Medi-Cal Ups Acupuncture Payments For Addiction

Medi-Cal supports acupuncture for the treatment of pain to address problem of opioids

Five Branches University of Traditional Chinese Medicine completes a successful pilot program with the Central California Alliance for Health examining the efficacy of acupuncture & Traditional Chinese Medicine for pain management. Results allow Medi-Cal patients to use acupuncture instead of opioids and reimbursement rates to acupuncturists double.

The United States is experiencing an epidemic crisis and the worst opioid drug addiction problem in history. Opioid painkillers, such as codeine and morphine, are highly addictive substances. When individuals in chronic pain cannot receive prescription narcotics, many are forced to resort to illegal street drugs like heroin, which are often less expensive. Opioid drug related deaths reached the highest number in history in 2014, claiming the lives of more than 29,000 individuals.

On March 29, 2016 (Atlanta, Georgia), President Barack Obama spoke to roughly 2,000 attendees at the National Rx Drug Abuse & Heroin Summit and stated,

“I think the public doesn’t fully appreciate yet the scope of the problem…the problem we have right now is treatment is underfunded.”

In a time when doctors, hospitals, healthcare organizations, medical universities, and patients are in desperate need of a different solution to pain management, the Central California Alliance for Health (CCAH) has taken pioneering steps in offering an alternative approach to supporting patients with chronic pain. Alan McKay, CEO of the CCAH, and Dr. Dale Bishop, Medical Director of the CCAH, wanted to help patients within Santa Cruz, Monterey, and Merced Counties that were suffering with severe and chronic pain to reduce their dependency on opioids. They turned to acupuncture and Traditional Chinese Medicine (TCM).

Five Branches University was chosen as a major treatment center along with four other providers in the Monterey Bay Area and Merced (California) to conduct a clinical trial pilot program. This pilot program was designed to determine the efficacy of acupuncture and Traditional Chinese Medicine at reducing a patient’s pain levels, and lower, if not cease, their need for prescription narcotics.

The pilot program, starting in the summer of 2014, was conducted for just over one year. Each of the patients referred for treatment by the CCAH were specifically selected to participate in the program due to their extreme need for alternative pain management solutions. The results were overwhelmingly positive with greater than 80% of the participants having a tremendous reduction in their pain levels and need for opioid medications.

opioid overdosing crisis

Source:BusinessInsider.com

Source:BusinessInsider.com

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Because of this success, the CCAH has now made unprecedented changes in the health insurance coverage of acupuncture for Medi-Cal patients. Now, all CCAH members, including adults, can self-refer to an acupuncturist for any medical condition and receive up to 2 visits per month. Since 2009, only pregnant mothers and individuals under 21 years of age could receive Medi-Cal reimbursement for acupuncture services. However, those are not all of the benefits that are now available. If a patient is getting beneficial results from their acupuncturist, they may request a referral from their primary care physician for a renewal of twenty extra visits to be used anytime within a three month time frame. Currently, there is no limit on how many times these twenty extra visits may be renewed. Many of the pilot program participants had their referrals renewed three to four times.

Additionally, the CCAH has authorized Medi-Cal to double their reimbursement rates for patients that receive acupuncture at the Five Branches University Health Center from $17 to $34. “I am completely shocked at the results of this pilot program,” said Akwia Knipe, clinical manager of the Five Branches University Health Center.

“Our health center is busier than ever, with half, if not more, of our daily patients using their Medi-Cal insurance benefits. Even after individuals have used their two treatments per month benefit, patients are paying out of pocket for acupuncture services until they receive their referral for treatment renewal, due to the life-changing benefits they are experiencing.

We are getting anywhere from fifteen to twenty new referrals for acupuncture from primary care physicians within Santa Cruz County per day,” she said.

Five Branches University and TCM Health Center was established in Santa Cruz, California, in 1984. Since then, the university has offered exceptional training in acupuncture and Traditional Chinese Medicine.

“We have been dedicated since day one to serving those most in need within our community, and that is why we have continuously partnered with and supported our Medi-Cal population,” said Ron Zaidman (CEO, President, and founder of Five Branches University).

“It was inspiring to meet with Alan McKay three years ago when he asked Five Branches to be a key part of this revolutionary pilot program that had the potential to improve the quality of life for so many people suffering from chronic pain.

This is a perfect example of the kind of service we strive to provide for our community, and everyone else who may benefit from acupuncture and Traditional Chinese Medicine received by our graduates.”

Currently, Five Branches University is working with the CCAH to provide the same health care benefits for Medi-Cal patients within Santa Clara County at its San Jose campus and TCM Health Center.

For more information about Five Branches University’s TCM Health Centers and graduate programs:

FIVE BRANCHES UNIVERSITY HEALTH CENTERS

DTCM/MTCM Program

DOCTORATE/Ph.D Program

 

About the Author:
Chase G. Waters is a doctoral fellow in Acupuncture and Oriental Medicine at Five Branches University and has a Masters in Traditional Chinese Medicine (MTCM).

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