Health Policy Paper

Overview & Procedure

Similar to the 2020 Health Topic Paper, there are several dimensions to the Health
Policy Paper.

In general, the student will look in detail at the current regulations, legislation
and/or issues affecting our field. There are several examples mentioned in the
syllabus. The ACA, the JACHO rulings, Dry Needling as a practice…all of these things
are examples of things that could be used, although I imagine there are a number of
things that could be used on a national and/or state level.

At any rate, whatever topic you choose, you’re paper will ultimately reflect how they
impact you, individually as a practitioner AND our profession. You will describe
how it affects 1) practice 2)patient care and 3) reimbursement. I will expect to find
examples of both positive and negative elements in your personal analysis of
whatever topic/s you choose.

Finally you will include what you suggest as “the next step” or “action plan” in your
local area, state and/or nation. This should include an outlined plan on how to
educate the public, healthcare administrators and/or legislators as the case may be.

Examples

1. Excerpt from a well-written, well-researched paper on ACA Section

2706 and Dry Needling in NJ

The problem with this section and the Affordable Care Act overall is that they left a loop hole in
which privatized major medical plans could be exempt from the Affordable Care Act,
specifically section 2706. For example the Port Authority of New York/New Jersey, a Federal
Agency, have all of their employees under medical coverage where acupuncture is only covered
when performed by a MD or a chiropractor regardless if the acupuncturist is licensed in their
state. On top of that, chiropractors are not licensed nationally or in New York or New Jersey to
perform acupuncture and according to the FDA, they are not allowed to purchase or use
acupuncture needles.

In New Jersey we have seen providers try to practice acupuncture even though it is beyond their
scope of practice. Physical therapists have begun treating patients with acupuncture needles since
2005 after the NJ State Board of Physical Therapy Examiners (NJ-SBPTE) stated they saw
nothing to indicate that dry needling was not within the scope of physical therapists. However the
NJ-SBPTE acknowledged that "The unlicensed practice of acupuncture is now a crime of the
third degree pursuant to N.J.S.A. 45:2C:21-20.1." (New Jersey State Board of Physical Therapy
Examiners. (2012, June 26). Public Session Minutes. Retrieved from
http://njpublicsafety.com/ca/pt/minutes/ptmin_062612.pdf Unfortunately, it took the NJ
Acupuncture Examining Board (NJAEB) several years to respond to indicate to the NJ-SBPTE's
change in scope to include dry needling/intramuscular stimulation. (NJ Consumer Affairs. (2014,
April 21). Rule Adoptions. Retrieved from
http://www.njconsumeraffairs.gov/Adoptions/acuado_042114.pdf)

Eventually the Department of Consumer Affairs along with the New Jersey State Board Medical
Examiners and the New Jersey Acupuncture Examining Board requested for the NJ State
Attorney General to give clarification on the law and scope for Physical Therapists. It took the
Attorney General over 5+ years to respond to the NJAEB request. During these 5+ years, physical
therapists were breaking the federal law that only medical doctors, dentists, and licensed

[SHORTENED TITLE UP TO 50 CHARACTERS] 4

acupuncturists may purchase and use acupuncture needles which are a Class II medical device.
(Food and Drug Administration, H. (1999, December 23). Acupuncture Devices and Accessories;
Revocation of Compliance Policy Guide. Retrieved from Docket No. 99N-50021)

The State Attorney General officially responded on February 9, 2017. The Attorney General
made it clear that it is not within any board to dictate what is or not within the scope of practice.
Basically the Attorney General reiterated what we all knew, which is that any use of any type of
needle by a physical therapist is illegal. The NJ PT Board has officially responded by instructing
all physical therapists to continue to perform dry needling and intramuscular therapy until
January 31, 2018. This defiant response and the strange date is because the NJ PT Board believes
they will be able to have acupuncture within their scope of practice by that date.

The past 5 years, physical therapists have gone to every length to reach out and lobby to the
legislators of NJ by bringing out famous physical therapists, such as the physical therapists for the
NY Giants. On the opposition side, we see a divided approach. Speaking with the lobbyist for NJ
Medical Association for MDs/DOs, the lobbyist felt that it is in the best interest for acupuncturists
to reach out to their local legislators since it is the legislators who write the laws and vote on
them. Meanwhile the NJAAOM (NJ Acupuncture Association of Oriental Medicine) has
instructed acupuncturists to not do anything and that they have everything under control.

2. Excerpt from another very good paper discussing the recent Herbal
Bill passed in NY and general next steps for our profession

Victorious Acupuncture Legislation in NY - Herbal Bill

Traditional Herbal Medicine takes its rightful place in the State of New York New York,
NY, USA, November 09, 2016. On November 4th, 2016, Licensed Acupuncturists in
New York celebrated as Governor Cuomo signed A.2558A Gottfried / S.3911B Nozzolio
into law as Chapter 400 of the Laws of 2016. The new law adds herbal medicine to the
scope of practice of acupuncturists in New York. Originally pioneered and drafted by the
hardworking volunteers of the former New York State Acupuncture Coalition (NYSAC)
the bill has been championed by the Acupuncture Society of New York (ASNY). After
amending the bill and clarifying its purpose, ASNY was able to secure its passage in both
the Assembly and Senate. Its passage would not have been possible without the strong
support and advocacy of the sponsors of this bill, Assemblyman Richard Gottfried and
Senator Michael Nozzolio, or the efforts of ASNY’s lobbying team at Shenker, Russo, &
Clark, LLP.

In the last decade there has been much support and advocacy for this bill by many of the
industry’s leading practitioners, all of the accredited schools of Acupuncture and Oriental
Medicine (AOM) in New York State, multiple affiliated professional AOM
organizations, many of the established businesses within the AOM community, and many
patients, as it is an essential clarification that accurately reflects the training Licensed
Acupuncturists receive as well as protects and preserves public safety. This is an
important victory, as acupuncturists receive significant training in herbal and dietary
supplements, and the profession’s statutory scope of practice now reflects this
commensurate with the scopes of other professions that include dietary training.

It is important to note that this bill applies only to New York State Licensed
Acupuncturists, and does not prevent other individuals from recommending or selling
herbal or dietary supplements, which are currently unregulated in New York State. In
addition, this law in no way “licenses” any practitioner, including Licensed
Acupuncturists, to engage in recommendations or administrations that they have not
specifically been trained in or are not qualified to give. Therefore, the public can be
assured that a Licensed Acupuncturist has met certain standards that they are held
accountable to. The law took effect immediately.

Next Step - Acupuncture Profession Plans of Action

I am proud to serve on the Board of Directors of The Acupuncture Society of New York.
ASNY is committed to continuing to advance the interests of the nearly 6,500
acupuncturists practicing throughout New York state, and looks forward to continuing
our efforts through the 2017 legislative session to uphold the integrity of the acupuncture
profession and make this highly effective therapy accessible to all.

The only way to change the acupuncture profession is to have an outlined plan on how to
educate other healthcare professions, government administrators and legislators. We truly
don’t have to look for these plans of action far, as these are already in place from the
years of cooperation between the national and local organizations. The National
Certification Commission for Acupuncture and Oriental Medicine - NCCAOM, the
American Society of Acupuncturists - ASA and the state organizations - in New York
that is ASNY all create a network of information flow from grass roots to the national
level. This network includes many other organizations serving all to the acupuncturists in
the US, making sure to protect the acupuncture profession and the patient.
Acupuncture is a young profession with many goals and much legislation is being created
every year as this medicine grows and impacts all aspects of healthcare. I urge every
acupuncturist to join their local organization that communicates with the governmental
body. If you already are a member of your local acupuncture association, then attend the
meetings and choose the representation you deserve. Ask what are the goals and plans to
achieve them. Find out how you can be of help. There is strength in unity and many local
acupuncture organizations in the US are lacking in memberships and funds to reach their
goals. Please, join, engage, and make a difference.

Hope this helps. We’ll continue to discuss this assignment in class over the next few
weeks.