Health Net seeks to cover Chinese herbs.

Is your Qi out of whack?

Woodland Hills-based Health Net might soon have you covered.

The health maintenance organization could become the first in the state to add both Chinese herbal medicine and acupuncture to its plan if the Department of Corporations approves its pending application.

While other HMOs offer some form of acupuncture coverage, the move by Health Net would be the first time that a California HMO has placed Chinese herbs on a defined formulary to be prescribed as part of acupuncture treatments.

The herbs have raised concerns from some doctors about impurities and potential harmful interactions with prescription drugs. This resistance, however, has begun to soften in recent years.

"There are two questions that have to be asked about herbs. Are they effective? Are they safe?" said Dr. Brian Fennen, president of the California Association of Acupuncture and Oriental Medicine. "Doctors have been fed a lot of propaganda that herbs are dangerous. They're not, if you prescribe them properly."

The battle for state approval has gone on for more than a year. Health Net has persevered under the belief that offering the alternative medicines would attract more enrollees.

But the Department of Corporations has repeatedly returned the HMO's petition for coverage and asked for more specific information about practices that would be included under the plan.

Department spokeswoman Julie Stewart said she could not comment on the status of the confidential review proceedings. She said the state has no definitive timetable on when the review process would be completed.

If the plan goes through, a Health Net enrollee could qualify for up to $500 worth of Chinese herbs a year to supplement acupuncture coverage.

Acupuncture is based on the theory that everyone has Qi, an internal energy source that flows through the body. By inserting needles into specific points, Qi presumably can be routed to areas of pain and speed the healing process. Practitioners then administer Chinese herbs for follow-up care.

"The public in California is very diversified," said Marilyn Nielsen, executive director of the acupuncture division at the state Department of Consumer Affairs. "There's a place for Western medicine and a place for acupuncture, and the public is demanding both. That's why the big HMO companies are starting to cover it."

Health Net definitely senses an untapped market for the services. Though it has offered acupuncture for several years, the company believes that adding Chinese herbs and acupuncture to its comprehensive coverage will attract even more devotees.

"The profession has been fighting for years to get insurance," Fennen said. "Most people we see are upper middle-class, educated people. If the Health Net deal goes through, that opens us up to everybody across the spectrum."

In time, Hearth Net estimates, as many as 700,000 of its members could seek traditional Chinese medicine treatments.

Kathy Baffone, Health Net's product development manager, said that if the plan is approved, patients would be allowed to see any of the 700 licensed acupuncturists under contract with Health Net.

There are 6,700 licensed acupuncturists in California, according to the Department of Consumer Affairs. The accreditation process requires a master's degree from a state-licensed acupuncture school and 3,000 hours of clinical training. Practitioners also must pass a state exam that includes questions on acupuncture and herbology.

Baffone said the HMO has taken precautions to ensure that all the acupuncturists under contract are licensed and qualified to dispense herbs.

"All of us who are involved with traditional Chinese medicine have reached a point where now we're really very comfortable with it," Baffone said. "There's a learning curve - it's more than just a basic level of knowledge. The DOC is going through the same learning process."

Fennen said recent media reports about the dangers of the Chinese herb Ma Huang and its possible connection to heart attacks have raised unnecessary concerns. "The base of Ma Huang is ephedrine, which is a stimulant," he said. "But you'd have to eat a lot of the stuff to do harm."

Dr. Yong K. Pak, who has been a licensed acupuncturist for 19 years and works at L.A.'s Shanghai Acupuncture Clinic, says the inclusion of herbal supplements in health care plans is essential to completing proper acupuncture care.

"Hopefully we can get insurance in both acupuncture and herbs," he said. "Very few companies recognize how it works. The herbs are very effective and some are better than (Western) chemicals."

Among the herbs Pak recommends are wild ylang, ginseng and suk ti wang, which he said serve to purify the internal organs. Each patient receives a hand-tailored dosage of the supplements based on their specific complaint.