Integrative Practitioner

The premier online community for integrative healthcare professionals

February 2013 John Weeks Integrator Round-up: Policy

US Senator Harkin, Champion for Integrative Health and Medicine, to Retire in Two Years 

U.S. Senator Tom Harkin (D-Iowa), the undisputed champion for complementary, alternative and integrative medicine for over 20 years, has announced plans to retire at the end of 2014. Harkin, who is 73 and presently is in his 29th year in the Senate, will not seek a sixth term. He serves as chairman of the Senate Health, Education, Labor and Pensions Committee as well as the Senate Appropriations subcommittee that handles the budgets for the same agencies. These include the National Institutes of Health and the National Center for Complementary and Alternative Medicine, which he created in 1998. A long-time supporter of chiropractic, in 1991 Harkin sponsored the original obscure amendment that created an exploration of unconventional therapies at teh NIH, which became the Office of Alternative Medicine and later NCCAM. His hand is on virtually all of the inclusion of complementary and alternative medicine and integrative health language in the Affordable Care Act.

Comment: Harkin has been friend, advocate and protector for the emergence of integrative health and medicine in the United States. That Harkin's close colleague and CAM/IM friend Barbara Mikulski (D-MD) has take the role of Appropriations chair that Harkin turned down a month ago takes the edge off this prospective loss. History will show that this single human being played a tremendous role in midwifing this movement and its values from the outside into the nation's dialogue over medicine and health.



Integrative Healthcare Policy Consortium (IHPC) Announces Campaign on Section 2706, "Non-Discrimination in Health Care"

The Integrative Healthcare Policy Consortium (IHPC) announced in late January 2013 that it is launching a strategic state-by-state campaign to support what it calls the "correct" implementation of Section 2706 of the Affordable Care Act." Section 2706 is called "Non-Discrimination in Health Care." According to the IHPC, the leading multidisciplinary lobbying organization for integrative health and medicine, the language "prohibits insurance companies from discriminating against health care providers relative to their participation and coverage in health plans." IHPC argues that "correct" implementation will "encourage the full utilization of healthcare providers and [create] reduction in costs for patient care." IHPC's release highlighted the organization's retention of Deborah Senn, JD, former Washington State Insurance Commissioner, as its lead consultant. Senn was insurance commissioner following the passage of the Every Category of Provider (ECP) law that required all health plans to include all types of licensed practitioners in that state.

IHPC plans to "strategically construct a state-by-state plan of action." Elements will include creation of a national clearinghouse to share best practices, organize a community of learning, and develop white papers and a toolkit for action for leaders of individual disciplines in their own states. Funding for the launch of the campaign and for Senn's work came from the chiropractic community. IHPC, which is backed by its 18-member Partners for Health, is seeking additional funding through other sources.

Comment: The known battle-lines are these: IHPC and the American Chiropractic Association lobbied the language into the 2010 healthcare law. US Senators Tom Harkin (D-Iowa) and Barbara Mikulski (D-MD) were champions. Those close to the law believe that the legislative intent was for an expansive understanding of "non-discrimination," such as Senn and IHPC advocate. On the other side of the battle is the American Medical Association. Within three months of the law's passage, the A.M.A.'s House of Delegates passed a resolution seeking repeal of Section 2706. (See Battle On: MD Specialists Promote Repeal of Non-Discrimination Vs Integrative Practitioners, Others.)  The A.M.A.'s own state-to-state "Scope of Practice Partnership" is charged to keep the impact of 2706 limited, if they can't amend the non-discrimination out of the reform act altogether.

For advocates of increased access, hiring Senn was brilliant. She proved a warrior in Washington for consumers and thus to access to these professionals. The question is whether the integrative health community - consumers, professionals, industry and philanthropy - has enough self-respect and chutzpah to take a fire-hose to the body to end this other form of discrimination. IHPC is taking contributions via their website. My spouse and I sent them $100. Consider doing this yourself and/or getting your organization to do so.

The Integrative Healthcare Policy Consortium (IHPC) that it is launching a strategic state-by-state campaign to support what it calls the "correct" implementation of Section 2706 of the Affordable Care Act." Section 2706 is called According to the IHPC, the leading multidisciplinary lobbying organization for integrative health and medicine, the language "prohibits insurance companies from discriminating against health care providers relative to their participation and coverage in health plans." IHPC argues that "correct" implementation will "encourage the full utilization of healthcare providers and [create] reduction in costs for patient care." IHPC's release highlighted the organization's retention of , as its lead consultant. Senn was insurance commissioner following the passage of the that required all health plans to include all types of licensed practitioners in that state. IHPC plans to "strategically construct a state-by-state plan of action." Elements will include creation of a national clearinghouse to share best practices, organize a community of learning, and develop white papers and a toolkit for action for leaders of individual disciplines in their own states. Funding for the launch of the campaign and for Senn's work came from the chiropractic community. IHPC, which is backed by its 18-member , is seeking additional funding through other sources. : The known battle-lines are these: IHPC and the American Chiropractic Association lobbied the language into the 2010 healthcare law. US Senators Tom Harkin (D-Iowa) and Barbara Mikulski (D-MD) were champions. Those close to the law believe that the legislative intent was for an expansive understanding of "non-discrimination," such as Senn and IHPC advocate. On the other side of the battle is the American Medical Association. Within three months of the law's passage, the A.M.A.'s House of Delegates passed a resolution seeking repeal of Section 2706. (See .)  The A.M.A.'s own state-to-state "Scope of Practice Partnership" is charged to keep the impact of 2706 limited, if they can't amend the non-discrimination out of the reform act altogether. For advocates of increased access, hiring Senn was brilliant. She proved a warrior in Washington for consumers and thus to access to these professionals. The question is whether the integrative health community - consumers, professionals, industry and philanthropy - has enough self-respect and chutzpah to take a fire-hose to the body to end this form of discrimination. IHPC is taking contributions via their website. My spouse and I sent them $100. Consider doing this yourself and/or getting your organization to do so.



Acupuncturists Hit 25,000 Signature Goal in Petition to White House for Inclusion in Social Security, Medicare

The American Association of Acupuncture and Oriental Medicine sent out a release on February 6, 2013 urging members to sign a "White House Petition to Designate 'Acupuncturist' as a Recognized Healthcare Provider under the Social Security Act."  The goal is to alert the Obama Administration "to the fact that acupuncturists are not currently recognized as healthcare providers under the Social Security Act and, therefore, cannot get reimbursement for services provided to Medicare patients." The petition was at 10,000 signatures at the sending and tipped over the 25,000 target just prior to the February 10, 2013 end-date.

Comment: I sent a push out to Integrator subscribers with a very self-interested lead in: Would YOU like to see acupuncture in your Medicare package?  Two licensed acupuncturists wrote back chastising me for the perpetuating a fiction that the White House passes legislation. I responded that while that is Congress' job, the White House has been known to influence legislation. As I said in my push: I am not sure how much influence these petitions have but do know that getting the White House's ear on anything related to integrative health care is rare.  

Comment from Ronald Hoffman, MD: [Hoffman is a clinician, author and radio host who is long-time leader in holistic and integrative medicine world.] "John, LOVE acupuncture, trained in it, want people to get it. But so DON'T want Medicare to cover it, regulate it, dictate what you can and can't do, penalize docs for not billing correctly (or allow scammers to game the system!), etc. And I sure don't want to be taxed to oblivion to create yet another entitlement as part of a creeping program of government-granted prerogatives! As it is, Medicare is unsustainable, why make it worse?  Bottom line, you can't have everything, or else you will have NOTHING. Thanks for your attention, or inattention as the case may be. Respectfully, Dr. Ron Hoffman."

Comment from JW on Hoffman's comment: "Hi Ron – One can opt in or out of payment. As it turns out, most professionals who have never had a chance to be involved [in insurance], would prefer they have an option. And as a general rule, incomes do go up with coverage. They certainly have in Washington State. MDs typically don’t appreciate this, having a different vantage point. Of course coverage would assist many to access. I am paying attention, perhaps to different things than you. I appreciate your feedback, though we disagree. If you are comfortable, I will post it - John."



Academic Integrative MD Organization (CAHCIM) Promotes Licensed Acupuncturists' Petition to the White House

The Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) sent an e-blast on Friday, February 8, 2012 that urged their members to sign the AAAOM's White House Petition to nudge the field of licensed acupuncturists on the many-stepped process toward becoming licensed providers under Medicare. CAHCIM is an MD-led organization the membership of which is 55 academic health centers and health systems. Acupuncture as performed by licensed acupuncturists is one among the top services most likely to be included in integrative medicine clinics in these arenas.  

Comment: The CAHCIM action note was an excellent sign of collegiality. I sent it off to a half-dozen leaders of acupuncture organizations to make sure they were aware. In this case, collegiality is spelled s-o-l-i-d-a-r-i-t-y. Nice.



Oregon Evidence Committee Includes "CAM" and Herbs in Back Pain Guidelines

Bill Walter, ND, sends notice that the Oregon Health Evidence Review Commission (HERC) has published guidelines on the management of acute, subacute, and chronic low-back pain that include, as non-pharmacological treatments, recommendations for coverage of yoga, acupuncture, spinal manipulation, cognitive therapy, and progressive muscle relaxation as non-pharm treatments. The section on pharmacological treatments recommended include devil's claw, capsicum, and willow. Walter notes that while information on the influence of these guidelines is here, there is jockeying underway regarding whether 
to give the agency more power. Concern includes who is to sit on the relevant "evidence-based" committee.
 
Comment: This good news follows inclusions of "CAM" in pain guidelines since the Joint Commission's May 1999 publication, and including that of the internal medicine discipline a decade later. What's missing yet is any sense of therapeutic order, or a charge to use less invasive first whenever possible; or as came up in a recent exchange with a national pain leader, an idea such as never only opioids. Now that CAM is on the bus, the effort must be to, when appropriate, move these therapies, approaches and providers to the front seats.

Back to February 2013 Round-up 

 

 

comments powered by Disqus
Connect with Us:   

Marketplace Spotlight

Featured Video

ADVERTISEMENT ADVERTISEMENT ADVERTISEMENT ADVERTISEMENT ADVERTISEMENT

CornerStone Partners