2018
INTEGRATIVE HEALTHCARE POLICY
A YEAR IN REVIEW
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Veteran's Administration Recognizes Licensed Acupuncture PAGE 6
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Oregon Medicaid Proposal to Cut All Opioids for Chronic Pain Patients PAGE 16
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Opioid Crisis Response Act of 2018 PAGE 23
2018 INTEGRATIVE HEALTHCARE POLICY
A YEAR IN REVIEW
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9 22 EDITORIAL Katherine Rushlau Editor krushlau@divcom.com SITE MANAGER Faith Irek Digital Product Manager firek@divcom.com SALES Carmella Perrone Sales Manager cperrone@divcom.com DESIGNER Mariah Blodgett Production Designer
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An Integrative Practitioner Publication Produced by
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Medicaid Covers Acupuncture in Ohio
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U.S. Department of Agriculture Opens Dietary Guidelines for Public Comment
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Veteran’s Administration Recognizes Licensed Acupuncturists
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Maine Government Passes Law Requiring Coverage for Naturopathic Services
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National Center for Complementary and Integrative Health Receives Largest Budget Increase in Over A Decade
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Congress Passes Legislation Expanding Veteran Access to Non-drug Chiropractic Services
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Integrative Health & Wellness Caucus on Capitol Hill
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NIH HEAL Initiative (Helping to End Addiction Long-term)
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Food and Drug Administration Committee Supports CBD Epilepsy Drug
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JAMA Opioid Addiction Prevention Strategies
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Open Letter from Homeopathic Practitioners Regarding Antibiotic Resistance
■ American Society of Clinical Oncology Endorses Guidelines Established by Society for Integrative Oncology ■
Oregon Medicaid Proposal to Cut All Opioids for Chronic Pain Patients
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Food and Drug Administration Releases Opioid Analgesic Risk Evaluation and Mitigation Strategy
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Preserving Patient Access to Compounded Medications
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Senate Passes Bill Banning “Gag Clauses” for Pharmacists
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Farm Bill
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New Report Reflects NCCIH Research Interest in Emotional Wellbeing
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Opioid Crisis Response Act of 2018
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World Health Organization Declaration on Primary Care
Integrative Healthcare Policy
Looking Back at 2018 THE HEALTHCARE INDUSTRY—
could not refuse participation in the plan or
towards non-pharmacologic and integrative
and the laws and policies that regulate the
coverage for providers if they act within the
approaches. The time has never been better
system—has been changing rapidly over
scope of their license or certification under
for integrative medicine to take center stage,
the past few years. At the demand of both
applicable state laws. While this does not
and developments in integrative healthcare
consumers and practitioners who advocate
explicitly call out integrative healthcare, it did
policy and regulation are reflective of this.
for a preventative, whole-person approach
open doors for many integrative care providers
to care, the industry has started to shift away
to receive coverage for their services.
from the traditional “sick care” model and bring
The purpose of this annual update is to summarize the past year’s successes,
Additionally, Section 3502 recommended
challenges, and progress in integrative
healthcare teams include “doctors of
healthcare policy on the national level. This
However, a real shift to integrative healthcare
chiropractic, licensed complementary and
includes key laws, actions, and other influential
requires not only awareness and acceptance,
alternative medicine practitioners.”; Section
statements by both federal government and
but solid organizational, institutional, and
4001 included integrative health as a focal
quasi-governmental agencies. The focus is on
policy change. As the process historically
point in its National Prevention Council;
practitioners and their patient practices, as well
goes, standard-setting, self-regulation, and
Section 5101 mandated a complementary
as nutrition and product-related regulations
then governmental action.
and alternative medicine (CAM) workforce
that significantly affect integrative practitioners.
for the National Healthcare Workforce
In addition, we do our best to outline any
In the early ‘90s, when the New England
Commission, though it was never funded;
significant progress made on the state level,
Journal of Medicine published a special report
Section 2301 allowed licensed midwives to
specifically regarding licensing, mandates, and
highlighting revealing more Americans (425
be included as practitioners in birth centers;
inclusion in state-specific legislation.
million visit) sought care from “providers of
and Section 6301 discussed patient-centered
unconventional therapy,” than primary care
outcomes research, and required advisory
physicians (388 million), stakeholders started to
panels to include “experts in integrative
pay more attention to the need for integrative
health,” and a licensed member of the CAM
care in the greater healthcare industry.
professions to sit on its Board of Governors.
More recently, the Affordable Care Act put
While much of the current healthcare system
integrative health in federal policy for the first
in the U.S. remains uncertain, national health
time. In Section 2706, which covered non-
crises with both opioid use and chronic pain
discrimination in healthcare, insurance plans
management have prompted yet another shift
integrative medicine to the general public eye.
As agents for this change, it has never been more important to remain at the forefront of this bridging between conventional and integrative care. We hope you find this resource useful in your endeavors. l Editor’s Note: For questions or comments, please e-mail Integrative Practitioner Editor Katherine Rushlau at krushlau@divcom.com
January 2018
Medicaid
Covers Acupuncture in Ohio
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Integrative Practitioner Takeaway
IN JANUARY, OHIO OFFICIALS
announced Medicaid would expand coverage to include acupuncture for treatments of certain types of pain, as noted in Section 5160-8-51 of the Ohio Administrative Code. The Governor’s Cabinet Opiate Action Team released new guidelines in January 2016 recommending treating pain without
require referral from a Medicaid physician. Ohio is one of the first states in the country, and the first state in the Midwest, to have Medicaid cover acupuncture. The Ohio Association of Acupuncture and Oriental Medicine (OAAOM) said it is a milestone for acupuncture professionals and practitioners. “[The OAAOM] is proud that we persuaded the Ohio Medicaid to adopt these rules,” said
opioids when possible, which prompted the
Jared West, president of association, in an
Ohio Department of Medicaid to look at
official statement.
alternatives. In 2017, Ohio Medicaid started covering acupuncture when performed by a physician for lower back pain and migraines.
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visits per year, according to the rule, and
West also said the association plans to build on its success with Medicaid and promote more acceptance by private insurance, as well
Now in 2018, Ohio Medicaid broadened
as calling for Medicaid to broaden coverage
its rules to cover acupuncture when
so other types of diagnoses are covered.
performed by acupuncturists, chiropractors,
The OAAOM has been pushing Medicaid to
and
acupuncture
include other evidence-based diagnoses that
providers, including nurses. It also covers
often lead to narcotic prescriptions, such as
acupuncture with electrical stimulation.
osteoarthritis of the knee, chronic pain, and
Coverage will include up to 30 acupuncture
postoperative pain. l
other
recognized
2018 Integrative Healthcare Policy | A Year in Review
Oregon and Vermont notably implemented Medicaid chronic pain treatment pilot programs in 2016, and other states are beginning to follow suit. Oregon has been a fantastic example of using science and research in healthcare policy, as well as how collaboration between medical professionals and academics in compiling and presenting emerging evidence can be used to leverage coverage of services such as acupuncture in Medicaid and private insurance programs. Another layer in the acupuncture coverage dilemma is evaluation and management. Ohio’s Medicaid program, for example, focuses on the acupuncture service itself, but does not cover assessing the needs of patients and impacts of treatment. Acupuncturists are trained in evaluation and management but would not be reimbursed for this type of work. This is an area of concern that will require persistent feedback through Medicaid comment periods, and other feedback channels in private insurance programs. Integrative practitioners specializing in acupuncture may also look to their state organization under the American Society of Acupuncturists for advocacy opportunities and other involvement. Click here to view a complete list of state organizations.
GOING FORWARD
Our work as the leading online community for integrative practitioners is made possible through your comments, tips, and ideas. We invite our audience to submit to our next volume.
Please e-mail editor Katherine Rushlau at krushlau@divcom.com for more information.
2018 INTEGRATIVE HEALTHCARE POLICY
A YEAR IN REVIEW
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