety Council hailed the CMS announcement.  In statement the NSC urged employers and insurance providers to make alternative treatment options such as acupuncture available.  Acupuncture also is an approved treatment through the Ohio Bureau of Workers’ Compensation.  So if a treatment request for acupuncture comes across your desk consider approving it.  It might cut down on the prescription drug costs in the claim.