WASHINGTON – The Trump administration on Monday proposed a plan to cover acupuncture for Medicare patients with chronic low back pain, framing it as a step that could safely treat pain without supplying more patients with opioids.

“Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to treat the very real problem of chronic pain, and this proposal would provide patients with new options while expanding our scientific understanding of alternative approaches to pain,” Health Secretary Alex Azar said in a statement.

The proposal, released by the Centers for Medicare and Medicaid Services, would apply only to patients enrolled in clinical trials supported by the National Institutes of Health or those approved by CMS. In its statement, CMS acknowledged that while “the evidence base for acupuncture has grown in recent years … questions remain.”

Some experts argue the benefits of acupuncture are nothing more than the placebo effect and the enjoyment of a ritual – results that do not merit coverage paid for by taxpayers.

Some medical groups, however, have recommended acupuncture for chronic low back pain, especially as clinicians try to resolve chronic pain issues without starting new patients on opioids. In 2017, for example, the American College of Physicians recommended that clinicians should first try therapies other than drugs for chronic low back pain, including exercise, yoga, and acupuncture.

A review last year from the government’s Agency for Healthcare Research and Quality found that acupuncture was associated with slight improvements in function and pain for patients with chronic low back pain in the short term, though it did not seem to improve function or pain in the long run. It rated the “strength of evidence” for acupuncture as “low” for function, “moderate” for short-term pain, and “low” for intermediate and long-term pain.

CMS is accepting comments on its proposal through Aug. 14.



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