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Well girls and boys, as i warned in an article over 10 years ago it now looks

like work comp in cal will not cover acup. State fund now states: Per laor code

section 4610(d) ACOEM guidlines all care must be based on evidence based.

" acupuncture has not been found effective in the management of back pain, based

on several high-quality studies, but there is anecoctdal evidence of its

successes. " therefore based on ACOEM guidelines, Edition 2, Published January

2004, we will not pay for acupuncture.

If you think studies like the German study will not effect you just stay asleep.

When i wrote the article some 10 years ago all i heard is everybody loves us, we

are much cheaper than everybody else, dont worry, dont be an alarmist, etc.

As you can see the writing is on the wall. I think you guys in schools with

excess to large number of patients better get it together all we will not have a

profession.

Alon

 

 

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, " alon marcus " <alonmarcus@w...>

wrote:

 

 

State fund now states: Per laor code section 4610(d) ACOEM guidlines all care

must be based on evidence based.

> " acupuncture has not been found effective in the management of back pain,

based on several high-quality studies, but there is anecoctdal evidence of its

successes. " therefore based on ACOEM guidelines, Edition 2, Published January

2004, we will not pay for acupuncture.

 

 

Alon

 

Where did this come from? It looks like its brand new. Is the last line an

exact quote from the guidelines or is it your interpretation (i.e. we will not

pay for acupuncture)? With the delay on WC checks, I bet people are just

finding out now that they are not getting paid if this is being widely enforced.

 

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I haven't been able to find 4610 in electronic version on web. So are my

students who

last year got these Workers Comp jobs now f------ed (fried)?

has anyone else heard of people being denied WC recently?

doug

 

, " alon marcus " <alonmarcus@w...>

wrote:

> Well girls and boys, as i warned in an article over 10 years ago it now looks

like

work comp in cal will not cover acup. State fund now states: Per laor code

section

4610(d) ACOEM guidlines all care must be based on evidence based.

> " acupuncture has not been found effective in the management of back pain,

based

on several high-quality studies, but there is anecoctdal evidence of its

successes. "

therefore based on ACOEM guidelines, Edition 2, Published January 2004, we will

not

pay for acupuncture.

> If you think studies like the German study will not effect you just stay

asleep. When

i wrote the article some 10 years ago all i heard is everybody loves us, we are

much

cheaper than everybody else, dont worry, dont be an alarmist, etc.

> As you can see the writing is on the wall. I think you guys in schools with

excess to

large number of patients better get it together all we will not have a

profession.

> Alon

>

>

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A workcomp insurance carrier

 

 

Teresa Hall, L.Ac, M.S, Q.M.E.

619-517-1188

-

" " <

Thursday, March 25, 2004 4:40 PM

Re: WC

 

 

> , " Alon Marcus "

<alonmarcus@w...>

> wrote:

> > These are the words. It comes from state fund

> > alon

>

>

> what is " state fund " ?

>

>

>

>

> Chinese Herbal Medicine offers various professional services, including

board approved continuing education classes, an annual conference and a free

discussion forum in Chinese Herbal Medicine.

>

>

>

>

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State fund is the largest WC carrier in CA. Has anybody been paid by them in

2004? Or has anyone on the list got authorization for treatment in 2004?

I am really curious to see what the medical world will do with the new

prolotherapy study that showed no difference between the prolo group and the

saline group. The study did state that both groups did quite well and got good

pain control and increased function. If this study is going to be used against

prolotherapy then it will the same as what we face with sham vs. real acup. If

they are going to say the study showed that ligament injections are useful

clinical tool then i think we could use it for our advantage. I am going to an

orthopedic meeting next month and will report

Alon

 

 

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, " Alon Marcus " <alonmarcus@w...>

wrote:

> State fund is the largest WC carrier in CA. Has anybody been paid by them in

2004?

Or has anyone on the list got authorization for treatment in 2004?

> I am really curious to see what the medical world will do with the new

prolotherapy

study that showed no difference between the prolo group and the saline group.

The

study did state that both groups did quite well and got good pain control and

increased function. If this study is going to be used against prolotherapy then

it will

the same as what we face with sham vs. real acup. If they are going to say the

study

showed that ligament injections are useful clinical tool then i think we could

use it for

our advantage. I am going to an orthopedic meeting next month and will report

> Alon

>

I have been paid by State Fund in 2004, however I am not sure that the

authorizations

I have been paid for occurred in 2004. I will have to look when I am at my

office.

Misha

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I have been paid by State Fund in 2004, however I am not sure that the

authorizations

I have been paid for occurred in 2004. I will have to look when I am at my

office.

Misha

 

>>>>Misha this only applies to 2004 and i think from February on, but I am not

sure. I have also received payments on a patient seen in January 2004.

Alon

 

 

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Here are some more wording from the WC letter.

" Since the NIH consensus statement on acup suggested it may have some value with

cretin pain syndromes, there has been increasing application in the clinical

arena. Unfortunately, the NIH statement was tenuous and based upon very limited

evidence. Thus the NIH statement should not be viewed as adequate evidence for

recommending acupuncture with chronic non-malignant pain syndrome patients. In

fact, a review of the literature since 1995 failed to show consistent,

well-controlled research support for the routine application of acupuncture.

Indeed, a recent study using more valid research methodology found that acup was

of little effectiveness for acute and chronic low back pain. Review of the

patient sample used indicated that chronic non-malignant pain syndrome patients

were included. Given this, and until more consistent, well controlled studies

demonstrate effectiveness, the current guidelines do not recumbent that

acupuncture be used with chronic non-malignant pain syndrome patients "

Alon

 

 

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, " alon marcus " <alonmarcus@w...>

wrote:

a review of the literature since 1995 failed to show consistent, well-

controlled research support for the routine application of acupuncture. Indeed,

a recent study using more valid research methodology found that acup was of

little effectiveness for acute and chronic low back pain. Review of the patient

sample used indicated that chronic non-malignant pain syndrome patients

were included. Given this, and until more consistent, well controlled studies

demonstrate effectiveness, the current guidelines do not recommend that

acupuncture be used with chronic non-malignant pain syndrome patients "

 

 

that seems pretty clear. anyone who is investigating this matter should

inquire about conditions other than low back pain as there is no evidence for

those, either. Interesting scenario. I wonder what kind of political

maneuvering would get the state fund to ignore the evidence or lack thereof.

In the absence of good research, politics is whimsical. Today's friends are

tomorrow's enemies. As long as cultivating friends in high places is how we

make our headway, we are always one election away from disaster. If

evidence showed acupuncture was effective for LBP at less cost than WM, then

it would be a no-brainer to our cost cutting governor.

 

It can be no coincidence that Governor Arnie came into power swearing to cut

costs and eyeing the WC budget. While he wrangles with how to get his

measures enshrined into law by either the legialsture or a referendum, he

still has a few options available to him right away. One power given to the

executive that can wielded without any consent from the assembly or public

is to enforce existing laws. It appears the guv may be asking the state fund to

enforce existing law which mandates evidence based treatment as the

standard of care. Clever guy.

 

Is there enough evidence for chiro and PT?

 

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Is there enough evidence for chiro and PT?

>>>Chrios only for acute simple low back pain, possibly neck pain. PT only for

active rehab, i.e. exercises

Alon

 

 

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, " alon marcus " <alonmarcus@w...>

wrote:

> Is there enough evidence for chiro and PT?

> >>>Chrios only for acute simple low back pain, possibly neck pain. PT only for

active rehab, i.e. exercises

 

 

so what form of WC therapy IS evidence based?

 

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so what form of WC therapy IS evidence based

>>>>>No evidence for ultrasound, electostim, very mixed on TENS, and most other

modalities. Life is going to change. What worries me is that this is were all

insurance is going. I think we are seeing the tip of the iceberg

alon

 

 

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I hear they are giving away land in Kansas... (my home state)

doug

 

, " alon marcus " <alonmarcus@w...>

wrote:

> so what form of WC therapy IS evidence based

> >>>>>No evidence for ultrasound, electostim, very mixed on TENS, and most

other modalities. Life is going to change. What worries me is that this is were

all

insurance is going. I think we are seeing the tip of the iceberg

> alon

>

>

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*LOL* Very Funny Doug

 

 

 

Teresa Hall, L.Ac, M.S, Q.M.E.

619-517-1188

-

" "

Monday, March 29, 2004 6:18 PM

Re: WC

 

 

> I hear they are giving away land in Kansas... (my home state)

> doug

>

> , " alon marcus "

<alonmarcus@w...>

> wrote:

> > so what form of WC therapy IS evidence based

> > >>>>>No evidence for ultrasound, electostim, very mixed on TENS, and

most

> other modalities. Life is going to change. What worries me is that this

is were all

> insurance is going. I think we are seeing the tip of the iceberg

> > alon

> >

> >

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I just heard from another practitioner that she was approved for some conditions

by state fund but was denied treatment for all her low back pain patients. I

think that is good news and means we need to collect positive studies and try to

build a case for effectiveness of acup in low back pain.

I still think we are dealing with different case managers not knowing what the

new guidelines are. Also I am wandering what will happen with payments even on

so-called approved treatments once they go the new mandatory medical review.

Alon

 

 

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