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CIH Directive, VERA, CARA

CIH Directive, VERA, CARA. CIH Directive. Getting CIH into the Medical Benefits Package. Getting CIH into the Standard Medical Benefits Package. 3 Steps to provide guidance and regulatory change CIH Memo

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CIH Directive, VERA, CARA

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  1. CIH Directive, VERA, CARA

  2. CIH Directive Getting CIH into the Medical Benefits Package

  3. Getting CIH into the Standard Medical Benefits Package 3 Steps to provide guidance and regulatory change • CIH Memo • Supports CIH implementation and will initiate vetting process for CIH services through the VEC and Integrative Health Coordinating Center (IHCC) • Signed by VEC Co-Chairs May 3rd, 2016 • Signed by Dr. Shulkin (USH) on May 24th, 2016

  4. Getting CIH into the Standard Medical Benefits Package • CIH Directive – Signed by USH May 2017 2: http://vaww.va.gov/vhapublications/ViewPublication.asp?pub_ID=5401 • LIST I: evidence of promising or potential benefit • Evidence of promising or potential benefit • Vetted by IHCC Advisory Group • VA must provide a mechanism to offer these approaches either within the VA facility or in the community if they are recommended by the Veterans health care team. http://vaww.infoshare.va.gov/sites/OPCC/SitePages/IHCC-Approved-CIH.aspx

  5. Getting CIH into the Standard Medical Benefits Package • CIH Directive • LIST II: Generally Considered Safe • Requires common knowledge, throughout the expert scientific community • Both internal and external to VHA • Reasonable certainty that it is not harmful under the conditions of intended use • Optional for inclusion in VA facility, depending on capability (staff/space) at sites

  6. Approved CIH Approaches LIST I • Acupuncture • Meditation • Tai Chi • Yoga • Massage for treatment • Guided imagery • Biofeedback • Clinical hypnosis LIST II • Healing Touch • Acupressure • Alexander Technique • Reflexology • Reiki • Therapeutic Touch • Emotional Freedom Technique • Animal-assisted Therapy (under recreational therapy) an be found here: http://vaww.infoshare.va.gov/sites/OPCC/SitePages/IHCC-Approved-CIH.aspx

  7. Getting CIH into the Standard Medical Benefits Package • Regulatory Change • Regulation incorporated into Benefits Handbook • CIH as part of the medical benefits package will be set in stone • NOTE: Wrapping 139 copay exemption into the regulation change

  8. Ongoing Efforts to Help the Field Increase CIH services • Office of Community Care • Telehealth • Volunteer Services • Position Descriptions • Whole Health Partners • Whole Health Partner Supervisor • Yoga Instructor • Tai Chi Instructor • Health Coach developmental PD pending

  9. CARA: REQUIRED CIH Services

  10. CARA 5 required CIH Approaches • 5 required CIH approaches for flagship sites – to meet CARA legislation • Acupuncture • Chiropractic/osteopathic • Meditation/mindfulness • Tai Chi/Qigong • Yoga

  11. VERA

  12. VERA and Whole Health • Whole Health will be a new price category in VERA (category 4) • 6-7k per veteran • In order to qualify for that category, a Veteran needs 10 CIH/WH visits

  13. ARC Tracking CPT Codes:

  14. What Qualifies for a CIH/WH Visit? • Proposal to ARC: • CIH Specific CPT Codes –tracked independently of stop code/CHAR4 codes • Hypnotherapy, chiropractic, biofeedback, acupuncture, massage, osteopathic • Non-specific CPT Codes – tracked only in association with either CIH/whole health stop code (139/159) or a CIH/whole health CHAR4 • Track both count and non-count CIH/whole health clinics **Note: Note titles will not be used for VERA tracking

  15. What Qualifies for a CIH/WH Visit? • We will NOT have confirmation that ARC will used our proposed tracking mechanism for CIH/Whole health VERA reimbursement until ~Q3 • ARC wants to run the data in the next 2 quarters to help make a final recommendation • Once they see the data, they will make a recommendation to the NLC and final determination for what qualifies for a CIH/WH visit will be made • Their decision at that point will be retroactive to Oct 1, 2017.

  16. What Qualifies for a CIH/WH Visit? • ARC is open to our proposal, but two aspects are unprecedented: • VERA tracking with stop codes and CHAR4 codes AND • VERA tracking data in non-count clinics • Note: Field may be tempted to try to use count clinics for their whole health model since VERA reimbursement is not typical for non-count clinics • however, the true WHS model includes non-licensed providers (e.g., WH partners, WH coaches, yoga instructors, etc.) which must use non-count clinics and ARC will only agree to track them if there are data in those clinics to track –THEREFORE, we must encourage the field to stay true to the model!

  17. Quick Reminder: Business Infrastructure • Two CIH/Wellbeing Stop Codes • 159 – Either position • CIH treatment • 139 – Either position • Wellbeing approaches • Co-pay exemption regulatory change underway; Timeline 1-2 years • CHAR 4 codes • National Note Title – Integrative Health Note • https://vaww.infoshare.va.gov/sites/OPCC/Shared%20Documents/CIH%20Coding%20Guidance

  18. *can only be used with Empower Veterans Program (EVP) Pain Program

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