The History of ASNY and Healthcare Reform

In October of 2012 ASNY was first made aware that Acupuncture was not included in the NYS Essential Health Benefits.  Immediately, we sprang into action and ran an analysis of the Milliman study (explained in the letter below dated 12/13/12) which examined a panel of large and small group insurance plans.  Alarmingly, many plans incorrectly listed acupuncture as a “not offered” service.  Plans that we knowingly included acupuncture were reviewed and benefits where inaccurately listed. Letters were drafted and sent to both Washington, DC and New York State. 

On 12/9/12, ASNY emailed members calling for letters to be sent to the Centers for Medicare & Medicaid Services and the Department of Health and Human Services in Baltimore, MD.  Washington directed ASNY and concerned members to Human Health Services of New York and the Department of Health: Health Exchange Department.  

On 12/13/12 ASNY requested that letters be sent to both of these entities including the appropriate addresses and contacts. (Please view below). 

On 1/13/13, ASNY requested additional emails be sent to the Department of Health and Health Exchange.  This email is found below and further outlines the issues.  

These emails and letters led to a meeting with Danielle Holloran from the Department of Health in February 2013.  Comments were made that the plans are “set in stone” and no changes will or can be made.  Acupuncture may possibly be available via rider.  

Their written reply post meeting can be seen HERE. 

As Healthcare Reform progresses in NYS, ASNY will share information.  At the current time, the plans are about to be unveiled October 1 and the health exchange will open shortly after. 


First ASNY Call To Action:

12/13/12 ASNY EMAIL

NEW ACTION NEEDED: ESSENTIAL HEALTH BENEFITS (MOST IMPORTANT)

 

As a result of your prior letters and comments the CMS/HHS requests that all future letters focus on one entity here in NY State, The Department of Health.   Letters should be sent from providers, students, patients, supporters, colleges and societies.

 

Deadline:  Mailed letters TODAY until Jan 10, 2013.

Subject: Acupuncture in NYS Essential Health Benefits

 

Address and mail letters to:

Donna Frescatore

Executive Director

New York State Health Exchange

Executive Chamber

State Capitol

Albany, NY 12224

 

Sample Patient Comment Letter:

My name is __________________________. I am a New York State resident who receives acupuncture for treatment of _____________________. I believe that Acupuncture has helped my condition and I strongly encourage and request that acupuncture services be included in New York Essential Health Benefits.

 

Name

Address

 

Sample Provider Comment Letter:

Acupuncture has been wrongly left out of New York State Essential Health Benefits. The CMS/HHS instructed me to contact your office directly as having the ability to make this addition.  Acupuncture falls within the requirements of the of the benchmark plans in both Preventative and Wellness Care services and Rehabilitative and Habilitative Services. Acupuncture services should be included within the New York State Essential Health Benefits.

 

Name

Address

 

THE HISTORY:

Milliman was the 3rd party agency that reviewed 6 large (50+ employees) and 4 small (less than 50 employees) health insurance plans here in NY State. Based on the findings of this review the Oxford EPO plan was selected as the model for NYS EHB. This plan does not include acupuncture in any capacity other than by option rider. A review of the Milliman review identified a handful of errors in the acupuncture data. ASNY presented the NYS Department of Health with letters of opposition including letters from other groups (including The Cancer Society, The Autism Society, The Chiropractic Society) and legislators (including Assemblyman Gottfried) asking for a different selection. The time has come to new write letters asking for acupuncture to be included as an Essential Health Benefit. There are 10 required areas in the “Benchmark Plans” for each state. Acupuncture best falls into 2 of these areas; Preventative and Wellness Care and Rehabilitative and Habilitative Services. Comments needs to be submitted mailed no later than December 21st and/or emailed no later than 5pm December 26th. On 12/20/12 the HHS contacted the ATCMS and ASNY to inform us to direct our effects to the DOH.  Please complete this request till Jan 1, 2013.

 

Second ASNY Call to Action:

1/13/13 ASNY EMAIL

 

It is time again to give another “push” to NYS Essential Health Benefits.  Please forward the email to friends, colleagues, patients and family.  Simply 1) cut and paste the information below into an email and send to the following email addresses.  2) Type your information at the bottom of the email. 3) Hit “send”.

 

Donna.Frescatore@exec.ny.gov

HealthCareReform@exec.ny.gov

 

Donna Frescatore

Executive Director

New York State Health Exchange

We are writing to express our great concern and strong disagreement of Acupuncture being left out of the Essential Health Benefits for NY State.  The Milliman has many errors just in the Acupuncture components:

 

  • Milliman lists acupuncture under “miscellaneous” with weight loss programs and gym memberships. Acupuncture is a NYS Medical license recognized and given by the NYS Office of Professions. Acupuncture should be listed with speech therapy, occupational therapy and physical therapy. Milliman states that 1 of the 10 objectives is “preventative and wellness services and chronic disease management”. Another is “Rehabilitative”, acupuncture falls within this objective as well.
  • Under the large group plans, ALL plans listed include acupuncture as a benefit. The BCBS NYSHIP plan is listed as not having acupuncture this is incorrect data.
  • Under the small group plans, HIP is listed as not having acupuncture benefits. This is incorrect data.
  • The HHS stated that you have the ability to make the changes to this plan to include acupuncture.

Additionally,

  • California, Colorado and Maryland are a few of the states that have included acupuncture as a benefit as part of their Essential Health Benefits. As a leader in this country, NY has neglected to include such a safe, powerful, drug-free and cost-effective modality.
  • Recognized by The World Health Organization, Acupuncture was identified as the number one complimentary treatment worldwide in a recent survey of 191 countries. The International Classification of Disease version 11 is set to include East Asian Medicine codes to diagnose patients using this system of healthcare.
  • Essential Health Benefits were selected from a list of the most common insurance company plans in the state. With the stated errors above corrected, acupuncture is covered in 100% of the examined plans. Leaving this treatment out of NYS does the public a huge disservice and is not an accurate reflection of the current plans.
  • New York State battles increased pain killer addiction statewide which has led to violent crime and theft. Additionally these addictions lead to personal and financial distress. Acupuncture is a proven, cost-effective and safe method of treating a host of conditions, drug-free.


 
 

   
 
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Acupuncture Society of New York
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