Supreme Court Paves Way for Acupuncture Parity
Source: AAAOM
http://www.aaaomonline.org/?page=supremecourt
U.S. Supreme Court Upholds Key Health Care Reform Elements
What it all means for California licensed acupuncturists…
In a 5–4 split decision, the Supreme Court upheld almost all of the Obama administration’s heath care reform legislation—the Patient Protection and Affordable Care Act (PPACA)—including the law’s individual mandate requirements.
In short, this ruling, coupled with legislation currently under consideration in the California legislature, will likely mean that the vast majority of California’s 38 million residents will have a basic level of acupuncture coverage starting in 2014. In all likelihood, this base acupuncture coverage will be equivalent to the coverage currently provided under the Kaiser Small Group HMO plan, which provides for up to 20 covered acupuncture visits per year.
It is important to understand that each insurance plan will still establish its own reimbursement rate for acupuncture services as they currently do. The adoption of the Kaiser Small Group HMO plan as a benchmark does not mean that Kaiser’s reimbursement rates will be adopted. It simply means that the acupuncture coverage value to the consumer must be as high or higher than the coverage provided by the Kaiser Small Group HMO for almost all insurance plans.
Another key provision of the health care reform law is the “Non-discrimination in Health Care” language. This language will, starting in 2014, prohibit health plans from discriminating against providers who are providing services within their state-defined scope of practice. In other words, plans could no longer require that acupuncture services be rendered only by a medical doctor.
