Executive Summary | Senate Bill 590 - Acupuncture Reimbursement | Mandated Benefits Review

Mandated Benefits Review - Senate Bill 590 - Executive Summary

In its present form, Senate Bill 590 does not mandate the coverage of a new benefit but, rather, would require that licensed physician acupuncturists and licensed non-physician acupuncturists be reimbursed for these services at the same rate when acupuncture services are covered. In this sense, Senate Bill 590 does not contain a "mandated benefit" as outlined in Act 34. Nonetheless, the Pennsylvania Health Care Cost Containment Council went forward with the review process as requested.

After reviewing the submissions received for Senate Bill 590, the Council finds no evidence to recommend the passage of this legislation at this time. We note the following points:

The information that was submitted to the Council was not sufficient for staff to perform a complete cost/benefit analysis. In fact, no information was received in support of this measure, only in opposition to it.
We conclude, further, that the information received was not sufficient to warrant a full review by a Mandated Benefits Review Panel, nor do we believe a panel of experts would come to conclusions different than the ones reached here.
Although acupuncture services have been effective in treating a number of disorders, submissions did not demonstrate that reimbursement issues regarding physician and non-physician acupuncturists result in financial hardship or inadequate health care to the citizens of Pennsylvania. In addition, no information suggesting public support for this measure was received.

One policy consideration noteworthy here is that Pennsylvania already recognizes a difference in status between physician acupuncturists and non-physicians acupuncturists. Currently, non-physician acupuncturists are permitted to practice only under the supervision of a physician acupuncturist. Opponents of this measure argue that such a standard requires different compensation levels because the services provided are not identical.

Finally, while this measure covers reimbursement issues and is not a mandate for health care benefits, submissions discussed mandates in general. In reviewing this information, the Council finds that caution must be used when considering health care mandates. In particular, attention must be given to the cumulative financial effect of enacting mandates. The Council notes, in particular, the correlation between the number of mandates and the increasing cost of health insurance, the increasing number of uninsured, the increased incentive for large employers to self insure, and the decreasing number of employees covered by employer sponsored health insurance.