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Acupuncture Coverage in Florida's Medicare Part C Advantage Plans and Statewide Medicaid Managed Care

Originally presented in webinar format by David Bibbey, LAc. The webinar is available to all FSOMA members here. Log into your membership account to gain access.

In recent years, acupuncture has gained recognition and acceptance as an effective complementary therapy for various medical conditions. Many patients are seeking acupuncture treatments to manage pain, improve overall health, and enhance their well-being. This article will explore the availability of acupuncture coverage under Medicare and Medicaid, shedding light on how these government programs can significantly impact the accessibility of acupuncture services for patients.

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The "Surprise Act"

The “Surprise Act” is a new Federal consumer protection law that protects patients from costly out-of-network billing charges related to emergency and urgent care treatment expenses.  Effective Jan 1, 2022, the federal law protects patients from “balance billing” practices that allow hospitals, outpatient facilities and transportation companies to bill patients for amounts not paid by insurers for covered and non-covered service by out-of-network providers.  

WHAT IS BALANCE BILLING?

"When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services."1

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