Bill to Allow Licensed Acupuncturists to be Medicare Providers Introduced in House
On May 9, Reps. Judy Chu (CA-28) and Brian Fitzpatrick (PA-01) introduced the Acupuncture for Our Seniors Act of 2023. The Acupuncture for Our Seniors Act would increase access to acupuncture in the US healthcare system by ensuring that licensed acupuncturists can participate as providers in Medicare. While Medicare has already acknowledged the value of acupuncture by issuing a National Coverage Determination for chronic lower back pain, licensed acupuncturists are still prohibited from being Medicare providers.
According to Rep. Chu, “Acupuncture treatment should be available to all Americans, and this bill moves us closer to this goal by connecting more Americans to the care they need, and ensuring we are giving our seniors on Medicare access to all available treatment options.”
The bill has been referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for further consideration.
COVID-era Telehealth Rules for Prescribing Controlled Substances Extended by DEA
During the COVID-19 public health emergency, authorized providers have been able to prescribe controlled substances via telehealth under certain circumstances. This included: (1) prescribing a controlled substance to a patient using telemedicine, even if the patient isn’t at a hospital or clinic registered with the DEA, and (2) prescribing buprenorphine to new and existing patients with opioid use disorder based on a telephone evaluation. While the public health emergency expired on May 11, the Drug Enforcement Administration (DEA), along with the Substance Abuse and Mental Health Services Administration (SAMHSA), issued a temporary rule to allow the following:
- All telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 public health emergency will remain in place through November 11, 2023.
- For any practitioner-patient telemedicine relationships that have been or will be established on or before November 11, 2023, all telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 public health emergency will continue to be permitted through November 11, 2024.
PCORI and AHRQ to Develop Systematic Review on Peripheral Nerve Blocks for Postoperative Pain Management
The Patient-Centered Outcomes Research Institute (PCORI) is partnering with the Agency for Healthcare Research and Quality (AHRQ) to develop a systematic evidence review on Peripheral Nerve Blocks for Postoperative Pain Management. From May 1-19, AHRQ accepted public comment in regard to a draft key question regarding surgical patients, seeking information on the effectiveness, comparative effectiveness, and harms of peripheral nerve blocks for managing postoperative pain and its sequelae (including opioid use), and how findings vary due to a patient’s clinical or demographic characteristics, provider characteristics, and clinical setting. This review is in its early stages, and this was just an initial public comment period regarding a draft question—there should be an additional comment period regarding more specific and/or additional questions as the study progresses.
More Veterans Gain Access to CBT for Pain via Expanded Program
Based on positive early findings in nine VA pilot sites across the country, the “Cooperative Pain Education and Self-management” program (COPES program) is being expanded into New England in 2024.
COPES is an 11-week, self-directed cognitive behavioral therapy (CBT) program for chronic pain that Veterans can complete from home using their telephone. Veterans learn pain management skills, engage in a walking program, set goals for meaningful activities, and complete a daily, automated two-minute call answering questions about their pain, sleep, steps, and skill use. In response to the information provided in the daily calls, Veterans receive a weekly personalized voice message from a master’s level coach.
According to findings from Health Services Research & Development, patients in COPES did just as well as those receiving in-person CBT for chronic pain and reported improvements in physical functioning, sleep, steps, and pain. Further, data indicates that a team of five master’s level pain coaches working from a single remote location, each providing 20% effort, can treat 250 Veterans per year at a cost that is comparable to that of one full-time pain psychologist. The centrally located team model allows COPES to be delivered to a wide geographic area that can aid lower resourced and rural facilities.