News – New regulation found after the CAMbrella deliveries:
The Regional Council of Emilia-Romagna Region has on May 5, 2013 passed new regulation on acupuncture.
The Regional Council of Emilia-Romagna Region, the Department of Health Policy, has passed the Resolution No 741, 26/05/2014 on “Approval of regional guidelines for the provision of professional services of Unconventional Medicine in the Region Emilia-Romagna whose deliverability is the responsibility of the regional health fund. Appointment of members of the Regional Observatory for Unconventional Medicine” (331).
The Emilia Romagna Regional Government has included acupuncture in the Essential Level of Care (LEA) of the Regional Health Service (RHS) for two indications: prevention of headache (migraine and tension type headache) and treatment of low back pain). Each Local Unit of the RHS must implement clinics able to offer this treatment to patients referred by their GPs or other specialists. It’s a first step toward integrative care in RHS.
The Regional Observatory for Unconventional Medicine (OMNCER), established by Resolution 297/2004, is prolonged until June 30, 2016. The program supports the integration of alternative and conventional treatments into the conventional care pathways of health services. OMNCER addresses selects and proposes the priority health-care fields and the unconventional treatments worth to be included (experimentally or definitively) in the RHS; moreover, OMNCER is involved in monitoring the implementation of the new services and in promoting their quality.
Notice! All text below is copied from the CAMbrella report – delivered Dec 31, 2012
In this summary, you will find:
- Direct links to the legislation of specific CAM therapies in Italy
- The legal and regulatory status of CAM and CAM practices in Italy
- The governmental supervision of CAM practices in Italy
- The reimbursement status of CAM practices and medicinal products in Italy
Go directly to legislation of specific CAM therapies in Italy:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) – Other treatments
Italy was a founding member of the European Union in 1957 (11) and a founding member of the Council of Europe on 5 May 1949 (12).
The legal and regulatory status of CAM and CAM practices
Italy has no general CAM legislation. The Italian Parliament and government have several times been requested to pass CAM legislation (28, 168). The Supreme Court of Justice (Suprema Corte di Cassazione (1982, 1999, 2003, 2005, 2007) has ruled that Non- Conventional Medicines may be practised only by medical doctors. The Supreme court stated that acupuncture is a medical act, homeopathic remedies must be prescribed only by medical doctors and it is an infringement of medical powers for anyone without a degree in medicine to practise Traditional and Non-Conventional Medicines (169, 170, 171, 172).
The Italian “National Federation of the Orders of Doctors and Dentists” (Federazione Nazionale Ordini dei Medici Chirurghi e Odontoiatri) (FNOMCeO) has by statement of 18 May 2002 urged the Italian Parliament to approve legislation of practice as a responsibility of a medical doctor, a dentist or regulated health professionals for the following treatments: Acupuncture, Traditional Chinese medicine, ayurvedic medicine, homeopathic medicine, anthroposophic medicine, homotoxicology, phytotherapy, chiropractic and osteopathy (28, 168).
The professional ethical code for medical doctors and dentists, approved 16 December 2006, article 15, confirms the following statement adopted in 2002: “physicians must not collaborate in any way with, or promote the activities of any person who is not a physician in the professional practice on Non-Conventional Medicines (in Italy)”(173).
The Permanent Conference of the Deans and Presidents of the Italian Schools of Medicine
issued on July 2011 its position paper saying that the acquisition of skills related to CAM is not an educational goal of the Degree in Medicine at the Italian Schools of Medicine, quoting the Italian text is “L’acquisizione di competenze relative alle CAM non rappresenta un obiettivo didattico del Corso di Laurea in Medicina.”
“Non-medically qualified practitioners can be prosecuted under Article 348 of the Italian Penal Code, although this rarely occurs”(28).
The governmental supervision of CAM Practices
We have found no specific governmental supervision regulations of CAM practice in Italy.
The reimbursement status of CAM practices and medicinal products
CAM in general is not included in the national health insurance service (60). If decided by the regional health authorities, CAM treatments provided by medical doctors may be
reimbursed by both public and private insurance companies. Chiropractic may be
Each Italian region has its own reimbursement regulation on medical acts
(21). In some Italian regions acupuncture treatment is covered by the national health
insurance system (106). Anthroposophic treatment is partially covered only by private
insurance (106). Homeopathy treatment is covered by private insurance (106).
11. EUROPA. Gateway to the European Union; member countries. Brussels EUROPA
Communication department of the European Commission; 2011 [cited 2011 November 3]; Available from: http://europa.eu/about-eu/countries/index_en.htm.
12. Council of Europe. Council of Europe. Strasbourg: Council of Europe; 2011 [cited 2011
November 7]; Available from: http://www.coe.int/lportal/web/coe-portal.
21. Maddalena S. Alternative medicines: on the way towards integration?; A comparative legal analysis in Western countries. Bern: University of Neuchâtel School of Law and Economics, Peter Lang Pub, Inc; 2005. 648 p.
28. ECH (European Committee for Homeopathy). ECH in European Countries. Brussels: ECH; 2011 [cited 2011 September 12]; Available from: http://www.homeopathyeurope.org/countries.
43. Ersdal G, CAM-CANCER consortium. How are European patients safeguarded when using complementary and alternative medicine (CAM)? Jurisdiction, supervision and reimbursement status in the EEA area (EU and EFTA) and Switzerland. Tromsø: NAFKAM, University of Tromsø 2005 28 October Report No.: Report CAM 21.11.05-1.doc.
60. ECHAMP. Homeopathic and Anthroposophic Medicine: Facts and Figures. Second Edition ed: ECHAMP E.E.I.G: European Coalition on Homeopathic and Anthroposophic Medicinal Products E.E.I.G; 2007.
106. CAMDOC Alliance ECH ECPM ICMART and IVAA. The regulatory status of Complementary and Alternative Medicine for medical doctors in Europe. Brussels 2010 January 2010. Report No.: 2010.
168. Roberti di Sarsina P, Iseppato I, editors. Non Conventional Medicine within the Italian Medical Profession. ECIM 2011; 2011; Berlin.
169. Roberti di Sarsina P, Iseppato I. Traditional and Non Conventional Medicines: the Socioanthropological and Bioethical Paradigm for Person-Centred medicine. The Italian context. EPMA. 2011;2:439-49.
170. Roberti di Sarsina P, Iseppato I. State of Art of the Regulative Situation of Non Conventional Medicines in Italy. The Journal of Alternative and Complementary Medicine 2010;16(2):141-2.
171. Roberti di Sarsina P, Iseppato I. Looking for a Person-Centered Medicine: Non Conventional Medicine in the Conventional European and Italian Setting. Evidence-Based Complementary and Alternative Medicine 2011;2011.
172. Roberti di Sarsina P, Iseppato I. Non-Conventional Medicine in Italy: The present situation. European Journal of Integrative Medicine. 2009;1(2):65-71.
173. Nuzzi R. Non Conventional Medicine in Italy. History, Problems, Prospects for Integration. Evidence-Based Complementary and Alternative Medicine. 2008;5(4):491-2.