April 15, 2003 - CAOMA arranged a meeting between representatives for the Coalition for Fairness in SB 228 and Senator Alarcon. Results of meeting are promising, with Senator Alarcon agreeing to remove reference to Medi-Cal fee schedule, and to continue working with acupuncturists tofurther amend SB 228.

Representatives of the acupuncture profession met with Senator Alarcon at his office in Los Angeles. The Sentor was gracious enough to take time out of his busy schedule, postponing his planned vacation to meet with us. It was clear from the personal exchange with Senator Alarcon at the meeting that the Senator had little understanding of the Licensed Acupuncturist profession, or of the common modalities and scope of practice of acupuncturists, and definitely did not intend to single out acupuncturists by reducing fees. Instead, he indicated that his intentions were to reduce the recent cost increases in Workers Compensation premiums that resulted from a variety of reasons. The Senator indicated that he would consider amending the bill to remove reference to Medi-Cal fees and rules. Other issues would have to be worked out later, in conjunction with other interested parties.

Based upon the conversation, it was clear that he had no idea how badly his bill would affect acupuncturists and our patients. He also was not familiar with the practice of moxibustion or cupping, both of which are itemized in the Worker Compensation Official Medical Fee Schedule (OMFS). As a result of the meeting, he seemed to accept the idea of removing the reference to the Medi-Cal fee scheudle and rules, and to allow fees for services not presently covered under MediCare to be based upon the current OMFS.

The following agenda was prepared for the meeting:

	•	Agenda

	•	Acupuncturist's Scope of Practice

	•	Primary Care Provider Responsibilities

	•	Evaluation & Management

	•	Common Procedures

	•	Comparison of Workers Compensation, MediCare, and Medi-Cal fee schedules

	•	SB228 Problems and Solutions

SB 228: THE PROBLEM & POSSIBLE SOLUTIONS:

Problem: Cannot Use Medicare because no Codes for Acupuncture, Cupping, or Moxibustion -- Cannot be used as a "Basis" for determining Acupuncture Fees

Problem: Medi-Cal is inappropriate as a "Basis” for determining Acupuncture Fees because:

	•	Medi-Cal fees for Acupuncture are outrageously low

	•	No codes for Electro-Acupuncturc, Cupping or Moxibustion

Standards: Are there any existing "Standards" that can be used as a basis for determining Acupuncture fees?

	•	The only existing "Standard" is the OMFS

	•	Used since 1992, with no complaints or signs of causing significant increases in cost to the WC System

	•	When the OMES Acupuncture codes were developed, they were based on the evaluation of factors current at that time (approximately 10 years ago), so the OMFS Acupuncture codes can still be considered current today.

	•	There really is no other valid "Standard" for Acupuncture Services used in California other than the OMFS.

Recommendations:

	•	Use the OMPS for Acupuncture as the starling point for Acupuncture, Electro-Acupuncture, Cupping, & Moxibustion Fees.

	•	Establish a separate set of codes for those Acupuncture services

	•	If SB228 reduces or increases the aggregate healthcare cost in the WC system, then the Acupuncture fees should be similarly reduced or increased by the same percentage.

	•	Other services would utilize the Medicare RBRVS (such as for E&M, modalities, and other services provided by the Acupuncturist that are listed in the Medicare RBRVS)

	•	The specific Acupuncture codes (only 4 codes) would be reviewed and revised by the Administrative Director periodically.

Coalition Members Registed to Attend:

(Note: a few additional representative showed up for the meeting at the last minute, and are not listed here).

Michelle Lau, LAc, PhD

President, Council of Acupuncture and Oriental Medicine Associations (CAOMA)

Kiyohide Tsubakiyama, LAc

President, Japanese Acupuncture Association of California (JAAC)

Hai Nguyen, LAc, OMD, PhD

President, Vietnamese Acupuncture & Oriental Medicine  Association and Institute(VAOMAI)

Yong Sup Lee, LAc

Executive Vice President, Association of Korean Oriental Medicine & Acupuncture of California (AKOMAC)

Julie Lin, LAc

Califoruia Alliance of Acupuncture Medicine (CAAM)

Ta Fang Chen, LAc

California Acupuncture Medical Association (CAMA)

Alejandro Katz, MD, LAc

Richard Fong, LAc, DC, CCN

CAOMA Opposes Reduced Workers Compensation Fees

SB 228 Impact on Fees for Acupuncture Services

Coalition for Fairness in SB 228 Meets with Senator Alarcon

SB 582 Text & Status