Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
【United Daily News / Li Dexian, Traditional Chinese Medicine Practitioner】2012.04.17
Over a year ago, when I opened my TCM clinic, I originally planned to offer tuina (massage therapy) as a self-paid service. At the time, the health bureau explicitly informed me that I could not set up a natural therapy area (with tuina practitioners) and that existing clinics with tuina practitioners must remove them by the end of April 2012, with no violations allowed.
Yet, some clinics still operate nearby, offering tuina for just an additional NT$10 under the national health insurance. Others exploit legal loopholes (such as setting up hidden rooms within clinics) to continue claiming health insurance reimbursements. Since enforcement has been lax, almost no clinics have been penalized for violations. However, many TCM clinics, having tasted the benefits, rely on tuina practitioners to generate profits—how could they give up such a lucrative opportunity?
I, on the other hand, have adhered to the policy and refrained from hiring tuina practitioners. After struggling for nearly two years (while nearby TCM clinics with tuina practitioners thrived), the policy is now set to reverse. How am I supposed to feel about this? In reality, many TCM clinics have already complied with government policies. Some clinics that relied entirely on tuina practitioners have closed, while others have laid off their tuina staff. Many law-abiding TCM practitioners have even taken up tuina themselves.
Some tuina practitioners often claim during sessions that a patient’s spine is misaligned or that nerves are being compressed, using pseudo-medical explanations. However, most consumers are simply there for a free massage. Using national health insurance resources for such purposes is inappropriate in both scenarios.
Currently, most tuina claims in TCM clinics are filed under acupuncture services because patients don’t have to pay the NT$50 co-payment. If filed under orthopedic services, patients would incur this fee. As a result, TCM practitioners often ask patients whether they’d prefer a free acupuncture session (with no NT$50 charge) instead of tuina—some even file tuina as acupuncture without performing any needling. Most patients opt to save NT$50 and endure a needle prick. The health insurance bureau has never audited these fraudulent claims, leading to substantial long-term losses.
I know several tuina practitioners who rent TCM licenses to operate and have already made hefty profits. At one clinic, two TCM practitioners were hired, and one female doctor even asked me, “What should we do when the April deadline arrives?” Long-term practitioners who have grown accustomed to simply signing off on paperwork are the biggest victims of this tuina practitioner withdrawal—many lack expertise in orthopedics, acupuncture, let alone internal medicine. Another male classmate of mine, a post-baccalaureate TCM graduate whose father is also a TCM practitioner, opposed the removal of tuina practitioners. I was puzzled—how could someone with formal training say such a thing? Turns out, he too relied on tuina practitioners to make money.
If tuina practitioners are allowed to assist TCM doctors, should pharmacists in hospitals or clinics also be permitted to hire assistants to dispense medication? Should nurses be allowed to have aides administer injections?
Over the past two years, the public has largely become aware that they can no longer exploit health insurance for free massages. Now, officials don’t want to be the “bad guys,” and the new regulations propose allowing independent, self-paid tuina rooms within clinics. However, there’s no guarantee that medical acts won’t occur or that health insurance claims won’t be filed—after all, the health insurance bureau has audited zero violations in this area over the past two years.
Personally, I oppose allowing tuina practitioners in TCM clinics, even under the guise of self-paid services in separate rooms. The potential for misconduct is too high, and the public may perceive it as another form of price inflation—damaging both clinic and government reputations.
Source: http://udn. com/ NEWS/ OPINION/ X1/ 7032632. shtml#ixzz1sH1gxGQP
Free Massage on Health Insurance
Over a year ago, when I opened my TCM clinic, I originally planned to offer tuina (massage therapy) as a self-paid service. At the time, the health bureau explicitly informed me that I could not set up a natural therapy area (with tuina practitioners) and that existing clinics with tuina practitioners must remove them by the end of April 2012, with no violations allowed.
Yet, some clinics still operate nearby, offering tuina for just an additional NT$10 under the national health insurance. Others exploit legal loopholes (such as setting up hidden rooms within clinics) to continue claiming health insurance reimbursements. Since enforcement has been lax, almost no clinics have been penalized for violations. However, many TCM clinics, having tasted the benefits, rely on tuina practitioners to generate profits—how could they give up such a lucrative opportunity?
I, on the other hand, have adhered to the policy and refrained from hiring tuina practitioners. After struggling for nearly two years (while nearby TCM clinics with tuina practitioners thrived), the policy is now set to reverse. How am I supposed to feel about this? In reality, many TCM clinics have already complied with government policies. Some clinics that relied entirely on tuina practitioners have closed, while others have laid off their tuina staff. Many law-abiding TCM practitioners have even taken up tuina themselves.
Some tuina practitioners often claim during sessions that a patient’s spine is misaligned or that nerves are being compressed, using pseudo-medical explanations. However, most consumers are simply there for a free massage. Using national health insurance resources for such purposes is inappropriate in both scenarios.
Currently, most tuina claims in TCM clinics are filed under acupuncture services because patients don’t have to pay the NT$50 co-payment. If filed under orthopedic services, patients would incur this fee. As a result, TCM practitioners often ask patients whether they’d prefer a free acupuncture session (with no NT$50 charge) instead of tuina—some even file tuina as acupuncture without performing any needling. Most patients opt to save NT$50 and endure a needle prick. The health insurance bureau has never audited these fraudulent claims, leading to substantial long-term losses.
I know several tuina practitioners who rent TCM licenses to operate and have already made hefty profits. At one clinic, two TCM practitioners were hired, and one female doctor even asked me, “What should we do when the April deadline arrives?” Long-term practitioners who have grown accustomed to simply signing off on paperwork are the biggest victims of this tuina practitioner withdrawal—many lack expertise in orthopedics, acupuncture, let alone internal medicine. Another male classmate of mine, a post-baccalaureate TCM graduate whose father is also a TCM practitioner, opposed the removal of tuina practitioners. I was puzzled—how could someone with formal training say such a thing? Turns out, he too relied on tuina practitioners to make money.
If tuina practitioners are allowed to assist TCM doctors, should pharmacists in hospitals or clinics also be permitted to hire assistants to dispense medication? Should nurses be allowed to have aides administer injections?
Over the past two years, the public has largely become aware that they can no longer exploit health insurance for free massages. Now, officials don’t want to be the “bad guys,” and the new regulations propose allowing independent, self-paid tuina rooms within clinics. However, there’s no guarantee that medical acts won’t occur or that health insurance claims won’t be filed—after all, the health insurance bureau has audited zero violations in this area over the past two years.
Personally, I oppose allowing tuina practitioners in TCM clinics, even under the guise of self-paid services in separate rooms. The potential for misconduct is too high, and the public may perceive it as another form of price inflation—damaging both clinic and government reputations.
Source: http://udn. com/ NEWS/ OPINION/ X1/ 7032632. shtml#ixzz1sH1gxGQP