Acupuncture Santa Cruz
Health Insurance News
New California legislation enacts acupuncture health insurance benefits for all California individual and small group health insurance plans. Authored by local State Assemblymember Bill Monning, the law takes effect in 2014. A similar law was also recently enacted in Maryland.
The acupuncture provisions apply to all individual health insurance policies and small group policies including HMO and PPO plans. Small group policies are those for companies with fifty or less employees until 2016 when it will change to the inclusion of one-hundred or less employees. Copays, deductibles and provider networks continue to be at the discretion of the insurance companies. The inclusion of acupuncture was supported by research demonstrating the cost-effectiveness of acupuncture in both preventative and rehabilitative medicine.
This new California law was based on an existing Kaiser Permanente health insurance plan. It serves as a model for determining medical benefit minimums for health insurance policies written in California. Treatment limitations for all insurance companies cannot exceed those in the Kaiser plan. As a result, there are no arbitrary caps on the maximum number of acupuncture office visits per year. Instead, limits on care continue to be regulated by the standard gatekeeper mechanisms such as an MD’s referral or a determination of medical necessity imposed by an insurance adjuster.
Acupuncture has come a long way to becoming part of the mainstream. Almost every state licenses acupuncturists. North Dakota, South Dakota, Wyoming, Oklahoma, Kansas and Alabama do not have laws providing for licensed acupuncturists yet. So much is at stake. People continue to suffer from conditions that are readily controlled by acupuncture and herbal medicine. Now, greater access to appropriate medical care is working its way into the medical system. It is my hope that the expansion of acupuncture health insurance will help my patients and prevent unnecessary suffering.