Sunday, July 7, 2019

Very Brief Blog: NCD Catch-up: New NCD Analysis for Acupuncture due July 15, 2019

Update July 15.  CMS posted a proposed decision covering acupunture for lower back pain under clinical trials only (CED), here.  Trade journal here.  CMS press release includes quotes from Alex Azar here.

Here's one I missed first time around.

On July 2, 2019, the Washington Post ran an article that Medicare was reviewing evidence for acupuncture, and will release a draft coverage position on July 15.

The backstory.  With the opioid crisis, there's new attention to non-opioid methods of pain control.  Acupuncture would be one, but for years (decades?) CMS has had an NCD stating that acupuncture was a non covered services - not reasonable and necessary.

The tracking sheet for the 2019 NCD review is here.  The topic was opened for new comment in January 2019, expecting a revised position in July and a final position in October.  The request was "internally generated," but it's likely that advocates for acupuncture raised visibility on the issue with CMS in light of the opioid crisis.  This NCD reopening focuses on acupuncture in the context of chronic lower back pain.

It looks to me like one of the last visits by CMS to this topic was acupuncture for fibromyalgia (not covered) in 2003.  Here.  See NCDs 30.3, 30.3.1.

There have been several annual rulemakings in the past couple years where CMS has publicly asked if it was doing enough, or doing the right things, for opioid management and control of overuse.

CMS doesn't have a benefit category for acupuncturists, so at least in the short term it would only be covered by physicians, nurse practitioners, etc, or incident-to a physician (performed in the same office when the physician is there).

A quick scan of the comments page suggests CMS received around 500 comment in January 2019.