Release 3
2024 Program Updates — New alternative treatments list
Samaritan is pleased to promote health care freedom for every member, and we continue to support the choice to use alternative treatments.
For any Need started on or after November 1, 2024, we are implementing a list of specific alternative treatments approved for sharing. The list applies to both Classic and Basic. This will streamline processing and provide members with clarity about what will and will not be approved for sharing. We believe this is good stewardship of time and funds and provides an extra measure of accountability among the membership.
These alternative treatments must be administered by a licensed medical provider. The provider who prescribes does not have to be the same provider who enacts the treatment.
- For Needs started on or after November 1, 2024, we will not share any alternative treatment that is not on the list.
- For Needs started before November 1, 2024, we will adhere to the guidelines about alternative treatments that are in effect on the date the Need is started.
Frequently Asked Questions
For Needs started on or after November 1, 2024, this is the list of alternative treatments Samaritan will share:
- Acupuncture/Acupressure
- Chiropractic treatments and related services
- Disc decompression
- Dry needling
- Hyperbaric treatments
- Massage therapy and related services
- Ozone injections (does not include insufflation)
- Physical therapy and related services
- Platelet rich plasma/stem cells
- Prolotherapy
- SoftWave Therapy
If a member has a cancer need, this list still applies. Alternative treatments not found on this list will not be shared.
By alternative treatments, we mean treatments that meet one or more of the following:
- Do not have American Medical Association (AMA) designations
- Are not Centers for Medicaid & Medicare Services (CMS) billable
- Are classified as complementary and alternative medicine (CAM) rather than as evidence-based medicine (EBM)
Note: Any treatment that has an AMA designation, is CMS-billable, or is classified as evidence-based medicine is not considered an alternative treatment and may be shared according to other sharing guidelines.
Yes, as long as the treatment is administered by a licensed medical provider.
We consider a Licensed Medical Provider to be a medical practitioner able to lawfully diagnose and/or provide treatment under the license of his/her jurisdiction. Samaritan will only share alternative treatments performed by Licensed Medical Providers.
Examples of Licensed Medical Providers include:
- Medical Doctor (MD)
- Doctor of Osteopathy (DO)
- Doctor of Nursing Practice (DNP)
- Physician Assistant (PA)
- Nurse Practitioner, Certified Nurse Practitioner (NP, CNP)
- Registered Nurse (RN)
Certain practitioners are licensed in a particular area of medical expertise and provide treatment for the Need being shared. Certain Licensed Medical Providers we share with limitations include:
- Doctor of Chiropractic (DC) – for eligible musculoskeletal condition Needs
- Licensed Physical Therapist (LPT)
- Licensed Occupational Therapist (LOT)
- Licensed Massage Therapist (LMP)
- Audiologist (AuD)
- Dentist (DDS or DMD) – for eligible dental Needs
- Optometrist (OD) – for eligible optical Needs
- Doctor of Podiatric Medicine (DPM)
- Licensed Speech Therapist/Speech Pathologist/Registered Speech Therapist
- Licensed Acupuncturist (LAC)
- Licensed Practical Nurse (LPN)
- Midwife (CM, CNM, CPM, RM, RNM)
Certain practitioners we do not consider to be Licensed Medical Providers include:
- Nutritionist/Dietitian
- Naturopathic Doctor (ND)
- Doctor of Naturopathic Medicine (NMD)
- Doctor of Natural Medicine (DNM)
- Traditional Naturopath (TN)
- Biblical Naturopath
- Homeopath
- Psychologist
- Doctor of Oriental Medicine (DOM)
- Doctor of Pastoral Counseling (DPC)
- Doctor of Pastoral Medicine (PSCD/DPSc)
We have three main reasons for implementing this list:
- To save the membership money and thereby help keep monthly Shares lower.
- To better ensure accountability for the whole membership.
- To provide an easier Need submission process.
We take seriously the responsibility of stewarding resources well, which God has entrusted to us. The way we have handled alternative treatments is one category we knew we could improve upon. For Needs started before November 1, 2024, members have had to supply Samaritan with written, detailed information about alternative treatments, and then Samaritan staff have had to evaluate the information to determine shareability. We have done this to protect the membership from costly, ineffective treatments that are far outside the normal range of reasonable medical practices. In effect, this has been a practice to keep members accountable to the larger membership.
However, as more members have been using alternative treatments as part of their health care choices, we have found that the more common alternative treatments were being approved on a fairly consistent basis for sharing, after the evaluation process. It has made sense, then, to create a list of the most accepted, most common alternative treatments that we have typically shared. That makes the Need submission process much easier for members and staff.