Workers’ Compensation Benefit
While there is much debate about healthcare coverage for acupuncture treatment, there is another avenue patients can sometimes use for such relief: workers’ compensation.
More states are allowing workers’ compensation coverage for such acupuncture treatment. Workers’ compensation insurance provides medical expenses and lost wages to employees who are injured while working.
In the past two years, more health organizations have supported non-drug therapies, such as acupuncture, for treating low back pain, for instance.
The Joint Commission has required hospitals to provide non-pharmacological pain options, such as acupuncture provided by licensed independent practitioners.
Slowly, states have begun to embrace acupuncture for workers’ compensation benefits, including Maryland and Virginia, where acupuncturists may accept the policies.
“Physical therapy, occupational therapy, massage and acupuncture are proven therapies for helping workers’ compensation insurance patients to recover from many injuries sustained on the job,” according to The Center Annapolis, which provides therapy.
Under Virginia law, “the employer and its insurance carrier must furnish other reasonable and necessary medical benefits to n employee hurt on the job. These lifetime medical benefits may include acupuncture.” It adds “The insurance carrier may have to pay for frequent acupuncture treatments if they provide pain relief. This is true even if the pain relief is temporary,” according to attorney Corey R. Pollard.
States Supporting Acupuncture
Back in the 1990s, California approved the use of acupuncture for a legitimate form of treatment for in part because many of its residents, including East Asian immigrants sought non-Western treatments, according to Dr. Robert Goldberg, chief medical officer of Healthsystems, which provides national workers’ comp pharmacy and ancillary benefits.
In Ohio, for example, the state’s Bureau of Workers began covering the use of acupuncture to cover workers compensation injuries several years ago. The Ohio program covers up to two hours of acupuncture.
In Pennsylvania, employees are covered under the state’s workers’ compensation program for acupuncture as long as the procedure is deemed medically necessary. In cases where that can’t be determined, an independent third party organization may review a claim on appeal.
Some workers advocacy groups have worked for years to have states approve it. Such was the case in Washington State, where there was a 20-year effort for approval of acupuncture for workers compensation. The state approved a pilot program.
That was approved after many studies that showed acupuncture was beneficial for patients having low back pain. Under the Washington state plan, each patient may receive as many as 10 acupuncture treatments for the life of their claim, if improvement is seen.
It is important that a physician refers the insured worker for acupuncture treatment, and an approved provider is used.
An Excellus BlueCross BlueShield program found that educating doctors about a restrained approach to back pain was worthwhile for patients.
Patients should keep records about how they are doing with the acupuncture, such as using a diary, and provide a file to physicians. They use the term “functional improvement,” which means improved daily living activities.
There is much disagreement in many states about what to do for insurance coverage, with political consequences.
In New York, the state Senate and the Assembly recently passed bills that would have expanded the state’s workers compensation law to allow more treatment options to include acupuncture by a licensed or certified practitioner. In effect, the legislation would have not only required acupuncturists to file an application to treat injured workers and but it would have created a committee to approve such applications and to enact a fee schedule. The governor, however, vetoed the measure.
Long Time Fight
Many groups supporting improved coverage for acupuncture have been upset about the lack of coverage for acupuncture. “The history of the acupuncture guidelines is a sad story of denial of this evidence-based, effective and low-cost treatment for injured workers,” said one group.
While there is evidence that acupuncture can help overcome pain, federal officials say more research is needed because of modest benefits, reports say.
Teresa Carr. Consumer Reports. Does Insurance Coverage Acupuncture and Other Nondrug therapies. 2917. Retrieved from: https://www.consumerreports.org/health-insurance/does-insurance-cover-acupuncture-nondrug-therapies/
Bastyr University. Alumna Expands Workers’ Comp Coverage for Acupuncture Treatment. 2018. Retrieved from: https://bastyr.edu/news/general-news/2018/07/alumna-expands-workers-comp-coverage-acupuncture-treatment
Angela Childers. Acupuncture Moving Mainstream in Workers’ Comp. Risk & Insurance. 2017. Retrieved from: https://riskandinsurance.com/acupuncture-moving-mainstream-workers-comp/
Louise Esola. N.Y. acupuncture bill vetoed. 2019. Business Insurance. Retrieved from https://www.businessinsurance.com/article/20190102/NEWS08/912325907/New-York-bill-that-would-have-allowed-acupuncturists-to-treat-injured-workers-ve
Sheri Barnes. Workers Compensation Now Accepted. Retrieve from:
Corey R. Pollard. Lifetime Medical Award and Benefits under Virginia Workers Compensation. 2018. Retrieved from: https://cpollardlaw.com/virginia-workers-compensation/types-of-benefits-explained/lifetime-medical-treatment/