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ASNY UPDATE
We Are All In This Together
Confusion Over Telemedicine
ASNY has been working to determine definitively if L.Acs in NY can engage in and be reimbursed for telemedicine. The answer appears to be no and yes. depending on which authoritative source you are referencing. Let's go over what we have heard and what we have found to back that up. We will be working from the guiding document of New York State Consolidated Laws: Public Health: Article 29G: Telehealth Delivery of Services. The most important things to note about this law is that it provides guidance for delivery of these services and allows for reimbursement of these services. Reimbursement in New York comes from Medicaid delivery and private insurers and allows several regulatory offices to have their own programs and fee schedules that include telehealth. This law empowers offices like the Office of Addiction Services and Supports (formerly OASAS) to form rules and regulations regarding telehealth standards of practice within their own programs.
 
The following information primarily discusses practices that are reimbursable through varying programs such as regulatory agencies like CMS for Medicare and state programs issued through Medicaid or regulatory agencies handling addiction, pain and mental health. While acupuncture may not be listed, that does not mean there is a prohibition on this activity. It may, however, keep you from being paid by anyone other than your patients for these services. There has been some question as to whether it violates your scope of practice. In most professional statutes, they would not have had time to open scope to allow for this and have often turned to the statutes below. At the time of this newsletter, there is no good information regarding whether or not acupuncturists can PERFORM telemedicine and still be practicing inside their scope as telemedicine is a means of delivery, and not a modality that falls into scope. Lastly, there is news that telehealth is not covered by many companies that offer liability insurance which is affecting whether people and schools will choose to incorporate it. Please remember that informed consent is not enough if a claim is made and liability insurance does not cover it directly.
 
ASNY hopes that you will read everything below and make up your own mind regarding your practice. Also remember that if you have filed for Unemployment Insurance or PUA: Telework would constitute being employed if you accept cash for services or reimburse for services.
New York Telehealth Statute
What it says:
 
As used in this article, the following terms shall have the following meanings:
 
  1. "Distant site" means a site at which a telehealth provider is located while delivering health care services by means of telehealth.
 
  2. "Telehealth provider" means:
 
  (a) a physician licensed pursuant to article one hundred thirty-one of the education law;
 
  (b) a physician assistant licensed pursuant to article one hundred thirty-one-B of the education law;
 
  (c) a dentist licensed pursuant to article one hundred thirty-three of the education law;
 
  (d) a nurse practitioner licensed pursuant to article one hundred thirty-nine of the education law;
 
  (e) a registered professional nurse licensed pursuant to article one hundred thirty-nine of the education law only when such nurse is receiving patient-specific health information or medical data at a distant site by means of remote patient monitoring;
 
  (f) a podiatrist licensed pursuant to article one hundred forty-one of the education law;
 
  (g) an optometrist licensed pursuant to article one hundred forty-three of the education law;
 
  (h) a psychologist licensed pursuant to article one hundred fifty-three of the education law;
 
  (i) a social worker licensed pursuant to article one hundred fifty-four of the education law;
 
  (j) a speech language pathologist or audiologist licensed pursuant to article one hundred fifty-nine of the education law;
 
  (k) a midwife licensed pursuant to article one hundred forty of the education law;
 
  (l) a physical therapist licensed pursuant to article one hundred thirty-six of the education law;
 
  (m) an occupational therapist licensed pursuant to article one hundred fifty-six of the education law;
 
  (n) a person who is certified as a diabetes educator by the National Certification Board for Diabetes Educators, or a successor national certification board, or provided by such a professional who is affiliated with a program certified by the American Diabetes Association, the American Association of Diabetes Educators, the Indian Health Services, or any other national accreditation organization approved by the federal centers for medicare and medicaid services;
 
  (o) a person who is certified as an asthma educator by the National Asthma Educator Certification Board, or a successor national certification board;
 
  (p) a person who is certified as a genetic counselor by the American Board of Genetic Counseling, or a successor national certification board;
 
  (q) a hospital as defined in article twenty-eight of this chapter, including residential health care facilities serving special needs populations;
 
  (r) a home care services agency as defined in article thirty-six of this chapter;
 
  (s) a hospice as defined in article forty of this chapter;
 
  (t) credentialed alcoholism and substance abuse counselors credentialed by the office of alcoholism and substance abuse services or by a credentialing entity approved by such office pursuant to section 19.07 of the mental hygiene law;
 
  (u) providers authorized to provide services and service coordination under the early intervention program pursuant to article twenty-five of this chapter;
 
  (v) clinics licensed or certified under article sixteen of the mental hygiene law and certified and non-certified day and residential programs funded or operated by the office for people with developmental disabilities; and
 
  (w) any other provider as determined by the commissioner pursuant to regulation or, in consultation with the commissioner, by the commissioner of the office of mental health, the commissioner of the office of alcoholism and substance abuse services, or the commissioner of the office for people with developmental disabilities pursuant to regulation.
 
 
 
 Health care services delivered by means of telehealth shall be entitled to reimbursement under section three hundred sixty-seven-u of the social services law.
 
  2. The department of health, the office of mental health, the office of alcoholism and substance abuse services, and the office for people with developmental disabilities shall coordinate on the issuance of a single guidance document, to be updated as appropriate, that shall: (a) identify any differences in regulations or policies issued by the agencies, including with respect to reimbursement pursuant to section three hundred sixty-seven-u of the social services law ; and (b) be designed to assist consumers, providers, and health plans in understanding and facilitating the appropriate use of telehealth in addressing barriers to care.
 
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In this case, the Commissioner of the Office of Alcoholism and Substance Abuse Services did put forward a rules process regarding Acupuncture and Telehealth: In September of 2019, OASAS proposed rulemaking for Designated Services (Acupuncture and Telepractice) and it was adopted in December of 2019 . It is important to note that there is a certification required by this agency in order to work with patients suffering with substance abuse issues and NOT a blanket designation that L.Acs who treat patients outside of this program for substance abuse may use telemedicine and be reimbursed for it.
A new subdivision (d) of section 329-4.2 of Title 12 NYCRR is hereby added to read as follows: (d) Authorized acupuncturists, physical therapists, and occupational therapists shall use Common Procedural Technology (CPT) code 99441 (telephone evaluation and management services provided to an established patient; 5-10 minutes of medical discussion) when telemedicine is used in accordance with section 325-1.8 of this Title, notwithstanding this code not appearing in the Official New York Workers' Compensation Acupuncture and Physical Therapy and Occupational Therapy Fee Schedule. Use of this code is limited to one unit per patient per day. 
In this case, it is important to note that this applies only to practitioners registered within the Workers Compensation system and is not guidance for practitioners treating pain outside of the WC System.
New York Telehealth Parity Law
New York State Telehealth Parity Law • Requires commercial insurers and Medicaid to provide reimbursement for services delivered via telehealth if those services would have been covered if delivered in person • Public Health Law (PHL) Article 29-G , Social Services Law § 367- u , and Insurance Law § 3217-h 
Private Billing companies point to the Telehealth Parity Law as explanation for why services are being reimbursed:
Billing companies have provided information saying Insurer policies that included acupuncture prior to this pandemic are, in fact, paying out for telemedicine services, but the information changes daily. You must verify (or better yet: have the patient verify as they are the customer who will be on the line for payment of service) before performing any type of service. The following companies have published their list of what is medically necessary:
Aetna
Center for Medicare & Medicaid Services
New York State issued a Medicaid update in February with a list of telehealth providers. Acupuncturists are not on that list.
CMS issued their recommendations on Non-Emergent, Elective Medical Services, and Treatment Recommendations : Acupuncture has recently been determined as covered by Medicare for Chronic Lower Back Pain and can be performed by L.Acs under the supervision of a physician, nurse practitioner or physician assistant (meaning L.Acs cannot directly bill for acupuncture services.)
The listing and recommendation is as follows:
Tier 1 Low acuity treatment or service: Acupuncture Consider postponing service or Consider follow-up using telehealth , virtual check-in, or remote monitoring.
DON'T FORGET ABOUT LIABILITY INSURANCE
As with all things related to your patients, don't forget about informed consent with regards to telehealth. ASNY also has recently heard of situations where practitioners were informed by the liability insurance companies that they DID NOT cover either telehealth, nor pandemic-related issues (bacteria and viruses) if people begin to open back up. Please check with your policy issuers BEFORE you make these decisions moving forward.
ASA & NCCAOM KEEP ACUPUNCTURISTS INFORMED ON NATIONAL ISSUES
The American Society of Acupuncturists has partnered with the NCCAOM to bring information each week through their series of Town Halls. ASNY highly encourages all who can attend to do so. They offer two free PDAs for attendance and give information that is invaluable to our professional licensees, students and vendors in the industry. You may find out more information by visiting their website: www.asacu.org.

Recently they issued a breakdown of the recent PAYCHECK PROTECTION PROGRAM & HEALTH CARE ENHANCEMENT ACT that was signed into law April 24, 2020. The Act funds programs that had previously run out of money through their initial relief effort while expanding and creating new programs to help those in need through these troubling times. ASA & NCCAOM's analysis is tailored to your needs, so please use the resource above when asking questions. ASNY believes it is the most comprehensive and specific information you can have.

ASA is advising to apply for these programs immediately as funding will not last.
COVID-19 PANDEMIC-RELATED PRIVATE
FINANCIAL ASSISTANCE PROGRAMS FOR
NEW YORK CITY SMALL BUSINESSES
ASNY COMMITTEES IN ACTION
ASNY relies on its committees to come up with solutions to expand our reach in health policy, enhance our member and public communications and create benefits for our members. We recognize that we are in a unique position to tap the talent of so many practitioners who arrived in this profession as a second career and hope that you guys can step in at a time of great public need. If you find yourself being affected by this crisis and want to help, please let us know.

ASNY is updating its systems to help streamline committee and volunteer activity. All events will be scheduled through a volunteer portal and can be checked there. If you have not already done so, please click on the button below to create an account at YourVolunteers.com:
COMMUNICATIONS
Chair: Viktor Krystufek
Monthly meetings:
`1st Monday of Every Month
9:00PM EST
Subcommittees: Newsletter, Public Education, Social Media
To participate, contact

The Mission of the Public Relations Committee is to develop and maintain the most effective and efficient means of promoting ASNY Activity, serve as central committee for determining policy for both inter and intra association communication, serve as liaison to other associations and members of the Acupuncture community, and are in charge of event management and ASNY brand development.  

  • Communication bridge b/w Board, Members, Allied Professionals, and General Public
  • Develop harmony building within the acupuncture community among allied associations
  • Community Outreach
  • Public education
  • Branding
  • Social media
FUNDRAISING
Chair: Michel Solounias
Meetings Coordinated
With Other Committees;
Announced Accordingly
To participate, contact

The mission of the ASNY Fundraising Committee is to create opportunities for ASNY's general fundraising an special campaigns.. We schedule and implement general and special programs such as sales, banquets, and continuing education courses.

  • Website Marketing
  • PDA Development & Implementation
  • Development of Member Benefits
  • Solicit Ad Sales
  • Fiscal monitoring of events
  • Fundraising
MEMBERSHIP
Chair: Peter Caron
Monthly meetings
4th Monday of Every Month
1:00PM EST
REGIONAL Meetings
being established
To participate, contact

The Mission of the Membership Committee is to develop and maintain programs that will address the needs of NYS L.Acs in every region. This committee will also develop outreach programs for both students and unaffiliated members.

  • Maintain Member list by Regions
  • Develop and Maintain Member Outreach Program
  • Develop Member Drives
  • Develop School Outreach Programs
  • Nominate Regional Directors to BOD
ADVOCACY
Chair: Timur Lokshin
Monthly Meetings:
2nd Thursday of Every Month
1:00PM EST
Subcommittees: Insurance, Federal,Opioids
To participate, contact

The Mission of the Advocacy Committee is to develop, maintain, monitor, adjust and implement legislative & regulatory strategies for New York State licensed acupuncturists. The Advocacy Committee will serve as direct liaisons between lobbyists and advocacy strategists, serve on coalitions, liaise with other associations, and educate members through calls to action in order to achieve member-driven legislative & regulatory goals.

The Responsibilities of the Advocacy Committee are as follows:

  • Maintain Legislative & Regulatory Calendar
  • Monitor Legislation & Regulatory Activity
  • Develop & Maintain Legislative & Regulatory Relationships
  • Liaison with Lobby/Advocacy Consultants
  • Develop Legislative & Regulatory Strategy
  • Develop & Disseminate Surveys & Polls for Membership 
  • Arrange Educational Webinars on L&R Activity
  • Create Written & Oral Testimony & Comments
  • Testify at Legislative & Regulatory Hearings
  • Prepare Reports for Newsletter, Calls to Action, & Updates
  • Develop Legislative & Regulatory Archives 

GOVERNANCE
Vice Chair: Timur Lokshin
Monthly Meetings:
3nd Thursday of Every Month
1:00PM EST
To participate, contact


The Mission of the Governance Committee is to organize policy and procedures, manage elections and bylaws amendments, seek and review board candidates, and monitor bylaws compliance. This committee is dedicated to vetting procedures and processes for the betterment and fluidity of the ASNY group and its members. These systems in place are designed to ensure efficacy and the longevity of the organization.

The Responsibilities of the Governance Committee are as follows:

  • Operations: Policy & Procedures Manual
  • By-Laws Monitoring and Adjustment
  • Liaison with Committees for SOPs and Policy Changes
  • Gather nominations for Director & Officer Candidates
  • Vet Candidates
  • Develop forms for implemented policies and procedures
  • Work with ASA Governance Committee
  • Provide Analysis to ASA for Bylaws & P&P Manuals
ASNY Committees Descriptions & Duties