Author: Chris Fadgen, M.Ac., L.Ac.

Cigna will no longer credential acupuncturists to provide services to their members as of September 1, 2021.  Cigna will not accept or process claims for acupuncture services, and all claims will be submitted to American Specialty Health, Inc. (ASH) for processing and payment. 

In short, ASH intends to dramatically reduce the payments made to practitioners in their network. This flat rate of $40 to $50 will not cover the provider’s patient care expense to deliver services.  The cost of delivering services during this COVID-19 pandemic has risen as providers purchase PPE and modify office spaces.  Acupuncture practices are primarily small businesses and will be negative impacted by this 70% reduction in the reimbursement rates.  Unfortunately, this change challenges the sustainability of many acupuncture practices.

Furthermore, ASH delivers a plan for acupuncture services which does not consider up-to-date research, clinical evidence, and CPT coding policy and fee structures utilized by CMS and other payers.  ASH continues to use the word “Oriental” on their website which demonstrates their outdated and biased view of East Asian Medicine (as of the date of this post).  It is not beneficial to Cigna members to have their acupuncture benefits managed by a company who has shown a disregard and lack of knowledge of East Asian Medicine.
 
Misrepresenting the practice of East Asian Medicine to health insurance consumers violates the right of patients to receive the full benefits of acupuncture and other treatment methods as it is intended under the scope of practice in our state.  Furthermore, Maryland licensed acupuncturists are independent medical providers who do not require supervision from other types of health providers or a third-party administrator. Acupuncturists are not exclusively musculoskeletal providers such as chiropractors, physical therapists, massage therapist, and fitness trainers. We practice a comprehensive medicine which goes beyond the musculoskeletal system and includes clinical evaluation and treatment of involving all the human physiological systems.   

Cigna will listen: 1-800-244-6224

Please note: This information must come from Cigna’s members, the patients and their employers. A phone call is always more powerful if they can make the time. Below is the phone information we have been given along with a phone script.

To (Cigna),
  
Because of the integration of Cigna with American Specialty Health for acupuncture services and the implementation of ASH’s significantly lower reimbursement rates, my acupuncturist of (X years) is terminating his/her contract with Cigna.  ASH reimbursement rates are so low that my acupuncturist cannot accept the rates and sustain his/her practice.  ASH severely limits the amount of time spent with patients to 1 unit which is just 15 minutes equaling around $40 per treatment.  A typical acupuncture treatment is 45-60 minutes, so this is not nearly enough time to give appropriate quality care. This change will end up costing my acupuncture practitioner, which is not sustainable for his/her practice.  For this reason, I will not be able to receive acupuncture treatments which I rely on for (conditions you get treated for). Please reconsider this drastic move on behalf of the best interest of your members and reinstate Cigna’s previous reimbursement rates. with 
  
Sincerely,
(Patient name)

What other information can my patients add to their message to Cigna?

You may also add information about how you were helped by your acupuncturist. We code for our time so your patient can describe their experience with the visits and how they have improved from each encounter to the next.  Writing from the heart with the truth is best.

Include the following information

• Provider Name: Christian Fadgen, M.Ac., L.Ac.
• NPI: 1902127574
• Service address:
  Ease Into Acupuncture (EIN: 83-2047210)
  1131 Belair Rd, Suite L-3
  Bel Air, MD 21014
• Reason for termination:
  Insufficient Practitioner Reimbursement
• Effective Date: June 1, 2021