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CMS Proposes Acupuncture Coverage for Lower Back Pain

July 16, 2019

After conducting evidence reviews and undergoing a public comment period, the Centers for Medicare & Medicaid Services (CMS) proposed to cover acupuncture as an alternative treatment method for beneficiaries with chronic low back pain, provided they are enrolled in a CMS-approved studies or National Institutes of Health (NIH) sponsored clinical trial.

Acupuncture, historically not covered by Medicare, would offer an alternative treatment to opioids. The proposed decision would increase access to treatment but also provide an opportunity to collect data on patient outcomes.

“Today’s proposal represents the Trump Administration’s commitment to providing Americans with access to a wide array of options to support their health,” said HHS Secretary Alex Azar in a press release. “Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to treat the very real problem of chronic pain, and this proposal would provide patients with new options while expanding our scientific understanding of alternative approaches to pain.”

Research on the effectiveness of acupuncture is limited but mounting evidence in its favor has been growing in recent years. The practice consists of a practitioner stimulating various points on a patients’ body with the use of a thin needle.

According to a press release, CMS and NIH have been conducting research with 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. The proposed decision marks the agencies’ intent to research Medicare coverage determinations.

“Chronic low back pain impacts many Medicare patients and is a leading reason for opioid prescribing,” said CMS Principal Deputy Administrator of Operations and Policy Kimberly Brandt in a press release. “Today’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. CMS will work closely with our sister agencies to monitor outcomes for Medicare beneficiaries receiving acupuncture to inform our understanding of the efficacy of this therapeutic approach.”

—Edan Stanley

Centers for Medicare & Medicaid Services. CMS Proposes to cover Acupuncture for Chronic Low Back Pain for Medicare beneficiaries enrolled in approved studies [July 15, 2019]. Accessed July 16, 2019.

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