by Steven Stumpf, EdD
Many LAcs assume state laws are pretty much the same when it comes to scope of practice and other matters of law that directly impact the ability of licensed acupuncturists to earn a living. This is not the case. I have a publication coming out in May in the journal EXPLORE that provides details on the variation between state laws. I will write more when the May issue of EXPLORE goes online in early May.
Acupuncture Laws: A Profession’s Growing Pains – does not address a couple of topics that should be of great financial interest to Guild members.
- Which states include acupuncture and acupuncturists in their workers compensation legislation?
- Which states include malpractice insurance under their acupuncture laws?
Here are the results of our survey of the states with acupuncture laws that require malpractice insurance. 37 states do not require LAcs to carry malpractice insurance. Zero states require LAcs to carry any kind of insurance. Six (6) states require LAcs to carry malpractice insurance. Two (2) additional states make reference to malpractice in code.
Connecticut (CT) is one of the eight states that references malpractice insurance in the law, however, CT is not one of the six that require LAcs to purchase malpractice as a condition of licensure. Not yet. There is a bill working its way through the CT legislature that will require LAcs to purchase malpractice insurance. The NGAOM supports the bill and has been instrumental in seeing the bill pass unanimously in the Public Health Committee. Leaders of a local organization of LAcs – CSAOM – oppose the bill because it will unfairly burden LAcs with an unnecessary expense, in other words malpractice insurance is not affordable for LAcs. It is not clear whether the members agree with the “leaders.”
More on the ethics of the “affordability” question in a minute.
Workers Compensation law provides LAcs one of the best opportunities to earn a decent living. A healthcare provider who wishes to treat WC patients must at least pass muster with private insurance companies. A handful of states include acupuncture services in the law. Only one (1) state lists licensed acupuncturists as providers in the law. That state is California. However, twelve (12) additional states mention acupuncture as an eligible treatment in their WC law. We know that Delaware also pays for acupuncturist services.
What is the point? Many licensed acupuncturists struggle to make a living. That is why the Guild is dedicated to “driving revenues to LAcs.” However, we recognize that the world of insurance reimbursement requires malpractice insurance if you want to bill carriers. This is why the state laws for chiropractors and physical therapists, for example, require the purchase of insurance as a condition for licensure. Their professional organizations pushed for laws that gave their members the opportunity to earn a decent living. Chiropractors and PTs enjoy the benefits of conforming to professional standards.
The CT “leaders” who oppose the new conforming law is concerned that requiring the purchase of malpractice insurance will unfairly burden LAcs who have a cash practice, or work part time, or are on hiatus. In other words, in their view it is unfair to discriminate against LAcs who wish to work in a non-conforming industry with minimal opportunities beyond part time, cash practices and who prefer not to bill insurance or treat WC patients.
We estimate as many as half of all LAcs do not carry malpractice insurance. Premiums for a complete policy that includes general and malpractice coverage can cost $1,000 annually. It is ironic that malpractice claims against poorly trained LAcs remain infrequent and that settlements generally are small. The odds of a malpractice claim are tiny with settlements often less than $20,000. However, damage is done to the profession every day by those who would ignore the standards of all other mainstream healthcare providers, instead choosing to keep all LAcs on the margins outside the healthcare mainstream. We believe there are more LAcs who wish to bill insurance, work with WC patients, and adhere to mainstream standards, than there are LAcs who prefer to work part time and exist on the fringes of healthcare.
These are the facts.
The acupuncture profession seems to breed misinformation. We deal in facts, improving our profession one point at a time.