HR 818 The Federal Acupuncture coverage Act 2005
HR818
The Federal Acupuncture Coverage Act
(The Hinchey Bill)
What it does:
The Federal Acupuncture Coverage Act has two purposes. If enacted, HR 818 would add acupuncture as a benefit covered under both Medicare and the Federal Employees Health Benefits (FEHB) program.
Medicare
Medicare is the national health insurance program for people over 65 and the disabled, providing coverage for 40 million Americans. HR 818 requires that acupuncture services be covered under Medicare Part B, the component of the Medicare program that insures for doctors' services and outpatient care.
Medicare Part B is a fee-for-service plan that is directly administered by the federal government. Medicare determines reimbursement rates on an annual and geographic basis for all covered procedures. Health care providers that want to serve Medicare patients agree to accept those rates or charge no more than 115 percent of the Medicare-approved rates. No health care provider is required to accept Medicare patients. If HR 818 is enacted, acupuncturists would not be required to accept Medicare patients.
Federal Employees Health Benefits (FEHB) Program
The FEHB program provides health insurance to federal workers, their dependents, federal retirees and their survivors, covering a total of nine million Americans. The program is administered by the U.S. Office of Personnel Management (OPM), which negotiates contracts with private health insurance companies to provide coverage to FEHB beneficiaries.
Federal workers have a wide variety of plans to choose from, including traditional fee-for-service policies, managed care options like HMOs and PPOs and new high-deductible catastrophic care policies. The policies available to each FEHB family are determined by where they live. The list of plans in your area is available on the Internet at http://www.opm.gov/insure/05/planinfo.asp.
Unlike Medicare, which is directly administered by the federal government, FEHB policies are administered by the individual insurance plans that are contracted to cover federal workers and their families. The insurance companies set their own policies on which providers will be covered under their plans and what rates providers will be paid.
However, federal law mandates that all plans contracted by FEHB participants include certain minimum benefits. If enacted, HR 818 would mandate that acupuncture services be included in the list of minimum benefits. Every insurance company that wants to offer a policy to federal workers would have to provide coverage for acupuncture services provided by state licensed, certified or registeredacupuncturists.
About one-fourth of insurance plans in the FEHB program are voluntarily offering acupuncture benefits now, although some plans will only cover acupuncture services if they are provided by an MD or DO. HR 818 would ensure patients have access to acupuncture services, provided by qualified acupuncturists, under every FEHB plan.
A directory of FEHB plans that are voluntarily offering acupuncture benefits in 2005 is available from Congressman Hinchey's office upon request. Practitioners should contact insurers directly to discuss participation in their plans.
History
Congressman Hinchey's advocacy for acupuncture and acupuncturists goes back to 1976 when, as a member of the New York State Assembly, he wrote the legislation that licensed acupuncture professionals. At the time, New York was a pioneer in this field. Today, more than 40 states and the District of Columbia license, certify or register acupuncture providers.
When he was first elected to Congress, Congressman Hinchey continued his advocacy for acupuncture, introducing the Federal Acupuncture Coverage Act in 1993. Support for the bill has been modest, but has grown steadily in every successive Congress, just as public acceptance of acupuncture has grown over the past dozen years. Although Hinchey's bill garnered only 5 cosponsors during the first term it was introduced (out of 435 members of the House), its supporters numbered 63 at the end of the 108th Congress in December 2004.
On February 15, 2005, Congressman Hinchey reintroduced the Federal Acupuncture Coverage Act for the 109th Congress. We are off to a strong start so far, with 25 bipartisan cosponsors.
Congressional Outlook
The Republican leadership in Congress has never allowed the Federal Acupuncture Coverage Act to be actively considered and there are several reasons for this. In part, it's against the political philosophy of the congressional majority to add new health benefits -- their agenda has focused predominately on contracting federal health programs, not expanding them. Secondly, it's an issue of education and acceptance -- most Members of Congress do not know much about acupuncture and are uncomfortable with federal programs promoting it as an alternative to Western medicine. Because the acupuncture community -- associations, practitioners and patients -- have not been a visible presence in Washington, most Members of Congress are also unaware that acupuncture is important to their constituents.
While we may not overcome the philosophical objections of all Republican congressional leaders, we can win majority support for the bill by making sure that individual Representatives know about acupuncture, understand its health and fiscal benefits, and know that acupuncture is important to their constituents. Congressman Hinchey continues to work hard to raise the profile of acupuncture in Washington, but it also requires a strong grassroots effort from the acupuncture community.
Legislative Strategy
We have three goals for the 109th Congress (January 2005 - December 2006):
Continue to increase the number of cosponsors of HR 818. If we are able to reach 100 cosponsors, which is nearly one-quarter of the House of Representatives, that is a significant enough show of support to ask the House Committee on Energy and Commerce, one of committees with jurisdiction over the bill, to hold a hearing on acupuncture that will better educate members of the committee and hopefully build support for the bill's future passage.
Find a sponsor for the Federal Acupuncture Coverage Act in the Senate. While it is not absolutely necessary for passage of legislation, it is helpful to have a bill introduced in both chambers of Congress. This will help build support for acupuncture in the Senate and increase awareness about our cause.
Pursue opportunities to insert HR 818's key provisions in larger reform bills. It is unusual for legislation like HR 818 to be enacted as a free-standing bill; usually, changes to Medicare and FEHB are made in large omnibus packages that combine provisions from dozens of individual bills. In the event that a Medicare or FEHB reform package is considered by Congress, we will be working to add the Federal Acupuncture Coverage Act's provisions to the larger bills.
What You Can Do to Help Pass HR 818
A strong, organized grassroots campaign is critical to advancing the Federal Acupuncture Coverage Act. Suggestions:
Call, write a letter or send an email to your congressional representative, asking him or her to cosponsor HR 818.
If your representative has already cosponsored the bill, call or write to thank him or her. (You can view the list of current cosponsors on the Internet at http://thomas.loc.gov/ by searching for bill number HR 818 or searching by the keyword "acupuncture.")
Schedule a meeting with your representative or his staff, in his home state office or in Washington, to talk about acupuncture and the need for HR 818. Attend the representatives' town hall meetings and raise the issue.
If you are active with an acupuncture or Oriental medicine association, encourage your organization to endorse HR 818 and promote the bill to its members.
Talk to your local media about acupuncture and HR 818. Write letters to the editor.
Most importantly, spread the word! If you are a practitioner or represent an acupuncture organization, urge your colleagues, members and patients to get involved in these activities.