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June 7, 2000, Wednesday

SECTION: PREPARED TESTIMONY

LENGTH: 1118 words

HEADLINE: PREPARED TESTIMONY OF GEORGE T. DEVRIES PRESIDENT & CHIEF EXECUTIVE OFFICER AMERICAN SPECIALTY HEALTH INC. SAN DIEGO, CALIFORNIA

BEFORE THE HOUSE COMMITTEE ON GOVERNMENT REFORM

SUBJECT - INTEGRATIVE ONCOLOGY - CANCER CARE FOR THE NEW MILLENNIUM

BODY:
HEALTH INSURANCE COVERAGE ISSUES COMPLEMENTARY & ALTERNATIVE HEALTHCARE

Good afternoon Mr. Chairman, and members of the committee. I am pleased to be before your committee today to discuss insurance coverage issues on complementary and alternative medicine.

I am the Chairman, President, and Chief Executive Officer of American Specialty Health Inc., (ASH) a company I co-founded in 1987. My company is a health services organization for complementary and alternative health care (CAM). We provide specialty health plans, networks, managed care programs, and discount networks for chiropractic, acupuncture, massage therapy, dietetics, and naturopathy. American Specialty Health assists health plans and insurance carriers in providing CAM programs for their covered members. When health plans and insurance carriers offer CAM programs, they often outsource the provision and administration to companies like ours. ASH currently covers approximately 25 million Americans through 68 health plans under CAM benefit programs, network programs, and discount network programs.

There has been a surge in interest in CAM care over the last decade. The Eisenberg study conducted at Harvard University and published in the New England Journal of Medicine reported more than two thirds of all Americans use some form of CAM health care during their lives. In another study, conducted by the International Society of Employee Benefit Specialists, sixty-seven percent of employee benefit specialists expect to see increased coverage of CAM in the future.

I personally speak with three to five health plans per week that offer or are considering offering CAM services for their enrollees. In general I find significant interest. The question that comes up is what approach will the health plan take.

Most health plans have a lack of experience and understanding of CAM. Many are choosing to start with a simple approach, through network discount programs. Under a network discount program, the health plan does not actually provide a covered benefit program but offers their member access to a credentialed network of CAM providers such as chiropractors, acupuncturists, massage therapists, naturopaths, and dieticians. The member still pays self-pays for services. However, they are able to obtain these services at a discount from a credentialed, pre-screened provider. The CAM provider benefits since major health plans are promoting and encouraging the use of CAM to their members.

Discount network programs provide high visibility for CAM. Inevitably, employer groups begin to request access to covered benefit plans for CAM from their regular health plans. Employers are interested more than ever in attracting and retaining top talent in their organizations. Expanding their employee benefit plans by adding coverage for CAM benefits gives employers an edge over their competitors.

Benefit programs are gaining employer interest. Typically health plans are offering supplemental benefit programs for services such as chiropractic, acupuncture and massage therapy. Supplemental Benefit Plans are offered much like a dental or vision plan. Employers purchase for their employees CAM benefits to add to their basic medical plan.

A key area of development in CAM is the concept of integrated health care clinics which combine both traditional medicine and CAM in their practice. In integrated clinics, there are medical physicians practicing side-by-side with chiropractors, acupuncturists, naturopaths, and massage therapists. They develop coordinated care plans based upon what is the best outcome for the patient. There are a number of these clinics in operation or planned. It is still a question whether health plans will cover services at these clinics or not in the future.

We should recognize that CAM is an important part of many Americans' personal health care system. This system includes their family physician, their specialist physician like an OB/GYN, and also includes their chiropractor, acupuncturist, massage therapist, and their dietary supplements like vitamins and herbal supplements. When the devastation of cancer strikes, many find significant support and relief from acupuncture, massage therapy and chiropractic. For example, it is well known and documented that pain relief can be obtained by acupuncture without the sedative and doping effects of narcotic painkillers. Your senate colleague, Senator Tom Harkin of Iowa knows first hand and speaks eloquently how CAM helped his brother live out his final days with cancer with a high quality of life free from pain, all from acupuncture treatments.

We still have a long way to go before CAM is fully integrated into our health care system. There are a variety of steps the Federal Government can take to support the development of CAM in our country and specifically within third-party reimbursement systems. These are:

1) The federal government can encourage states to enact licensure statutes and procedures for providers. For example, Naturopathic physicians are only licensed in eleven states. Acupuncturist licensure or certification vary significantly among the approximately 30 states where it is licensed or certified. These disparities create unequal access to CAM care for Americans in the various states. This could be corrected by providing CAM benefits for Medicare beneficiaries that would stimulate licensure in the several states.

2) The federal government can support and encourage accreditation of schools and universities that train providers in CAM. The US Department of Education and the Department of Health and Human Services ought to explore all the ways to achieve such an objective.

3) The federal government should promote and fully fund research on the clinical efficacy of CAM. This would mean the continued funding and expansion of the National Center for Complementary and Alternative Medicine at the NIH.

4) The federal government should promote tax equality in employee benefit plans allowing coverage of CAM benefits like dietary supplements. Legislation such as HR 3306, introduced by you Mr. Chairman, would create the tax incentives and equality necessary to encourage covered benefits in the health plans. I cannot stress enough how important this is. I personally know of Fortune 500 companies who have expressed interest in obtaining such coverage but will not because of the tax issue.

5) The federal government should promote and encourage CAM education at U.S. medical schools.

6) The NIH Consensus Statement on Acupuncture, published in 1997, encouraged coverage for acupuncture under Medicare and Medicaid.

I will be pleased to answer any questions you have.

END

LOAD-DATE: June 9, 2000

Document 3 of 27.


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