,i #aaeth ,,congress #ast ,session ,h4 ,r4 #bhci ,,in ,,the ,,house ,,of ,,representatives ,june #h1 #bjag,ms4 ,judy ,chu of ,california introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,armed ,services1 ,veterans' ,affairs1 and ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title #aj1 ,united ,states ,code1 to ensure access to qualified acupuncturist services for military members and military dependents1 to amend title #ch1 ,united ,states ,code1 to ensure access to acupuncturist services through the ,department of ,veterans ,affairs1 to amend title ,,xviii of the ,social ,security ,act to provide for coverage of qualified acupuncturist services under the ,medicare program2 to amend the ,public ,health ,service ,act to authorize the appointment of qualified acupuncturists as officers in the commissioned ,regular ,corps and the ,ready ,reserve ,corps of the ,public ,health ,service1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,acupuncture for ,heroes and ,seniors ,act of #bjag4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,definitions4 ,sec4 #c4 ,inclusion of acupuncture services through military health care system and ,,tricare program4 ,sec4 #d4 ,acupuncture health services for ,,tricare program beneficiaries4 ,sec4 #e4 ,inclusion of acupuncturist services at veterans health facilities4 ,sec4 #f4 ,coverage for acupuncturist services under the ,medicare program4 ,sec4 #g4 ,acupuncturists in the ,regular ,corps and the ,ready ,reserve ,corps of the ,public ,health ,service4 #b4 ,definitions ,in this ,act1 except as otherwise provided3 7#a7 ,the term qualified acupuncturist services means-- 7,a7 acupuncturist services-- 7i7 that are furnished by a qualified acupuncturist2 and 7ii7 which the qualified acupuncturist is legally authorized to perform under ,state law2 and 7,b7 services and supplies that are furnished by a qualified acupuncturist incident to the services described in subparagraph 7,a74 7#b7 ,the term qualified acupuncturist means an individual who is licensed or certified as an acupuncturist by a ,state or1 in the case of an individual in a ,state that does not provide for such licensure or certification1 meets such criteria 7such as accreditation through an appropriate nationally recognized certification authority for acupuncturists7 as the ,secretary of ,health and ,human ,services may specify4 ,in specifying such requirements1 the ,secretary may use the same requirements as those established by such a certification authority4 7#c7 ,the term ,state means the #ej ,states1 the ,district of ,columbia1 ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 ,american ,samoa1 and the ,northern ,mariana ,islands4 #c4 ,inclusion of acupuncture services through military health care system and ,,tricare program 7a7 ,members of the uniformed services 7#a7 ,in general ,chapter #ee of title #aj1 ,united ,states ,code1 is amended by inserting after section #ajgdm the following new section3 #ajgdn4 ,provision of acupuncturist services 7a7 ,in general ,in accordance with section #ajgd7;c7 of this title1 and under regulations prescribed by the ,secretary1 members of the uniformed services entitled to medical care under section #ajgd shall be entitled to qualified acupuncturist services 7without the requirement of a referral7 provided in a military medical treatment facility or a private facility by an acupuncturist who is licensed or certified in the ,state in which the facility is located1 or1 in the case of a facility in a ,state that does not provide for such licensure or certification1 meets such criteria 7such as accreditation through an appropriate nationally recognized certification authority for acupuncturists7 as the ,secretary may specify4 ,in specifying such requirements1 the ,secretary may use the same requirements as those established by such a certification authority4 7b7 ,civilian employees ,the position of certified1 trained acupuncturist for civilian employees in the ,department of ,defense shall be the grade of ,,gs-#ab or higher under the ,general ,schedule under section #eccb of title #e4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #ajgdm the following new item3 #ajgdn4 ,provision of acupuncturist services4 4 7b7 ,,tricare program ,section #ajgi7;a7 of title #aj1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#ab71 by inserting or paragraph 7#ah7 after except as authorized in paragraph 7#d72 and 7#b7 by adding at the end the following new paragraph3 7#ah7 ,acupuncturist services may be provided without the requirement of a referral if performed by an acupuncturist who is licensed or certified in the ,state in which the services are furnished1 or1 in the case of services furnished in a ,state that does not provide for such licensure or certification1 meets such criteria 7such as accreditation through an appropriate nationally recognized certification authority for acupuncturists7 as the ,secretary may specify4 ,in specifying such requirements1 the ,secretary may use the same requirements as those established by such a certification authority4 4 7c7 ,effective date ,the amendments made by this section shall take effect on the date that is #ahj days after the date of the enactment of this ,act4 #d4 ,acupuncture health services for ,,tricare program beneficiaries 7a7 ,plan required ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,defense shall develop a plan to provide qualified acupuncturist services1 as a permanent part of the ,,tricare program pursuant to the amendments made by section #c1 for covered beneficiaries 7as defined in section #ajgb of title #aj1 ,united ,states ,code74 7b7 ,contents of plan ,the plan shall require that a contract entered into under section #ajig of title #aj1 ,united ,states ,code1 for the delivery of health care services shall-- 7#a7 include the delivery of qualified acupuncturist services2 7#b7 require that qualified acupuncturist services may be provided only by a qualified acupuncturist2 and 7#c7 provide clarity on the process that a covered beneficiary must use to select and have direct access to a qualified acupuncturist 7without the requirement of a referral74 7c7 ,implementation of plan ,the plan developed under subsection 7a7 shall provide for implementation of the plan to begin not later than #bgj days after the date of enactment of this ,act4 7d7 ,submission ,the ,secretary shall submit to ,congress the plan developed under subsection 7a74 #e4 ,inclusion of acupuncturist services at veterans health facilities 7a7 ,acupuncturist services 7#a7 ,in general ,subchapter ,,ii of chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #agbj;,h4 ,provision of acupuncturist services 7a7 ,in general ,the ,secretary shall carry out a program to provide acupuncturist services to veterans enrolled in the health care system established under section #agje7;a7 of this title 7without the requirement of a referral74 7b7 ,locations ,the program under subsection 7a7 shall be carried out at in at least one facility of the ,department in each ,veterans ,integrated ,service ,network4 ,in selecting such facilities1 the ,secretary shall ensure that the program is carried out in both urban and rural areas4 7c7 ,services available ,the ,secretary shall ensure that the acupuncturist services available under the program are able to address1 at a minimum1 the following3 7#a7 ,chronic and acute pain4 7#b7 ,cancer pain4 7#c7 ,postoperative nausea and vomiting4 7#d7 ,postsurgical gastroparesis syndrome4 7#e7 ,opioid-induced constipation4 7#f7 ,opioid-induced pruritus4 7#g7 ,chemotherapy-induced neuropathy4 7#h7 ,aromatase inhibitor-associated joint pain4 7#i7 ,neck dissection-related pain and dysfunction4 7#aj7 ,stress management4 7#aa7 ,mental health conditions4 7#ab7 ,substance abuse4 7#ac7 ,symptoms relating to traumatic brain injury and post-traumatic stress4 7d7 ,administration 7#a7 ,the ,secretary shall carry out the program through-- 7,a7 qualified acupuncturists appointed as employees of the ,department located at medical centers and clinics of the ,department2 and 7,b7 through contract qualified acupuncturists if-- 7i7 the ,secretary is unable to make appointments described in subparagraph 7,a72 7ii7 a patient requires specialty care that an employee under such subparagraph is not able to provide to the patient2 or 7iii7 there is an emergency that requires the use of such a contract acupuncturist4 7#b7 ,the ,secretary shall provide training and materials to health care providers of the ,department who provide primary care to veterans to explain the benefits of acupuncturist services4 7#c7 ,in this section1 the term qualified acupuncturist means1 with respect to the furnishing of services in a ,state1 an individual who is licensed or certified in the ,state in which the services are furnished1 or1 in the case of services furnished in a ,state that does not provide for such licensure or certification1 meets such criteria 7such as accreditation through an appropriate nationally recognized certification authority for acupuncturists7 as the ,secretary may specify4 ,in specifying such requirements1 the ,secretary may use the same requirements as those established by such a certification authority4 7e7 ,regulations ,the ,secretary shall prescribe regulations to carry out this section4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #agbj;,g the following new section3 #agbj;,h4 ,provision of acupuncturist services4 4 7#c7 ,conforming amendment ,section #agja7f7 of such title is amended by adding at the end the following new subparagraph3 7,h7 ,acupuncturist services in accordance with section #agbj;,h of this title4 4 7b7 ,advisory committee 7#a7 ,in general ,subchapter ,,iii of chapter #e of such title is amended by adding at the end the following new section3 #edg4 ,advisory committee on acupuncturist services 7a7 ,acupuncture advisory committee 7#a7 ,the ,secretary shall establish an advisory committee to be known as the ,advisory ,committee on ,acupuncturist ,services 7in this section referred to as the ,committee7 to provide the ,secretary with assistance and advice in the development and implementation of the program established by section #agbj;,h of this title4 7#b7 ,the ,committee shall consist of members appointed by the ,secretary from the general public1 including-- 7,a7 not fewer than five practicing acupuncturists1 of which at least four shall be ,state licensed acupuncturists2 7,b7 one veteran from each of the ,armed ,forces2 7,c7 not fewer than two representatives from veterans service organizations2 and 7,d7 a representative of the ,department of ,defense4 7b7 ,duties ,the ,committee shall-- 7#a7 review and evaluate the ability of a veteran to access an acupuncturist at facilities of the ,department2 7#b7 advise the ,secretary with respect to-- 7,a7 protocols governing direct access to acupuncture care2 7,b7 protocols governing the scope of practice of acupuncture practitioners2 7,c7 the definitions of services to be provided by acupuncturists2 and 7,d7 such other matters the ,secretary determines appropriate2 and 7#c7 upon the determination of the ,secretary that the program of acupuncturist services under section #agbj;,h of this title has been fully implemented1 submit to the ,secretary a report containing the evaluation of the ,committee of the implementation of such program4 7c7 ,chairman ,the ,secretary shall designate one member of the ,committee to serve as the chairman of the ,committee4 7d7 ,meetings ,the ,committee shall meet at the call of the ,chairman1 but not fewer than three times during each fiscal year1 beginning in the fiscal year following the fiscal year in which this section is enacted4 7e7 ,report ,following the date on which the ,committee submits to the ,secretary the report under subsection 7b77#d71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report containing the following3 7#a7 ,a copy of the ,committee report1 together with the comments of the ,secretary on the report4 7#b7 ,an explanation of the criteria and rationale that the ,secretary used to determine that the program of acupuncturist services under section #agbj;,h of this title was fully implemented1 as described in such subsection 7b77#d74 7#c7 ,the views of the ,secretary regarding the future implementation of such program4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #edf the following new item3 #edg4 ,advisory committee on acupuncturist services4 4 7c7 ,conforming amendments 7#a7 ,authority for appointments ,section #gdja7a7 of title #ch1 ,united ,states ,code1 is amended by inserting acupuncturists1 after chiropractors14 7#b7 ,period of appointments ,section #gdjc of such title is amended by adding at the end the following new subparagraph3 7,i7 ,acupuncturists4 4 7#c7 ,pay 7,a7 ,scale ,section #gdjd of such title is amended-- 7i7 in subsection 7a77#b71 by inserting 1 acupuncturists1 after physicians2 and 7ii7 in the list in subsection 7b71 by inserting 1 ,,acupuncturist1 after ,,physician4 7,b7 ,treatment ,section #gdca of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7i7 ,treatment of acupuncturists ,for purposes of this subchapter1 an acupuncturist is deemed to be a physician4 4 7#d7 ,malpractice and negligence suits ,section #gcaf7;a77#b7 of such title is amended by inserting acupuncturist1 after chiropractor14 7#e7 ,hours and conditions ,section #gdba7;b7 of such title is amended by adding at the end the following new paragraph3 7#i7 ,acupuncturists4 4 7#f7 ,effective date ,the amendments made by paragraph 7#d7 apply with respect to services provided on or after the date that is #bgj days after the date of enactment of this ,act4 #f4 ,coverage for acupuncturist services under the ,medicare program 7a7 ,in general ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7#a7 in subsection 7s77#b7-- 7,a7 by striking and at the end of subparagraph 7,,ee72 7,b7 by adding and at the end of subparagraph 7,,ff72 and 7,c7 by adding at the end the following new subparagraph3 7,,gg7 qualified acupuncturist services 7as defined in subsection 7iii77#a772 2 and 7#b7 by adding at the end the following new subsection3 7iii7 ,qualified acupuncturist services 7#a7 ,the term qualified acupuncturist services means such services furnished by a qualified acupuncturist 7as defined in paragraph 7#b771 and such services and supplies furnished as an incident to services furnished by the qualified acupuncturist1 as the qualified acupuncturist is legally authorized to perform under ,state law4 7#b7 ,the term qualified acupuncturist has the meaning given such term in section #b of the ,acupuncture for ,heroes and ,seniors ,act of #bjag4 4 7b7 ,payment rules 7#a7 ,payment under physician fee schedule ,section #ahdh7;j77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c77 is amended by inserting 7#b77;,,gg71 before 7#c714 7#b7 ,separate payment for services of institutional providers ,section #ahcc7;a77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#b77;,b77 is amended-- 7,a7 in clause 7i71 by inserting and in the case of qualified acupuncturist services1 after #aiii12 7,b7 in clause 7ii71 by inserting or in the case of qualified acupuncturist services1 after #aiii12 and 7,c7 in clause 7iii71 by inserting 7other than qualified acupuncturist services7 after such services4 7#c7 ,qualified acupuncturist treatment as a practitioner ,section #ahdb7;b77#ah77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieu7b77#ah77;,c77 is amended by adding at the end the following new clause3 7vii7 ,a qualified acupuncturist 7as defined in section #ahfa7;iii77#b774 4 7#d7 ,separate billing for acupuncturist services furnished in an inpatient hospital setting ,section #ahfa7;b77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7b77#d77 is amended by inserting qualified acupuncturist services1 after qualified psychologist services14 7c7 ,effective date ,the amendments made by this section apply with respect to services furnished on or after the date that is #bgj days after the date of enactment of this ,act4 #g4 ,acupuncturists in the ,regular ,corps and the ,ready ,reserve ,corps of the ,public ,health ,service 7a7 ,authorization of appointment ,section #bjg of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bji7 is amended-- 7#a7 in subsection 7a77#a71 by inserting acupuncture1 after nursing12 and 7#b7 by adding at the end the following3 7j7 ,appointment of qualified acupuncturists 7#a7 ,eligibility ,acupuncturists shall be eligible for appointment as officers in the commissioned ,regular ,corps and the ,ready ,reserve ,corps of the ,public ,health ,service4 7#b7 ,qualification2 training1 equipment1 and preparation ,the ,secretary shall ensure that acupuncturists in the commissioned ,regular ,corps and in the ,ready ,reserve ,corps-- 7,a7 are qualified acupuncturists 7as defined in section #b of the ,acupuncture for ,heroes and ,seniors ,act of #bjag72 and 7,b7 are trained1 equipped1 and otherwise prepared to fulfill applicable public health and emergency response service responsibilities in the ,commissioned ,corps4 4 7b7 ,required placement 7#a7 ,in general ,not later than #ij days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall ensure the appointment of no fewer than #f acupuncturists into the commissioned ,regular ,corps and the ,ready ,reserve ,corps of the ,public ,health ,service4 7#b7 ,reports ,not later than #abj days after the date of enactment of this ,act1 and quarterly thereafter1 the ,surgeon ,general of the ,public ,health ,service shall submit to the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate a report on all measures taken by the ,president1 the ,surgeon ,general1 and the ,secretary of ,health and ,human ,services to carry out the provisions of this section1 including the amendments made by this section4