Medicare said this month that it would cover acupuncture for people with chronic low back pain, seeking to give patients alternatives to potentially addictive narcotic pain relievers.On January 21, the Centers for Medicare and Medicaid Services (CMS) announced a national coverage determination for this treatment. For coverage purposes, people must have had chronic low back pain that has persisted for at least 12 weeks or more, the agency said. This pain should not have an identifiable cause, such as infections, diseases, surgery and pregnancy.

Under these circumstances, CMS will cover up to 12 visits in 90 days. The agency said it will cover eight additional sessions for those patients who demonstrate improvement. There is a limit of 20 acupuncture treatments covered per year. Treatment should be discontinued if patients show no improvement, CMS said."We are taking advantage of important lessons learned from the private sector in this critical aspect of patient care," Kimberly Brandt, Chief Deputy Administrator of Operations and Policies at CMS said in the announcement. "Excessive dependence on opioids for people with chronic pain is one of the factors that led to the crisis, so it is vital that we offer a variety of treatment options for our beneficiaries."

In the decision memorandum, CMS said insurers, including Aetna, several Blue Cross Blue Shield, Cigna, Kaiser Permanente and United Healthcare plans provide some acupuncture coverage. The agency said the relative safety of acupuncture and the serious consequences of the opioid crisis in the United States provided "sufficient reasons to provide this non-drug treatment" to people enrolled in Medicare who have chronic low back pain.

"While a small number of adults 65 years or older have enrolled in published acupuncture studies, patients with chronic low back pain in these studies showed improvements in function and pain," CMS said.Round Trip ProblemIn the decision memorandum, CMS said it had reflected and then, in 1980, rejected the idea of covering acupuncture. In 2004, CMS considered acupuncture for fibromyalgia but found no convincing evidence of this benefit. In that same year, CMS also reached the same conclusion about the use of acupuncture to relieve pain in patients with osteoarthritis.

CMS also noted in the memo that many groups and individuals had written to the agency in support of Medicare acupuncture coverage, and patients often included personal pain relief reports.But some commenters told CMS that acupuncture was a "pseudoscience," with positive results described in some report probably due to the placebo effect.Among the critics of the proposal was Steven L. Salzberg, PhD, director of the Center for Computational Biology at the Johns Hopkins University School of Medicine. He told CMS that he was concerned about the use of taxpayers' money to cover acupuncture."No well-designed study has shown that it has any benefit beyond a placebo effect, and scientifically there is no serious debate about its effectiveness," Salzberg said in his comment sent to CMS in January 2019. "Simply put, I don't work , and patients who believe in acupuncture are being deceived. Testimonies such as those in the comments here do not include evidence. "

Salzberg confirmed to Medscape Medical News on Tuesday that it remains his point of view.

For more news, follow Medscape on Facebook, Twitter, Instagram and YouTube.

. (tagsToTranslate) acupuncture (t) traditional Chinese medicine (t) alternative medicine / complementary medicine (t) alternative treatment (t) medicine (alternative / complementary) (t) pain (t) chronic back pain (t) back pain ( chronic) (t) chronic pain (back) (t) chronic pain (t) elderly / elderly concerns (t) geriatrics (elderly care) (t) opioids (t) pain (pain management) (t) management from pain

Read the rest here:

Medicare chooses to cover acupuncture for pain in the midst of an opioid crisis - NewsDio