[Congressional Record Volume 144, Number 99 (Wednesday, July 22, 1998)]
[Senate]
[Pages S8779-S8780]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HARKIN (for himself and Ms. Mikulski):
  S. 2340. A bill to amend title XVIII of the Social Security Act to 
provide for coverage of qualified acupuncturist services under part B 
of the medicare program, and to amend title 5, United States Code, to 
provide for coverage of such services under the Federal Employees 
Health Benefits Program; to the Committee on Finance.


         The Patient Access to Acupuncture Services Act of 1998

  Mr. HARKIN. Mr. President, I am pleased today to introduce the 
Patient Access to Acupuncture Services Act of 1998, to provide limited 
coverage for acupuncture under Medicare and the Federal Employees 
Health Benefits Program. This is an important bill that reflects an 
appropriate and needed response to both progress in science, and to the 
demand for complementary and alternative treatments of pain and 
illness.

  I would like to acknowledge Senator Mikulski, who is cosponsoring 
this bill with me. Senator Mikulski has been a strong supporter of 
effective alternative therapies and has long realized and appreciated 
the importance and significance of such therapies to our health care 
system.
  Mr. President, approximately 90 million Americans suffer from chronic 
illnesses, which, each year, cost society roughly $659 billion in 
health care expenditures, lost productivity and premature death. 
Despite the high costs of this care, studies published in the Journal 
of the American Medical Association reveal that the health care 
delivery system is not meeting the needs of the chronically ill in the 
United States.
  Many of these Americans are looking desperately for effective, less 
costly alternative therapies to relieve the debilitating pain they 
suffer. In 1990 alone, Americans spent nearly $14 billion out-of-pocket 
on alternative therapies. Harvard University researchers have found 
that fully one-third of Americans regularly use complementary and 
alternative medicine, making an estimated 425 million visits to 
complementary and alternative practitioners of these therapies--
surpassing those made to conventional primary care practitioners!
  And with good reason. Last November, a consensus conference of the 
National Institutes of Health approved the use of acupuncture in 
standard U.S. medical care. It was the first time that the NIH had 
endorsed as effective a major alternative therapy, and it was just the 
type of medical breakthrough that I had hoped for and envisioned when I 
worked to establish the Office of Alternative Medicine at NIH.
  The NIH experts cited data showing that acupuncture can effectively 
relieve certain conditions, such as nausea, vomiting and pain, and 
shows promise in treating chronic conditions such as lower back pain, 
substance addictions, osteoarthritis and asthma.
  In 1993, the FDA reported that Americans spent $500 million for up to 
12 million acupuncture visits. In 1996, after reviewing the science, 
the FDA removed acupuncture needles from the category of ``experimental 
medical devices'' and now regulates them just as it does other devices, 
such as surgical scalpels and hypodermic syringes. Acupuncture is 
effectively used by practitioners around the world. The World Health 
Organization has approved its use to treat a variety of medical 
conditions, including pulmonary problems and rehabilitation from 
neurological damage.
  It has been reported that more than 1 million Americans currently 
receive acupuncture each year. Access to qualified acupuncture 
professionals for appropriate conditions should be ensured. Including 
this important therapy under Medicare and FEHBP coverage will promote a 
progressive health system that integrates treatment from both 
acupuncturists and physicians. It will expand patient care options. I 
also believe it will reduce health care costs because of the relatively 
low cost of acupuncture compared to conventional pain management 
therapies.
  Research is still needed to demonstrate the effectiveness of other 
alternative therapies. This research is vitally important, but we must 
act now to help the millions Americans who can benefit from the 
knowledge we have already gained.
  The 21st century is just around the corner. Less than 50 years ago, 
treatments that are now considered conventional--organ transplants, 
nitroglycerin for heart patients, immunology, and x-ray and laser 
technology--were decried as quackery by the medical establishment. 
Everyday we face new biological and emotional challenges for which 
modern Western medicine has no remedy. Now science is revealing the 
effectiveness of many complementary and alternative treatments, 
including acupuncture, and increasingly more Americans are choosing 
them to manage their health and treat their illness.
  Let us listen to the science, and heed the urgent need for progress. 
Mr. President, the nation's leading scientists have demonstrated the 
safety and effectiveness of acupuncture as a treatment for a wide range 
of pain and illness. It makes common sense that Medicare and FEHBP 
cover this legitimate course of therapy.
  Mr. President, I ask for unanimous consent that a copy of this bill 
be entered into the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2340

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Patient Access to 
     Acupuncture Services Act of 1998''.

     SEC. 2. COVERAGE OF ACUPUNCTURIST SERVICES UNDER MEDICARE.

       (a) In General.--Section 1861(s)(2) of the Social Security 
     Act (42 U.S.C. 1395x(s)(2)) (as amended by section 4557 of 
     the Balanced Budget Act of 1997) is amended--
       (1) in subparagraph (S), by striking ``and'' at the end;
       (2) in subparagraph (T), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(U) qualified acupuncturist services (as defined in 
     subsection (uu));''.
       (b) Payment Rules.--
       (1) Determination of amount of payment.--Section 1833(a)(1) 
     of the Social Security Act (42 U.S.C. 1395l(a)(1)) (as 
     amended by section 4556(b) of the Balanced Budget Act of 
     1997) is amended--
       (A) by striking ``and'' before ``(S)'', and
       (B) by striking the semicolon at the end and inserting the 
     following: ``, and (T) with respect to qualified 
     acupuncturist services described in section 1861(s)(2)(U), 
     the amounts paid shall be the amount determined by a fee 
     schedule established by the Secretary for purposes of this 
     subparagraph;''.
       (2) Separate payment for services of institutional 
     providers.--Section 1832(a)(2)(B)(iii) of the Social Security 
     Act (42 U.S.C. 1395k(a)(2)(B)(iii)) is amended--
       (A) by striking ``and services'' and inserting 
     ``services''; and
       (B) by striking the semicolon at the end and inserting the 
     following: ``, and qualified acupuncturist services described 
     in section 1861(s)(2)(U);''.
       (c) Services Described.--Section 1861 of the Social 
     Security Act (42 U.S.C. 1395x) (as amended by section 4611(b) 
     of the Balanced Budget Act of 1997) is amended by adding at 
     the end the following:

                   ``Qualified Acupuncturist Services

       ``(uu)(1) The term `qualified acupuncturist services' means 
     such services (with such frequency limits as the Secretary 
     determines

[[Page S8780]]

     appropriate) furnished by a qualified acupuncturist (as 
     defined in paragraph (2)) and such services and supplies 
     (with such limits) furnished as an incident to services 
     furnished by the qualified acupuncturist that the qualified 
     acupuncturist is legally authorized to perform under State 
     law (or under a State regulatory mechanism provided by State 
     law).
       ``(2) The term `qualified acupuncturist' means an 
     individual who has been certified, licensed, or registered as 
     an acupuncturist by a State (or under a State regulatory 
     mechanism provided by State law).''.
       (d) Guidance by Secretary of Health and Human Services.--
     The Secretary of Health and Human Services shall provide 
     States with guidance regarding what services a qualified 
     acupuncturist (as defined in section 1861(uu)(2) of the 
     Social Security Act (42 U.S.C. 1395x(uu)(2)) (as added by 
     subsection (c)) should be legally authorized to perform under 
     State law (or under a State regulatory mechanism provided by 
     State law). In providing such guidance, the Secretary of 
     Health and Human Services shall take into consideration the 
     recommendations of the Director of the National Institutes of 
     Health relating to the effectiveness of certain acupuncture 
     services and modalities.
       (e) Effective Date.--The amendments made by this section 
     apply to services furnished on or after January 1, 1999.

     SEC. 3. COVERAGE OF ACUPUNCTURIST SERVICES UNDER FEDERAL 
                   EMPLOYEES HEALTH BENEFIT PLANS.

       (a) In General.--Section 8902(k)(1) of title 5, United 
     States Code, is amended by inserting ``acupuncturist,'' after 
     ``nurse midwife,'' each place it appears.
       (b) Applicability.--The amendment made by subsection (a) 
     applies with respect to services provided on or after January 
     1, 1999.

 Ms. MIKULSKI. Mr. President, today I join my good friend and 
colleague, Senator Harkin, in introducing a bill to allow for coverage 
of acupuncture services under Part B of Medicare and the Federal 
Employee Health Benefits Program (FEHBP). I am proud to be the lead 
cosponsor of this legislation.
  I like this bill for three reasons: it gives patients access to 
affordable, quality health care; it offers patients choice of 
treatment; and it lets patients decide what treatment works for them.
  Some years ago I had some very severe illnesses. Western medicine was 
of limited utility for me and I turned to acupuncture. Acupuncture 
helped me get well and has helped me stay well. Time after time, 
constituents have confirmed what I already know about acupuncture--it 
is an effective treatment for a number of conditions.
  Last November, the Western medical establishment formally endorsed 
what American consumers have been saying for a long time. The National 
Institutes of Health convened a federal panel of experts in medicine, 
anthropology, biostatistics, epidemiology and other scientific 
disciplines to discuss the validity of acupuncture as an effective 
treatment option. The panel concluded that there is clear evidence that 
acupuncture is an effective treatment for certain kinds of pain and 
nausea and may be effective for other conditions. Equally important, 
acupuncture has fewer side effects and is less invasive than many 
``traditional'' medical practices. The panel decided that, given its 
good safety profile and the fact that it is often less expensive than 
conventional medicine, it's time to take acupuncture seriously.
  I think it's time that the federal government take it seriously, too. 
The time has come for Medicare and FEHBP to cover acupuncture for 
American patients who seek this treatment option. I urge the Senate to 
approve this legislation to allow American patients to choose this less 
invasive, less costly, and effective treatment option. I applaud 
Senator Harkin for taking the lead on this important effort.
                                 ______