Dr. Amy Matecki, MD, L.Ac., Governor Appointee, Board President
California Acupuncture Board,
1747 North Market Blvd., Suite 180
Sacramento, CA 95834
August 2, 2019
Dear Dr. Matecki,
Centers for Medicare & Medicaid Services (CMS) posted a Proposed Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N) on 7/15/2019, with the quoted following requirements for those participating in the trial:
“Physician assistants, nurse practitioners/clinical nurse specialists (as identified in 1861(aa)(5)), and auxiliary personnel may furnish acupuncture if they meet all applicable state requirements and have:
• A masters or doctoral level degree in acupuncture or Oriental Medicine from a school accredited by the Accreditation Commission on Acupuncture and Oriental Medicine (ACAOM);
• a current certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM); and
• maintained licensure in a U.S. state or territory to practice acupuncture.”
We believe that the first two requirements do not meet the actual conditions of our acupuncture profession. California acupuncturists account for nearly 40% of the nation’s total. If this proposal is passed with the above requirements, most of the California L.Ac.s will not be allowed to participate in the project. In California, with only master or doctoral degree from an ACAOM accredited school, or holding a NCCAOM certificate doesn’t meet the California laws to practice acupuncture. The practitioner must pass the California Acupuncture Board Exam to acquire the California acupuncture license in order to practice here. You know, this is because the California Acupuncture Licensing Examination is different from the NCCAOM exams. About the degree requirement from an ACAOM accredited school, an applicant who has completed education and training outside the U.S. is allowed to take the California board exam and eventually acquire license to practice in California if the applicant meets the educational standards established pursuant to the California laws. The exclusion of California L.Ac.s from this clinical trial just because of some incomprehensive information or misunderstanding about the different acupuncture laws of different states would be regrettable and unfair. Therefore to accommodate the reality of the profession, we recommend to keep only the last requirement, “maintained licensure in a U.S. state or territory to practice acupuncture.”
As a state regulatory body upholding acupuncture practice standards and enforcing the relevant laws, California Acupuncture Board has the authority to explain to the CMS the current status of the profession, and request an amendment be made before the CMS comment period deadline of August 15, 2019.
It is reported that Veterans Affairs (VA) medical institutions also take the NCCAOM certificate as one of their requirements recruiting acupuncturists. In addition, VA medical institutions also employ physical therapist to perform dry needles/acupuncture. We believe that the above situations are inconsistent with CA’s acupuncture laws. The California Acupuncture Board, as a government agency defending the interests of the Californian people and enforcing California acupuncture laws, should write directly to the relevant Federal VA departments to explain the CA acupuncture laws, and please emphasize that:
1. In California, the legal definition of acupuncture includes dry needling. Physical therapist practicing dry needling in California is a violation of California law.
2. The California Acupuncture Licensing Examination and NCCAOM are two different and independent examination systems, California L.Ac.s do not need the NCCAOM certificate to practice in California. VA medical institutions’ excluding California L.Ac.s who account for 40% of all acupuncturists in the United States is ignorance to the current status of the profession and unfair to all the competent L.Ac.s in California.
Thank you for your attention to these matters.
Dr. Jun Hu
President of the American Association of Chinese Medicine and Acupuncture