Acupuncture could soon be covered by Medicare and Medicaid. News from the Center Medicare and Medicaid Services

    Posted by Samad Saifudin on Feb 20, 2020 10:52:48 AM
    Samad Saifudin
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    This week we were joined by Mina Larson, the CEO of the NCCAOM and Marilyn Allen from the American Acupuncture Council to discuss the exciting changes announced by the CMS (the Centers for Medicare, Medicaid Services). 

    Guest Bios

    Mina Larson
    CEO of NCCAOM
    Mina is a seasoned Non-Profit Association Executive with an emphasis in Certification and Credentialing. Current Chief Executive Officer of a national certification board, NCCAOM. She’s a proven leader and innovator with a demonstrated history of leading and growing several departments to include Government Relations and Advocacy, Communications and Public Relations and Professional Ethics and Disciplinary Review, and experienced in the areas of Strategic Planning and Governance for Nonprofits.

    Marilyn Allen
    Editor of Acupuncture Today
    Marilyn Allen is a founding member of COMRE. Ms. Allen is a nationally recognized speaker and educator on the subject of alternative healthcare professions and serves as the Editor of Acupuncture Today, one of the leading periodicals for the acupuncturist profession. Ms. Allen regularly speaks at associations, schools, and regulatory boards on the topics of practice management, risk management and ethics. In addition Ms. Allen is currently serving as the liaison to the World Health Organization for the International Classification of Traditional Medicine Committee and is a U.S. delegate to the International Standards Organization’s technical advisory group.

    Key Takeaways:

    This change will have a monumental impact on the number of Americans who will now have access to acupuncture as well as combat the opioid epidemic by providing patients with an alternative to managing and treating chronic pain. All insurance companies take cues from Medicare and Medicaid on what services should be routinely covered, therefore this signals a shift in coverage across all insurance networks.

    Links and Other Goodies:

    Our Take:

    With expanding licensure requirements and more widely accepted coverage, the earning potential of our graduates will surely rise. This makes now the perfect time to begin your career at a school that will fully prepare you to be a leader in this field.

    Transcript:

    Intro (00:04):

    Integrative medicine has been around for thousands of years and is now a widely used form of healthcare across the modern world. In this podcast we discuss holistic wellness and share how integrative medicine has evolved to become a part of our culture today. This is All Things Integrative brought to you by the Virginia University of Integrative Medicine.

    Speaker: Chad Egresi  (00:32):

    Thanks for joining us today, ladies. We really appreciate you coming to Virginia University of Integrative Medicine to speak a little bit about the recent changes by CMS to Medicare and how that impacts the overall healthcare landscape and specifically how it can help our acupuncturists. My name is Chad Egresi. I am the Dean of Enrollment Management at Virginia University of Integrative Medicine. And this is All things Integrative. So welcome. 

    Speaker: Mina Larson

    Thank you, Chad. Thank you for having us here. 

    Speaker: Marilyn Allen

    Thank you very much. It's a privilege to be here. 

    Speaker: Chad Egresi

    Thanks for being here. So we have today with us Marilyn Allen from the American acupuncture council as well as Mina Larson, who is the CEO of the NCCAOM. Mina, can you first tell us what the NCCAOM stands for? 

    Speaker: Mina Larson

    Yes, Chad, the NCCAOM stands for the national certification commission for acupuncture and Oriental medicine. 

    Speaker: Chad Egresi

    Perfect. So I should know that. And I do know that, but sometimes the CS slipped my mind, which one's the which, which C is the, the certification in Michigan is a very long name. So that kind of works well. 

    Speaker: Mina Larson

    Exactly. 

    Speaker: Chad Egresi

    So thank you very much man. I appreciate that. Marilyn, can you tell us a little bit about what it is? The American acupuncture council.

    Speaker: Marilyn Allen (01:52):

    The American acupuncture council is a malpractice insurance carrier. We insure the majority of acupunctures throughout the United States. And I also need an editor for acupuncture today, which is the newspaper that goes out to everybody. And like I told you earlier, it's, it's a newspaper. It's not a scientific journal. 

    Speaker: Chad Egresi

    Okay. All right. And what kind of things can people expect to find in that newspaper? All we have statistics in the newspaper. 

    Speaker: Marilyn Allen

    We try and bring the headlines of what's going on. We featured a CMS, which is the Centers for Medicare, Medicaid services in the United States and we all referred to as CMS, but sometimes we forget what it stands for and just articles about different times of treatments that people are giving. And of course there's advertisements, so we know the people who are selling things to the acupuncturists. 

    Speaker: Chad Egresi  (02:46):

    Okay, Wonderful. Mina, so you told us what the NCCAOM stands for. Can you tell us a little bit about what the NCCAOM does? 

    Speaker: Mina Larson

    Absolutely. The NCCM is a certification credentialing organization. It's a 501c6 nonprofit organization. NCCAOM's primary mission is to ensure the safety of the practice of acupuncture and Oriental medicine. We partner with 47 States plus the district of Columbia to ensure that entry-level competency hasn't been met through our certification exams. So basically in a nutshell, NCCAOM administers a set of modular examinations to ensure the safe practice of acupuncture and Oriental medicine in the U S and we do that through the licensure requirements. Some States like here in our great state of Virginia, certification is actually required as a prerequisite for practicing in that state, other States. Like for example, New York, there are, they have to pass some of the examinations in order to practice. So we have about 18,800 certified acupuncturists here in the U S and what we're really proud of is our information that we provide to the public so that they can seek qualified acupuncturists in the U S and that's through our website, find a practitioner directory.

    Speaker: Chad Egresi (04:07):

    Wow. Sounds like a lot of information. 

    Speaker: Mina Larson

    Yes, it is. We, our website, has been created for a hub for many different audiences. One of course for the public so that they can seek information about acupuncture, particularly if they want to find out if acupuncture works for a particular ailment. We have research and data to show how acupuncture is effective for many, many different ailments as well as conditions. We also have information, as I mentioned about our many certified acupuncturists throughout the world. They can find that information and, and really find someone within their radius to get treatment as well as a Q&A that we've created about the profession and the growth of the, the medicine here in the U S 

    Speaker: Chad Egresi (04:54):

    Okay, Great. Thank you. So, so Mina, you've talked to us a little bit about how we educate the public and how the NCCM supports the public and prospective students. I want to turn it over to Marilyn and ask her how the American acupuncture council supports prospective students and help how it engages with the public. 

    Speaker: Marilyn Allen

    Well, we're basically an insurance company so we insure people, but I want to, I want to kind of tag along with what Mina said because safety is probably the number one issue in healthcare worldwide today. And it's, they're going to be some new safety codes that people will have to diagnose and use in their, in their clinics. We want people to be safe because if a patient is injured or in any way has a problem, then they sue for malpractice. So the number one way you don't get sued for malpractice is to be able to communicate with your patients. Not just put the needles in or give them a prescription, but talk to them, explain to them going on.

    Speaker: Marilyn Allen (05:58):

    It's a very effective medicine and it is a safe medicine, but we do have some issues with it. So we work at going out to the schools talking to the students teaching classes on ethics and safety so that we are assured and the public has the right to know that their acupuncturist has malpractice insurance. So if something does happen and an accident does happen, that they would have some kind of coverage for recovery. 

    Speaker: Chad Egresi

    Wow, very important. Thank you for talking about that. You know, you guys both hit on information about safety. I think that from a, from a public perspective, there's definitely an interest in ensuring that if they do see an acupuncturist, they can be confident that they've gone through a certain number of hours of training and that they have that kind of malpractice insurance to protect them.

    Speaker: Marilyn Allen  (06:53):

    The acupuncture students go to school somewhere literally between three and 4,000 hours. And this program can take anywhere from three to five years depending upon if they're working at the same time, if they have small children at home or whether they're going to school full time. That's a lot of training. They have basic science training. They have a clinic where they practice. And when they come out, they take their exams, they carry malpractice insurance. You can go to an acupuncturist and feel that you're going to receive what you need to receive for your healthcare issue. 

    Speaker: Chad Egresi

    Quality care, [inaudible] care. Wonderful. Wonderful. All right, so we've talked about your background and some information about what you guys do and how you help the public, how you help prospective students. There was a really big announcement in the last couple of weeks that I know you guys are aware of and we are too.

    Speaker: Chad Egresi  (07:48):

    That's the title of our episode and that's what we really want to talk about for the most part here. So we're gonna, we're gonna get into some information about how the recent changes by the CMS to Medicare have impacted the overall landscape and specifically how it can benefit our acupuncturists. So we have a couple of questions. We hope that the conversation we can have as engaging and gets the public involved so that they understand better how to reach an acupuncture as to where to go, you know, you know, how to, how to become a student potentially, where we are, where you guys are and, and, and how this stuff is going to impact the overall landscape. So I'm going to read directly from some information that I think was announced by the NCCAOM. And we'll go from there. So on Tuesday, January 21st, the centers for Medicare and Medicaid services, the CMS announced the historic decision to not only cover acupuncture for low back pain, but also to go out of their way to include license, acupuncturist as a key group of providers for acupuncture services. So can you tell us a little bit more about what this all means? What

    Speaker: Chad Egresi (08:55):

    The CMS’s decision to cover these things for our acupuncturists. 

    Speaker: Mina Larson

    Yes, absolutely. Chad. So this is as you mentioned in the information that the American Society for Acupuncture, ASA, and NCCAOM released on the 21st. This is a monumental decision that was made by the center for Medicare and Medicaid services. This was supposed to be a study that was going to look at the efficacy and cost effectiveness of acupuncture for back pain, but ultimately the decision was made even before the study was finalized. And the reason why the decision was made is because of exactly the, what we are talking about in terms of the effectiveness for acupuncture, particularly with pain particularly amongst the senior population, which had already been evidenced through a lot of the studies that had been shared with CMS. So the NCCAOM had partnered with ASA and other organizations to provide comments to the CMS and some of the other federal agencies such as the NIH within the past year and a half.

    Speaker: Mina Larson (09:56):

    So they had gathered enough information to be able to make this decision. What disposition means for the public is that acupuncture is now going to be covered for back pain amongst the, the senior population. We still have a lot of work to do. It's not instantaneous. Obviously with the federal government, there's a process involved. And that we need to look at reimbursement rates. We need to look at access in terms of who will be providing the services right now CMS has declared, there'll be licensed acupuncturists that have possessed a license from that state and that had graduated from an ACAOM, ACAOM stands for the Accreditation Commission for Acupuncture and Oriental Medicine. They're the accrediting board that approves the schools on their recognized by the department of education.

    Speaker: Mina Larson (10:46):

    Those acupuncture's must have graduated from an economic credit school, but there still is a lot of work to do and the NCCAOM is really looking forward to doing some of that work with our federal lobbyists and with partnership through organizations like the ASA to, to open up the social security act so that we can really finalize this whole process so that seniors will be able to get acupuncture through the most qualified acupuncturist, which is NCCN board certified and licensed acupuncturist. We're really excited about this because this will immediately open up access so that insurance companies will also follow that model of what the Medicare CMS is doing for Medicare so that more and more patients will be able to get access for acupuncture services. And again, what I mean acupuncture services, I also mean I community acupuncture, but there's a lot covering acupuncture.

    Speaker: Mina Larson (11:38):

    Most of our practitioners are also able to do Chinese medicine. You know practice Chinese medicine as well as Asian body work. But by now we call it acupuncture services for the purposes of the government. But this will really integrate the medicine and our biggest desire here at NCCAOM is to have acupuncture be a household name so that anyone and everyone who wants to have access to it can get access to it. Whether they have the money to be able to pay for it or not. That's what we want to do.

    Speaker: Chad Egresi (12:10):

    Sounds interesting. 

    Speaker: Marilyn Allen

    I think one of the things that people don't realize is [inaudible] out of our population of 300 million, 80 million people are seniors and they're 10,000 people a day turning into seniors. It's a, it's a huge number of people. The right now do not have access to the medicine unless they pay cash. This will be where insurance will help them pay their bill and they'll be able to get the benefits because acupuncture probably the first thing everybody thinks about is pain that they treat. And they're probably the number one doctors for treating pain worldwide. But they also treat stress and many, many, many other conditions that they don't have to take as much medication. And we do have an opioid crisis in this country as we know. And so if we can help people to stay off of that rather than trying to get them off of it will can have a healthier population of people who have a better lifestyle.

    Speaker: Chad Egresi (13:13):

    Yeah, that's huge. I agree completely. I think we're exactly, you know, right on the same page. So we've talked a little bit about how this change will impact our general public and the population of aging people in the country. Specifically. How do you think that it's going to help prospective students as far as getting into the field and deciding to make a decision to go to school and become an acupuncturist? 

    Speaker: Marilyn Allen

    Well, let's hope they'll realize that there's no shortage of patients out there. Plus when insurance comes in through CMS social security act and through Medicare being a payer that's kind of the the, I'll say the gold standard and all the other insurance companies look at Medicare and see what they are covering. And that's the type of thing that will open up insurance reimbursement for many, many people, even though today many insurance companies are covering acupuncture. 

    Speaker: Chad Egresi

    Okay. Okay. So definitely it sounds like it's a, you know, we have such a, a large population in this country and with an aging population with the opioid crisis, there's no shortage of potential future opportunities and patients

    Speaker: Mina Larson (14:28):

    Absolutely not actually in the field. And I can point out the NIH actually does a survey every several, several years on what we called complementary and alternative medicine, which is not called integrative medicine. And they look at the growth of, of integrated message to chiropractic care and massage therapy and acupuncture. And you can tell I can based on that information and based just on our own research, acupuncture has grown tremendously in terms of consumer usage. A lot of patients are realizing as Maryln stated that it works well for pain addiction. A lot of other ailments that they traditionally were not aware of. And we have a lot of research out there also to really showcase that. So based on that information and seniors being added, insurance companies adding into the program, we're going to need a lot of acupuncturists to be able to enter the school systems and graduate, get credentialed and be able to practice.

    Speaker: Mina Larson (15:28):

    Those, those numbers need to really escalate. And it is a profession, again, that is growing the U S business, the U S Bureau of Labor Statistics has recently in the past several years have distinguished acupuncturists as a profession. They're being tracked right now. If you go to the BLS website, you'll see that. And they're actually through their database called ONAC you can see that acupuncturist has been tagged as a growing and emerging profession. And this is very important because the government is tracking us and showing the growth in that profession as well. And we really want to be able to multiply that by having acupuncture, being able to come in and practice and, and treat the many, many patients that are going to be out there for us. 

    Speaker: Chad Egresi

    And that information is based on hard data, right? Yes, yes. Great. 

    Speaker: Marilyn Allen (16:20):

    As much as I have traveled around the world working with the who, I've realized that this is a, a very valid paradigm of medicine. Not to replace Western medicine, but when you work in conjunction together the healthcare of patients improves and the world health organization has recognized acupuncture based on two studies that they did through WHO finding out that the countries of the world, 82% of the world's population uses some form of complementary medicine. We're not just looking at the United States, but we're looking all over the world and the world is looking for better health care because we want better quality of life for our citizens and we want to cut down on the diseases and cut down on the deaths. So when you integrate medicines together and people begin to work together, you have a better system and a more complete system because acupuncture and Eastern medicine just looks at them with a different paradigm. I say they look at them with a different set of eyes.

    Speaker: Chad Egresi (17:24):

    Absolutely. I couldn't agree more. Having been treated in both perspectives, you know, from personal experience. I would agree completely. So we've talked a little bit about the government. We got into the Bureau of Labor and Statistics. Either you Mina or you Maryln, can you tell us a little bit about any legislative work that you're aware of that's currently going on? Any kind of bills that may be coming through the government that could affect us 

    Speaker: Mina Larson (17:50):

    well in terms of states there's constantly Regulation is happening because the practice of acupuncture is regulated through state practice acts. So currently we have 47 States that have acupuncture practice acts where you can practice. And as I mentioned for those who are seeking acupuncture in those States, they can get that information through our website. In terms of federal there's one particular legislation that we're very excited about and that's called a No Pain Act. It's a bill that's being introduced by both Senate and and, and house of representatives that focus on non-pharmaceutical interventions for pain and addiction, particularly through post operative care, surgical care. So this is very important for us because we want to get acupuncture because there's lots of lots of evidence that shows that acupuncture really works for controlling pain after surgery. We are working with an organization called voices for non-opiate choices to get acupuncture showcased.

    Speaker: Mina Larson (18:49):

    So this is an important bill that we're tracking as well as I mentioned earlier about CMS and working with congressional representatives. Some of them who already have a Medicaid type bill introduced working with them to specifically finalize the CMS decision so that we can make it we can actually roll it out and have acupuncturists be able to, to become providers that needs to happen. So that's when it's early stages right now cause we have to really work with Congress in order to get all of those finalizations done within those bills. But those are the legislations that I'm aware of that are important right now, particularly with opiates because as I talked to members of Congress from both sides of the aisle, you know, that's one thing that both Republicans and Democrats agree on is that we need to bring other interventions to control the, the serious opioid crisis that we have here in the U S and acupuncture is one of the best Remedies. 

    Speaker: Marilyn Allen (19:48):

    Absolutely. There's plenty of evidence out already shows that it works well on pain. 

    Yes, absolutely. Absolutely. 

    Speaker: Marilyn Allen

    Well, I think the other legislation or not was, is veterans veterans and opened up yes. For veterans to have the benefits of acupuncture. Yes. about a year and a half ago and they were very specific about it. But a practice, an acupuncturist in their own practice can treat a veteran if they cannot get to a veteran's facility or get a timely appointment. And there are so many people coming back with various types of conditions. Every combat that they've been in, things are different. If we look at Vietnam and Agent Orange and then the Gulf War, it came was chemical and now it's different things. So it's important that we know this. The Rand Corporation, which does research, did a two year study on veterans and the things that they need.

    Speaker: Marilyn Allen (20:49):

    And they found out by looking at our, our physicians that not many people really even know that our medical providers know the questions to ask because you can ask if they're in military and then you have to know about the kind of conditions they've they've been in and where they were, were treated or where they have served and how long have they been deployed and things like that. And it's really important that we take care of our veterans because we send our best out and they come back, many of them with, with many chronic issues, particularly PTSD. And they need to know that they do have some, some choices that they can make. And it's called veteran's choice. And we have a very successful program up in Chicago that is just using acupuncture in the Strozier Center. And they have just many hundreds of veterans coming in for help and, and it's, it's helping with their lifestyle and things that they can do and they can participate again. So it is important that we include this medicine and there are many facets to including it, but we need to include it because we have healthcare in the United States that serves millions of people and they need to be able to again, have a good lifestyle, better quality of life, better quality of life. Yeah. Yeah.

    Speaker: Marilyn Allen (22:08):

    Less side effects, all of those things. Longer life, longer life. 

    Speaker: Chad Egresi

    Wonderful. so we, we, we've talked a little bit about advocacy. We haven't brought up one area that's a little bit controversial so we're going to bring it up and see how we, how we can approach this. How is it important to advocate for acupuncture is in the evolving world of dry needling and programs with physical therapists, chiropractors, and what I've recently heard nurses potentially having access to dry needling. 

    Speaker: Mina Larson

    Thank you for bringing that topic up. As acupuncture becomes more and more popular as a viable form of medicine. And as I mentioned, there's research and plenty of data out there of patients have been successfully, successfully treated for many islands. Everyone wants to, a lot of other professions have come in and, and created abbreviated programs to be able to offer dry needling.

    Speaker: Mina Larson (23:05):

    It's called trigger point dry needling and our profession calls it a form of acupuncture as well as acupuncture such as some of what the nurses are, are starting to do out in the, in the West coast. And it's important that we distinguish what licensed acupuncturists do in terms of their training to education, their background, the fact that, you know NCCAOM portrait about acupuncture's have, have taken tests and are certified and have to continue with their with our re-certification and maintenance of certification as part of continued competencies. It's a very rigorous certification program versus someone who has taken a weekend course and is performing acupuncture or dry needling. It's important for the public to know that because oftentimes, you know, here, you know, someone says, Hey, go see this particular person. He's a chiropractor and he does acupuncture.

    Speaker: Mina Larson (23:57):

    Well, that chiropractor has maybe done a hundred or 200 hour courses for someone who is a licensed acupuncturist, and has done over two to 3000 hours. And it's not just about the hours, it's about the competency, the experience, you know, the ability to be able to really look at someone who has a particular ailment and be able to, it diagnosed through acupuncture and oriental medicine and have that background particularly I want to really point out that acupuncturist who are licensed and board certified OSHA also had been trained for the safety aspect of it. They have done a, completed a program called the clean needle technique, which ensures that they know what they're doing in terms of safety, bloodborne pathogen disease, spreading illness through, because you're actually puncturing the skin with acupuncture. They've done that. And, and with NCCAOM we have several exams in order to be certified.

    Speaker: Mina Larson (24:52):

    One of them is our biomedicine exam. This exam, you have to pass it in order to be certified in Virginia because it's a certified required state. You have to make sure that that exam is, is passed and that exam has your safety, red flags, ethics, practice management, all of the things you need to really need to know in order to be able to work in an integrative setting. And, and some of these other practitioners particularly with the physical therapists and chiropractors, they don't have that training. So I would really caution the public about seeking someone who is not licensed through the state. Particularly NCCAOM certification is also a good credential you should look for. And again, I go back to our website for that. Because the efficacy is noticed. When you go see someone who is state licensed and board certified, they can treat you for PTSD, they can treat you for psychiatric issues, they can treat you for a lot of different elements for autoimmune versus just pain or a particular type ofissue that you might be having that's related to chiropractic medicine or physical therapy.

    Speaker: Mina Larson (26:01):

    Yeah. Okay. Did you want to add to that? 

    Speaker: Marilyn Allen

    Well, I think, I think acupuncture treats the whole person. Right? And I think that's really what we're trying to look at is we've not broken it apart. We're looking at the entire, yes. You know, the physical, the spiritual, the mental. Yes. Because that's what disease is. Yes. And we want to be able to help people to gain to a new level of health. Not that acupuncture is the only thing they should do. We're not advocating that, it's an, it's an integrated thing, but we want the, the people, the, the public to know that there's ways to find people who are well trained and well qualified and we don't want accidents to happen or things to, right. You know, we just want people to

    Speaker: Chad Egresi (26:44):

    Feel better, 

    Speaker: Marilyn Allen

    have a better quality of life, 

    Speaker: Chad Egresi

    There you go, right there. 

    Speaker: Marilyn Allen

    And also, I just wanted to add one thing because this is important in terms of the whole perspective of the so many different professions practicing acupuncture. Acupuncture is not a modality. It's, it's really a medicine. And I think that's what the difference between licensed acupuncturists and someone who's doing it. Like for example, a nurse who's not taking a weekend, you know, a couple hundred questions. It's a whole mechanism of medicine that we learn through the schools and through the certification and the continued competency that we have to do through certification and licensure. So that's very important to know. It's not just an add on that somebody added because they thought it would be great to be able to practice a little bit of dry needling. Right. 

    And so, yes, I think people, so many people want to use it because simply it works.

    Speaker: Marilyn Allen  (27:32):

    It really works with no side effects. And people always ask, well, I'm afraid of needles. Do the needles hurt? No, the needles are very, very, very small and very thin and they all come packed in little packages. We know that they are clean. They're sterile. They, you can only use them once. But it was so funny and people think they're thinking about the hypodermic needles. Sure. Well those are large. Okay. And but no, these are very small and don't usually leave any kind of mark. You just feel different. Right. 

    Speaker: Chad Egresi

    For the most part, painless. You know what I mean? Having experienced that, I think all of us here have gotten a treatment in, in our, in our lifetimes. And you know, there are certain points that are different than others. You know, if you stick a needle in the end of your little finger, it may feel a little bit different than the one that goes into your arm.

    Speaker: Chad Egresi  (28:27):

    And so there is, you know, there's an understanding about the front of the public house, but, as a person who has experienced it and is afraid of needles usually passes out when they get their blood drawn. I can tell you from experience that it is absolutely not a concern for me. Right. And so from a public perspective, we hope that people see the potential benefits of this because it's miraculous. It really is work so well on things, whether it's from stress, the common cold, you know, the pain management and addiction, things like that. There's evidence that shows that and we've experienced it. Absolutely. 

    Speaker: Chad Egresi

    That's correct. Yeah. So thank you. You know, for, for talking through that with me, I appreciate you taking the opportunity to mention my own experience. 

    Thank you. 

    Yeah

    I think we're in the same boat because neither one of us are providers, but we've all experienced the medicine. I had it 30 days continuous because acupuncture is, it builds, so you have to keep, you know, doing it until your system gets accustomed to it. I had 30 days every day before I had my cataract surgery. When I went back to my ophthalmologist the next day, he said, well, I've never seen anybody's immune system be so strong, 

    recovered so quick, 

    Speaker: Marilyn Allen

    you recover very quickly. It's becoming very

    Speaker: Marilyn Allen (29:42):

    Popular for a postsurgical pain. Because many people do need surgery. We're not saying that they don't, right. But there's ways that you can combine them, particularly people going through chemotherapy. It does help with nausea. You feel not quite as sick as you have before. And so we'd like to open this up to, you know, as many people to enjoy it as possible. And it does relax you. 

    It's a [inaudible] that is definitely true. Absolutely. 

    Speaker: Marilyn Allen

    Now the American medical association owns the procedure coats and the acupunctures have worked for quite a while, several years to try and become a member of that committee. And it was just this past year that they have been awarded a seat on that committee to talk about procedure codes and how they, how they're used and what the definition of them is and what the timing is and things like that. So acupuncture is now being accepted in that way to be able to help in the development of codes that people can use for their insurance. 

    Speaker: Chad Egresi (30:54):

    Very Interesting. That's a so, so you're saying that now we're kind of at the table. Acupuncture is at the table to help make sure that our medicine has its own code system. And so, so from a layman's perspective, cause I'm not an acupuncturist, can you tell us what that means to an acupuncturist to have their own code when it comes to insurance and,

    Speaker: Marilyn Allen (31:15):

    Well, number one, it gives them the ability to bill someone's a patient's insurance for reimbursement. And when an insurance company reimburses, that actually helps the patient to pay their bills. Sure. Insurance companies don't pay a hundred percent. They pay a percentage of what they deem is reasonable usually customary. But it does help a patient pay their bill. Sure. Patients have copays and deductibles and there's managed care and there's many different ways they've discovered that it's very popular for automobile accidents. And the more cars we have on the road, the more automobile accidents. And I'm back in Washington, DC from California. And I know that California, we have a lot of cars, but I think you have just about as many as we do. And, and people are, are under so much pressure. We have more accidents, but it does help with that if someone is injured at work. Many States cover workers comp insurance, federal health savings plans and medical savings accounts in many cases pay for acupuncture. Plus Medicaid in a number of States is now paying for acupuncture in California MediCal pays for it. And that has helped to raise the the recognized

    Speaker: Marilyn Allen  (32:41):

    Need to put this in for, for seniors. And that's why I believe CMS has lurked at looked at this and said, yes, we need to put this in for conditions 

    Speaker: Chad Egresi

    wow. So those codes are really important. [inaudible] Yes. Yeah. Yes, it's really important. All right. So before you guys, before you guys got here, we took some questions from our current students who are enrolled here. And I'd like to present a couple of those to you now if you don't mind. Absolutely. Okay. All right. So are there any upcoming changes to the NCCAOM boards that we should be ready for?

    Speaker: Mina Larson (33:17):

    Well at this point one of the, one of the emphasis I want to provide to students is that the NCCAOM is focusing on providing even more information for exam preparation. So we've created an NCSM exam prep center where not only do we have our study guides and content outlines and some information about, you know, the examination in terms of content because we just converted our content outline to 2020 from last year. We had our job analysis and job analysis, I want to take a second to talk about that because there's a lot of confusion about our exams. The NCCAOM examinations are tailored from the job analysis. The job analysis is a survey and nationwide survey that we send to hundreds and thousands of acupuncturists in the country. And we, we ask certain questions in terms of their knowledge, skills and abilities to be able to practice their practice style, demographic information.

    Speaker: Mina Larson (34:15):

    And then we get that information and we are subject matter experts gathered together to create a blueprint for the examinations to come on the content outlines. So our exams are tailored towards what's being practiced out there, not what the schools teach or what ACCOM requires. It is important for students to know that because we get students to call and say, I got an A+ and then I didn't pass. Well you really have to focus on the content outlines and because we have a calm and assists term in terms of an accrediting body, but every school has a different, you know, they take the curriculum and they have different styles of how they teach it, which is why the NCCAOM exams as a certifying body that's also accredited must look at everything through what's being practiced out there through our job analysis. So going backtracking to policies our new content outlines for 2020 are now on our website.

    Speaker: Mina Larson (35:07):

    So if you are graduating and getting ready to take our exams or even interested in the profession and want to know a little bit more about what's on those exams, you can go to our website and go to our exam prep area and download the content outlines to study guides. We have our practice tests and I'm very excited to announce that we're going to soon have even more practice test questions and we've made the bank more robust so that we can provide you with as many practice test questions as we can so that you get a nice look and feel of what's to be on those. Those practice tests questions. And again, NCCAOM is the only organization that administers the official NCCAOM practice test. There's a lot of other places that offer it, but they're not affiliated with us. So we have our own practice test and we encourage students, we offer our rates that's, that's affordable students to go and download that information.

    Speaker: Mina Larson (35:59):

    So the 2020 content outlines. One more really important announcement is that right now we're in a linear examination process, which means that after a job analysis we have to actually go linear to be able to calibrate items. It's a process that we'd have to do to ensure that our exams are psychometrically valid and reliable. So we're administering the exams through certain exam periods. After July, it's going to go back to adaptive, which is continuous, which means that once you are deemed eligible to test, you get a letter from us and you can pick up the phone and schedule like you're scheduling a doctor's appointments. So, but we always encourage our students, make sure you prepare, you know, you have a four year application time to submit your to finish out your certification, you know, schedule it out the way that's comfortable for you.

    Speaker: Mina Larson (36:47):

    So and then one more very exciting news. We've revamped all of our computer systems to make sure that we're online and everything is processed expeditiously. So our application, which used to take four to six weeks is now one week. So when students are going on and applying, it should be very fast. They don't have to wait. The period they had everything is now online and paperless. So we encourage anyone who wants information about that to look that up and particularly those that are interested in entering the profession. We have a lot of information on our website for that too. 

    Speaker: Chad Egresi

    Okay. Can you remind our guests about when the change is going to take place for the exam? 

    Yes. So in, so right now we're, we're doing, we just finished out and the one exam administration we're going to have another one in April where we have a two week period where we administer the exams through linear.

    Speaker: Mina Larson (37:42):

    And then in July we go back to adaptive, which means that, yes. So, which means that you'd go back to doing continuous exams and then that's going to be the adaptive format. We'll, we'll continue throughout make it easier, make it easier. Right. Absolutely. Exactly. So with the NCCAOM examinations, again, once you finished out your your, your education schools, you, you've graduated and you finished that CNT that I talked about earlier, then you're eligible to take our examinations, his systems. And again, we have centers throughout all of, you know, the whole entire world. I mean, you name it, we have a center and we partner with Pearson Vue, which is one of the best test administration organizations in the, in the, in the world. So we make it very secure and safe as well. 

    Perfect. And they're a very large organization, so I'm sure, yes.

    Speaker: Mina Larson (38:29):

    Part of the reason why we have so many tests. 

    Exactly. Exactly. Yes. 

    Great partnership. Yes. Thank you. 

    Speaker: Chad Egresi

    So I'm on a little bit of a different track here from a research perspective and, and you know, if you guys don't have information on this, that's sure. But it's a question from our students who are going to ask it. So are there any breakthroughs and acupuncture research that you guys are aware of that you can talk about at this point? 

    Well, the CMS research was fairly breakthrough even though it wasn't complete in terms of the, the, the study, the, the research has started already. And, and based on, you know, how quickly this decision was made. That was something that really showed the effectiveness of, of, of back pain. So I want to point out an organization that I think students would benefit from.

    Speaker: Mina Larson (39:16):

    And that's the Society for Acupuncture Research, SAR is an organization. That's, that's what we would call the research institution of our profession. They often collect a lot of research that, that are, that are, that show the efficacy, cost-effectiveness of, of acupuncture, but also have acupuncturists that are involved in it. We're really trying to work with SAR and some of the other organizations are trying to work with the NIH so that we can have studies that really compare acupuncture. In terms of showing that cause when, when you're dealing with, when you're dealing with research, you're dealing with Western based research and that's often hard to show in terms of the effectiveness. And it's, and we, so we tried to go ahead and take acupuncture research and show the effectiveness of it and have licensed acupuncturist who are also credentialed to be able to be involved in it and the just medical doctors.

    Speaker: Mina Larson (40:15):

    Okay. So SAR is a good organization to go to. They have a lot of research information out there. We do have NCCAOM to update its list of research. And we've broken it down to ailments. Like for example, migraines. You hit that button and you can see the actual research that's been conducted from migraines. Back pain is lots and lots of information for back pain. So we have that also on our website. Right. 

    Speaker: Chad Egresi

    Those are huge, right? Back pain and migraines? 

    Speaker: Mina Larson

    Back pain or migraines are huge. Absolutely. and as a matter of Maryln mentioned pain is what acupuncture is often associated with. But I can't emphasize mental health enough because to me mental health is a major crisis in the U S you see what's happening in the news. And there are many acupuncturists that are trained to be able to treat mental health such as what Maryln mentioned within the VA.

    Speaker: Marilyn Allen (41:03):

    We have some talented acupunctures within the department of defense that are actually treating active military for PTSD, for depression. So this is something that we're trying to gather more research on this to show that this is a solution and the epidemic that's happening that's also tied to the opioid epidemic. So I think it's just important for us to collect that research and, and, and, and be able to show it to the, to the right entities to make decisions. 

    Speaker: Chad Egresi

    How about the NIH? Is the NIH working on anything right now? 

    Speaker: Mina Larson

    Well, we actually had an opportunity to meet with NIH and speak to them about some of the research that's happening and whether we want, we're really emphasizing that they should be working with our profession. I know that HR6, which was a bill that was passed last year and signed by the president, which was focused on it's called the Support Act.

    Speaker: Mina Larson (41:58):

    It was a bill that was focused on alleviating this huge opioid epidemic epidemic that's happening in the country. And it really gave the marching orders to the different agencies on what they need to do to deal with this, this epidemic. Like it gave direction to the DEA, to the NIH, to the HHS and with the NIH it gave a lot of funding, millions and millions of dollars to to be able to look at research in terms of non, you know, as I mentioned, non-pharmaceutical research to show, you know, how it can help with pain and addiction. So there's a lot of money sitting there and I think we have to constantly be working with the NIH so that some of this research is geared towards acupuncture because non-pharmaceutical can be many things, you know as you know, there's chiropractic care and massage therapy, but acupuncture in terms of our belief in what we've been able to show is one of the most effective treatments for pain and addiction.

    Speaker: Marilyn Allen (42:56):

    Yeah, no, well the, they just added a diagnostic code that acupuncture can be paid on for postpartum depression. So that's, that's one. Everything is you know step-by-step and we just had a company that actually looks at all of the diagnostic codes. Those are different than the treatment codes and everybody uses the diagnostic codes and we all use them for billing. But the reason they were actually started back in the 18 hundreds is because they wanted to track how many people died of a certain code. So countries of the world today have to report mortality, morbidity, which is diseases associated, but the person didn't die in comorbidities. So the United States along with them 175 other countries and who report these statistics and when acupuncture gets included because so many people around the world are using some type of complementary medicine, we'll see how, how that works out.

    Speaker: Marilyn Allen (44:01):

    The Australian acupuncture association has gathered all the research that they could find worldwide and put it up on the web so that people can download it to see, there is lots and lots of research around from many different countries, but we like our research to come from our soils. So that's a, that's an issue. And we also have to have people who write grants. Right. That's a, that's a big issue. And in that area we're kind of new at it. We're like teenagers and we aren't quite there yet as a profession, but we're getting there because they did a big research project in Washington state because Washington state did not let acupuncturists treat injured workers, well injured workers are a big, a big part of the population. And they found out that it was extremely effective. So they, they even stopped it in the middle of the, of the things that just put it into worker's compensation. So

    Speaker: Mina Larson (45:04):

    Like CMS, similar, similar to the CMS. I think, you know, we were expecting the timeline for CMS to happen sometime in 2023 we were not, but I think some of it had to do with just the effectiveness of acupuncture and the many, many seniors that Maryln mentioned that are entering into that age group. So, so and again, I think our question research is to continue to work with the government, you know, and get government funded research because it'll not only benefit them, but it'll their constituents, but will also benefit as we, as we mentioned, the public right. And costs and health care costs and all of these issues that are facing and plaguing our country 

    Speaker: Chad Egresi

    at the broadest level. Yes. Yes, absolutely. So we're, we're kind of coming down to the end of our, our, our conversation here. But one of the things that, that I do want to ask you guys is what, what are your kind of final thoughts and advice to people who are interested in coming into the field and becoming an acupuncturist?

    Speaker: Mina Larson (46:07):

    Sure. I will start with finding information about the medicine. Looking at the qualifications that are required. You know I said as we've, Marilyn and I both think and many other leaders within the profession think that this medicine is going to continue to grow. More patients are going to be interested even more patients than we described and be more interested in it. So, we really encourage potential students to really look into the programs. ACCAOM, has information about all of the schools. Look at the local schools within your area here in Virginia. We have a wonderful school here with an excellent program. You know, take the time to come to the school and talk to some of the some of the school officials and others on the counselor share to give you information about the medicine itself. I think it's important to do that. Definitely get treatment. I think you should be a consumer come out to have a great clinic here. Get treatment, find out more about the medicine and really make that investment. Do you want to add?

    Speaker: Marilyn Allen (47:07):

    Well, I would say that because of the expansion of acupuncture, more people are trying it. We have federal loans for going to school and yes, they can make a living out of this because more clients and patients are seeking this. And I think in the, that the medicine, this medicine is an old medicine. It has been around for centuries. We can't exactly say how many centuries, but it has gained its own recognition as a medicine that has stood the test of time and that it's going to survive. And I think today is probably the best time in the history of medicine for anybody to go to school and become a professional because of the acceptance, the reimbursement and the field that you can help someone gain a new level of health and watch patients who have been sick, who have many diseases. Acupuncture gives hope and hope you cannot miss. You know, and it's very, it's one of those things that just changes people's lives. 

    Speaker: Mina Larson (48:25):

    And with the Center for Medicare, Medicaid services decision to cover acupuncture for back pain, we're going to need thousands of acupunctures to come into school, become educated, get credentialed and practice because there's going to be people lining up to get treatment. 

    Speaker: Marilyn Allen

    The field is not saturated by any means.

    Speaker: Chad Egresi (48:46):

    Thank you. That's a very good point. Very important as well for prospective students who are out there thinking whether or not this is something that's viable. As we are on the All Things Integrative Podcast, the final question that I have for you, both of you is what does integrative mean to you?

    Speaker: Mina Larson (49:04):

    Integrative means to me a system of medicine where practitioners and providers work together to treat the patient. And all interests are focused on the patient. So you have physicians, nurses, acupuncturists, chiropractic care, mental health providers, massage therapists, others working together as a patient-centered team and patient-centered care to be able to help the patient together and solve problems together to communicate together. I think I want to emphasize that because it's important for all the whole team to communicate on how to best treat that patient and that's what patients are looking for now. They're done with going to one doctor who doesn't work with another doctor. That's why you're seeing integrative medicine clinics grow and and expand throughout the country because patients want that now.

    Speaker: Marilyn Allen (49:56):

    I think that integrated care is patient-centered care. The patient has to be the person who is part of the decision making team. And when you add all of the different types of things in, including acupuncture and all of our Western medicine and our physical therapy and what we know about exercise, not every buffet is right for everybody, but the patient and the medical provider providers begin to put together a

    Speaker: Marilyn Allen   (50:28):

    That will help each individual, each citizen of the United States begin to have a health care regime that works for them 

    Speaker: Chad Egresi

    and a quality of life while your quality of life, the phrase of the day 

    Speaker: Marilyn Allen

    As we get older and older, we want a really good quality of life

    Speaker: Chad Egresi

    Absolutely. I couldn't agree more. So ladies, I really appreciate you being here today. Thank you, Marilyn. Thank you Mina. Thank you for best of luck as you continue to do your good work and, and the American council acupuncture council and the NCCAOM. And we hope to see you guys here soon. Again,

    Speakers: Mina Larson, Marilyn Allen  (51:03):

    Thank you very much for having us. Absolute pleasure. 

    Speaker 1 (51:05):

    Thanks for listening to All Things Integrative. Be sure to tune into our next episode where we'll share more information on how integrative medicine can help you lead a happier, healthier life.

    Topics: Podcast