Matters in Healthcare: Is acupuncture regulated? What about co-pays?

Question: I have tried lots of traditional treatments to resolve my chronic back pain, but I’m still suffering. Friends have suggested that I try acupuncture to relieve the pain, but how do I know if my acupuncturist is credibly trained?

Answer: Chronic pain is frustrating and can be debilitating for patients, but your first port-of-call for a health concern that is not a serious or life-threatening emergency, should be your general practitioner (GP). 

From your question it sounds like you have already explored the extent to which your GP and other medical specialists can assist with your pain. Acupuncture falls within the category of Complementary and Alternative Medicine (CAM) in Bermuda and is not currently regulated. 

Physicians, nurses and dentists, on the other hand, are regulated professionals. 

These professionals are subject to legislated requirements regarding qualifications and scopes of practice. They include, for example, the Medical Council, which is governed by the Medical Practitioners Act 1950.

In Bermuda currently CAM professionals are not subject to legislation regarding credentials or practice standards. 

There are, however, very active professional associations which will vet the credentials and practice standards of their members. For example, the Bermuda Massage Therapy Association ensures that their members: have attended an accredited school in Canada, the US or the UK; complete clinical and academic requirements; hold a license, certificate or registration in their professions; and possess valid CPR certification. 

Regarding your question on acupuncture in Bermuda, the modality is overseen by the Acupuncture and Oriental Medicine Association. 

To a suitably qualified acupuncturist you may contact the Chairperson of the Association. You may find this information on BHeC’s website under Professional Bodies: www.bhec.bm/for-professionals/professional-bodies/

Before you visit your CAM professional, however, you may also want to check with your insurance company whether your visit will be covered by your policy. Insurers are not required to cover CAM services and policies vary, so it’s worth checking before you go. 

Q: I went for a health visit this week and my [healthcare provider] charged me more than $50, as well as what they will be submitting to my insurance company. Is there any regulation on how much a provider can charge on top of what they are reimbursed from an insurance company?

Answer: No, in most cases. The $50 that you mention is the amount a healthcare provider charges as a co-pay. A co-pay is quite simply the difference between what your insurance company will pay a provider for their service, and the total cost of a visit.

Most healthcare fees and coverage are not regulated in Bermuda.  This means each party in the health system can set their rates. 

The exception to this is that most hospital-based treatment and some diagnostic tests are regulated and have fees set by Government. Regulated fees exist for treatments covered by the Standard Hospital Benefit, and hospital-based work by private physicians and dentists. 

These fee schedules set the maximum that can be charged, prohibit a co-pay for these services and stipulate who can provide the service. Regulated fees are published on BHeC’s website under Fee Schedules: www.bhec.bm/for-professionals/fee-schedules-2/.

Jennifer Attride-Stirling is the CEO of the Bermuda Health Council.