Humana Complementary and Alternative Medicine Form

Description

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices and products that are not generally considered to be part of conventional medicine (eg, Western medicine). In general, CAM can be separated into two main subgroups: nutritional approaches and psychological and/or physical approaches. CAM assessments and therapies purportedly reduce disease based clinical symptoms and improve health and wellness.

• Nutritional approaches include a variety of products, such as herbs (eg, botanicals), probiotics, vitamins and minerals. They are widely marketed, readily available and often sold as dietary supplements.³⁷
• Psychological and/or physical approaches use a variety of techniques such as hypnosis, massage, meditation, music and relaxation therapy. These approaches are often administered or taught by a trained practitioner or teacher.³⁷
• Other complementary health approaches may not fit into either of the above groups. Examples may include the practices of traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy and naturopathy.³⁷

For information regarding coverage determination/limitations not addressed in this medical coverage policy, please refer to the following:

Coverage Determination

Any state mandates for CAM take precedence over this medical coverage policy.

Please refer to specific certificate language to determine benefit availability and terms and conditions of coverage for CAM as it may be excluded in some certificates.

Services provided by a psychiatrist, psychologist or other behavioral health professionals are subject to the provisions of the applicable behavioral health benefit.

The following are generally considered alternative medicine and may be excluded by certificate. Please consult the member’s individual certificate regarding Plan coverage.

For those Plans that do not specifically exclude CAM, these are considered experimental/investigational as they are not identified as widely used and generally accepted for the proposed uses as reported in nationally recognized peer-reviewed medical literature published in the English language.

CAM Practices and Products

• Acupressure: Bodywork therapy in which the practitioner uses their fingers, palms, elbows or feet, or special devices to apply pressure to acupoints on the body's meridians.
• Alexander’s Technique: Bodywork technique in which physical alignment is taught by mentally focusing on the way correct alignments should look and feel through touch and verbal guidance by the practitioner.
• Amma Therapy: Focuses on moving Qi (energy) in the body by accessing acupoints along the body’s meridians. Therapists use their fingers to manipulate these points, combined with a deep, circular, therapeutic massage technique.

• Antineoplastons: Composed of chemical compounds that are naturally present in the urine and blood purported to provide a natural biochemical substance that is excreted and therefore lacking in people with cancer.
• Apitherapy and Bee Sting Therapy: The use of products derived from bees as medicine, including venom, honey, pollen and royal jelly.
• Applied Kinesiology (AK): Treatment that uses nutrition, physical manipulation, vitamins, diets and exercise to restore and energize the body. Weak muscles are proposed as a source of dysfunctional health.
• Aromatherapy: Concentrated mixtures of naturally occurring aromatic, volatile compounds extracted from plants through a distillation process.
• Art Therapy: The encouragement of free self-expression through painting, drawing or modeling.
• Ayurveda: Health system that originated in India and incorporates the body, mind and spirit to prevent and treat disease. Includes special types of diets, herbs and minerals.
• Bovine Cartilage Products: Cow cartilage as a dietary supplement.
• Buteyko Breathing Technique: A series of reduced breathing exercises that focus on nasal breathing, breath holding and relaxation.

CAM Practices and Products

• Cancell/Cantron/Protocel Cancer Therapy (also referred to as Sheridan’s Formula, Jim’s Juice, JS-114, JS-101, 126-F): A liquid produced in various forms and can be administered orally, rectally and topically. Purported therapy for cancer and a wide range of other diseases. Exact composition is unknown.
• Cellular Therapy (Fresh Cell Therapy): Injection or ingestion of tissue (eg, cartilage, embryonic, organs, fetal, glandular) obtained from animal (eg, sheep, cow and shark) tissues.
• Chakra Healing/Balance: The process of restoring a harmonious flow of energy across the chakra system (each of the centers of spiritual power in the human body, usually considered to be seven in number).
• Chelation Therapy: Involves the removal—through intravenous infusion of a chelating agent (synthetic amino acid ethylenediamine tetraacetic acid [EDTA])—of heavy metals, including lead, nickel and cadmium, as a way to treat certain diseases.
• Colonic Irrigation, Colonic Lavage, Colonic Cleansing: A procedure to wash out or lavage material on the walls of the bowel to an unlimited distance without inducing defecation.
• Color Therapy/Chromotherapy: The visible spectrum of light and color is used to affect a person’s mood and physical or mental health.
• Craniosacral Therapy: A noninvasive osteopathic technique designed to increase flow of cerebrospinal fluid through the application of gentle pressure on the bones of the head, spine and pelvis.
• Crystal Healing: The practitioner places crystals on different parts of the body, often corresponding to chakras; or the practitioner places crystals around the body in an attempt to construct an energy grid, which is purported to surround the client with healing energy.
• Cupping: A therapy in which heated glass cups are applied to the skin along the meridians of the body, creating suction as a way of stimulating the flow of energy.

Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

CAM Practices and Products

• Ear Candling: Hollow cones that are about 10 inches long and made from a fabric tube soaked in beeswax, paraffin or a mixture of the two. Warmth created by the lit device purportedly produces suction that draws wax and other impurities out of the ear canal.
• Essiac (tea): Health tonics or herbal dietary supplement reported to contain four herbs: burdock root (Arctium lappa L.), Indian rhubarb root (Rheum palmatum L., sometimes known as Turkish rhubarb), sheep sorrel (Rumex acetosella L.) and the inner bark of slippery elm (Ulmus fulva Michx. [synonym Ulmus rubra]).
• Faith Healing: Healing by religious belief and prayer.
• Feldenkrais Therapy: A bodywork technique that integrates physics, judo and yoga. The practitioner directs sequences of movement using verbal or hands on techniques or teaches a system of self-directed exercise to treat physical impairments through the learning of new movement patterns.
• Float Therapy (Sensory Deprivation Tank): A lightless, soundproof tank filled with salt water at skin temperature, in which an individual floats.
• Gerson Therapy: An organic vegetarian diet plus nutritional and biologic supplements, pancreatic enzymes and coffee or other types of enemas are the main features.
• Guided Imagery: Technique in which an individual focuses on mental images in order to evoke feelings of relaxation to improve emotional and physical health.
• Hellerwork: A bodywork technique that treats and improves proper body alignment through the development of a more complete awareness of the physical body. The goal is to realign fascia for improvement of standing, sitting and breathing using body energy, verbal feedback and changing emotions and attitudes.
• Herbal Supplements/Medicine: Use of plants or plant extracts in the form of extracts, tinctures, teas, capsules and tablets.

Complementary and Alternative Medicine Effective Date: 08/24/2023 Revision Date: 08/24/2023 Review Date: 08/24/2023 Policy Number: HUM-0564-006 Page: 6 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

• Histamine Therapy: Use of intravenous or subcutaneous histamine as a type of desensitization therapy.
• Holistic Medicine: Care of the whole individual (eg, body, mind, emotions, spirit and relationships) in the context of the individual’s values, beliefs, culture and community by integrating conventional and alternative therapies to prevent and treat disease.
• Homeopathy: A form of treatment in which substances (eg, minerals, plant extracts, chemicals or disease producing germs), which in sufficient doses would produce a set of illness symptoms in a healthy individual, are given in small, highly diluted quantities to purportedly produce a cure of those same symptoms, based on the theory that like cures like.
• Hypnosis/Hypnotherapy: Trance-like state in which one becomes more aware and focused and is more open to suggestion and can concentrate more clearly on a specific thought, feeling or sensation without becoming distracted.
• Iridology: Patterns, colors and other characteristics of the iris can be examined to purportedly determine information about an individual’s systemic health.
• Iscador (Mistletoe Extract): The berries, leaves and stems of mistletoe are used to make extracts.
• Kelley-Gonzales Therapy: A program of dietary restriction, intake of digestive aids (eg, pepsin and pancreatic enzymes) and frequent coffee enemas.
• Laetrile/Amygdalin/Vitamin B-17: A chemical found in the pits of many fruits and in numerous plants (eg, raw nuts, lima beans, clover and sorghum).

• Leech Therapy/Hirudotherapy: One or more leeches are attached to the skin of the problematic area and purported to gain potential benefits of leech saliva that is secreted while the leeches are feeding.
• Macrobiotics: The use or theory of a macrobiotic diet (high-complex carbohydrate, low fat vegetarian diet).

Complementary and Alternative Medicine Effective Date: 08/24/2023 Revision Date: 08/24/2023 Review Date: 08/24/2023 Policy Number: HUM-0564-006 Page: 7 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

CAM Practices and Products

• Magnet Therapy: Magnets are placed directly on the skin to purportedly stimulate living cells and increase blood flow by ionic currents that are created from polarities on the magnets.
• Massage Therapy (Remedial Massage/Visceral Massage): Manual manipulation of soft body tissues (eg, muscle, connective tissue, tendons and ligaments).
• Meditation/Transcendental Meditation (TM): A practice where an individual uses a technique, such as focusing their mind on a particular object, thought or activity, to achieve a mentally clear and emotionally calm state.
• Megavitamin Therapy: Use of large doses of vitamins, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat diseases.
• Mesotherapy: Technique that uses injections of vitamins, enzymes, hormones and plant extracts into the mesoderm (middle layer) of skin, to purportedly rejuvenate and tighten skin as well as remove excess fat.
• Mineral Supplement: Dietary supplement.
• Mirror Box Therapy: Viewing the reflection of the intact limb in place of the amputated limb is purported to help an individual that feels they still have a pain in the limb after having it amputated (phantom limb pain).
• Moxibustion Therapy: Procedure involving the use of heat by burning the herb Artemisia vulgaris (dried mugwort) on particular points of the body.
• Music Therapy: The use of music in an either active or passive mode to purportedly reduce stress, anxiety and pain.
• Myotherapy: Focuses on treating the soft and connective tissues of the body drawing on a variety of modalities.

Complementary and Alternative Medicine Effective Date: 08/24/2023 Revision Date: 08/24/2023 Review Date: 08/24/2023 Policy Number: HUM-0564-006 Page: 8 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

CAM Practices and Products

• Naprapathy: Employs gentle manipulation of ligaments, tendons and muscles, noninvasive therapeutic modalities, nutritional counseling and exercise in the treatment of pain.
• Naturopathy: A health system that includes practices that emphasize diet, nutrition, homeopathy, acupuncture, herbal medicine, manipulation and various mind-body therapies.
• Neural Therapy: Strategically placed injections of a local anesthetic to purportedly restore normal energy flow and to let the body heal itself.
• Over-the-Counter Biologics: A product that is produced from living organisms or contain components of living organisms.
• Ozone Therapy: Purports to increase the amount of oxygen in the body through the introduction of ozone, which is a colorless unstable toxic gas with a pungent odor and powerful oxidizing properties, formed from oxygen by electrical discharges or ultraviolet light. It differs from normal oxygen (O2) in having three atoms in its molecule (O3).
• Pilates: An educational and exercise approach using the proper body mechanics, movements, truncal and pelvic stabilization, coordinated breathing and muscle contractions to promote strengthening.

• Polarity Therapy: Purported to restore a balanced distribution of the body's energy and incorporating manipulation, exercise and dietary restrictions.
• Primal Therapy: Focuses on an individual’s earliest emotional experiences and encourages verbal expression of childhood trauma.
• Probiotic Supplements: Live microorganisms (eg, bacteria, yeast), that are similar to beneficial microorganisms found in the human gut that can be consumed through fermented foods or supplements. They are also called friendly bacteria or good bacteria.

Complementary and Alternative Medicine Effective Date: 08/24/2023 Revision Date: 08/24/2023 Review Date: 08/24/2023 Policy Number: HUM-0564-006 Page: 9 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

CAM Practices and Products

• Psychodrama: Therapy which an individual uses role playing, to act out events from their past and dramatic self-presentation to investigate and gain insight into their lives.
• Qigong: A form of Chinese exercise stimulation therapy that proposes to improve health by redirecting mental focus, breathing, coordination, and relaxation. The goal is to rebalance the body's own healing capacities by activating proposed electrical or energetic currents that flow along meridians located throughout the body. In Chinese medical training and practice this therapy includes external Qi, which is energy transmitted from one person to another so as to heal.
• Ream's Testing: Laboratory test kit purported to analyze chemical, digestive and nutritional imbalances within the body.
• Reflexology (Reflexotherapy/Zone Therapy): A bodywork technique that uses reflex points on the hands and feet. Pressure is applied at points that correspond to various body parts, to eliminate blockages thought to produce pain or disease.
• Regenokine/Orthokine Therapy: An individual’s own blood is extracted, manipulated and then reintroduced to the body as an anti-inflammatory drug to purportedly reduce chronic pain and osteoarthritis.
• Reiki: The practitioner serves as a conduit for healing energy directed into the body or energy field of the recipient without physical contact with the body.
• Relaxation Response: A physical state of deep rest that purportedly changes a person's physical and emotional responses to stress.
• Revici’s Guided Chemotherapy: Individually guided chemotherapy using lipid and lipid-based substances.
• Rife Therapy/Rife Machine: Electrical pads are placed on either the feet or hands. These pads are attached to a machine, which produces electrical impulses purported to kill or disable diseased cells.

Complementary and Alternative Medicine Effective Date: 08/24/2023 Revision Date: 08/24/2023 Review Date: 08/24/2023 Policy Number: HUM-0564-006 Page: 10 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

CAM Practices and Products

• Rolfing: A bodywork technique that involves the myofascia. The body is realigned by using the hands to apply deep pressure and friction that allow more sufficient posture, movement and the release of emotions from the body.
• Rubenfeld Synergy Method (RSM): A technique that combines elements of bodywork with talk therapy.
• Salt Room Therapy/Halotherapy: Uses dry aerosol microparticles of salt or minerals to simulate the microclimate of salt mines to purportedly treat respiratory and skin conditions.
• Shark Cartilage Products: Shark cartilage as a dietary supplement.

CAM Practices and Products

• Shiatsu: A Japanese bodywork technique involving finger pressure at specific points on the body mainly to balance energy in the body. The major focus is on prevention by keeping the body healthy. The therapy uses more than 600 points on the skin that are proposed to be connected to pathways through which energy flows.
• Tai Chi: A technique that uses slow, purposeful motor physical movements of the body to control and achieve a more balanced physiologic and psychological state.
• Telomere Testing: Laboratory testing telomere length.
• Therapeutic Touch: A body energy field technique in which hands are passed over the body without actually touching to recreate and change proposed energy imbalances for restoring innate healing forces.
• Thermogenic Therapy: Production of artificial fever.
• Thought Field Therapy (TFT) (Callahan Techniques Training): Tapping on meridian points on the body, purported to release energy blockages that cause negative emotions.
• Traditional Chinese Medicine: An ancient form of medicine that focuses on prevention and disease with an emphasis on maintaining balance through the body by stimulating a constant, smooth-flowing Qi energy. Herbs, acupuncture, massage, diet and exercise are also used.

Complementary and Alternative Medicine Effective Date: 08/24/2023
Revision Date: 08/24/2023
Review Date: 08/24/2023
Policy Number: HUM-0564-006 Page: 11 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.

• Trager: A bodywork technique in which the practitioner enters a meditative state and guides the individual through gentle, light, rhythmic, nonintrusive movements. Simple, active, self-healing movement exercises are taught to an individual.
• Trichuris Suis (T. suis) Ova Therapy: Ingestion of the T. suis ova (eggs) as purported therapy for disease and allergy.
• Tui Na: Traditional Chinese Medicine (TCM) therapeutic massage and body work.
• Vibrational (Flower) Essences: Nonaromatic liquid solutions purportedly infused with the life force, energy patterns and consciousness of their source.
• Whole Body Vibration: An individual stands on a platform that produces vibrations.
• Wilderness Programs/Outdoor Behavioral Healthcare (OBH)/Adventure Therapy: Immersion in the wilderness or wilderness like setting, group living with peers, individual and group therapy sessions, and educational and therapeutic curricula, including backcountry travel and wilderness living skills.
• Yoga: Mind-body exercises that generally includes postures, breathing techniques and meditation.

Note: The criteria for CAM are not consistent with the Medicare National Coverage Policy and therefore may not be applicable to Medicare members. Refer to the CMS website for additional information.

Background

Additional information about CAM may be found from the following websites:

• National Center for Complementary and Integrative Health
• National Library of Medicine

Medical Alternatives

Physician consultation is advised to make an informed decision based on an individual’s health needs.

Complementary and Alternative Medicine Effective Date: 08/24/2023
Revision Date: 08/24/2023
Review Date: 08/24/2023
Policy Number: HUM-0564-006 Page: 12 of 24

Humana's documents are updated regularly online. When printed, the version of this document becomes uncontrolled. Do not rely on printed copies for the most up-to-date version. Refer to Medical and Pharmacy Coverage Policies to verify that this is the current version before utilizing.