Go directly to legislation of specific CAM therapies in Lithuania:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) – Other treatments
Lithuania regained its sovereignty from the Soviet Union via the declaration of independence on 11 March 1990 (11). Lithuania became a member of the European Union in 2004 (11) and became a member state of the Council of Europe on 14 May 1993 (12).
The legal and regulatory status of CAM and CAM practices
Since independence, medical education has undergone substantial reforms following EU requirements and WHO recommendations (189). Only medically qualified professionals are allowed to practise CAM treatment in Lithuania (106, 190). In Regulation 1999 No. 62, homeopathy, manual therapy and reflexology are listed as medical specialties only to be practised by medical doctors (191).
Only practices offered by licensed medical professionals are regulated by the state. Any other practices (health promotion or similar) are allowed, unless they are dangerous, called “medical” or offered as treatment (190).
The State Accreditation Agency, Ministry of Health (MOH) is responsible for licensing and certification of health care professionals in both the public and private sector. Specialists require a certificate from the Ministry of Health to practice (50, 189). The act of medical practice No 68-2365 on 28 June 2004 states that a physician must have a basic licence for medical practise in some specialty. No CAM specialties are listed in the this law (190, 192).
Consequently no CAM therapists are certified by the state (190). Other specialties called “narrow specialization of medical practice” (No.V-469) are not certified by the State Accreditation Agency. The specialist only needs a certificate for fulfilled introductory course in the specific CAM practice (Order No. V-680)(190).
If the physician wants to practise legally as a CAM therapist (homeopath, manual therapist, reflexotherapist) he has to work in an institution, public or private, which is licensed to offer such therapy. An order of MOH, V-364 of 14 May 2004, lists the out-patient health care services which require a licence given by State service for accreditation in health care.
Homeopathy, manual therapy and acupuncture are the only CAM therapies listed as such services. The document was published in the Official Gazette “Valstybės žinios” No 86-3152 on 28 May 2004 (193). Other CAM treatment may be offered as “good practice” within the specialty of the physician, not as a CAM practitioner.
The National Board of Health is responsible for the coordination of health policy in Lithuania. It coordinates and regulates education and training, licensing and certification, and performance standards. The Ministry of Health is responsible for establishing standards in CME (continuing medical education) and partly funding it (189).
The list of professionals is the basis for licensing of health professionals. In the absence of licence, having an expired licence or no issued licence in the specialty, it is illegal to provide medical practice which legally is to be performed by a defined “doctor by professional qualification and the competence of health care”, including personal health condition, disease prevention, diagnosis and treatment of patients.
The governmental supervision of CAM Practices
The Medical Audit Inspectorate under the Ministry of Health, established in 1998, is involved in the establishment of medical standards and quality control with respect to health care providers (189). In the period between 1995 and 2001, the Ministry of Health, in conjunction with the Ministry of Education, the universities and the professional organizations, prepared and approved medical standards for different categories of physicians and nurses (189).
The reimbursement status of CAM practices and medicinal products
Health care, provided by public or private health care, are covered from the Compulsory Health Insurance Fund (CHIF). Acupuncture and manual therapy are included in the Health Care approved by the Ministry of Health as paid medical services. Homeopathic treatment is not reimbursed in Lithuania (41).
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.
41. ECHAMP. Homeopathy and anthroposophic medicine in the EU: Facts and Figures 2011 (Third edition). In: European Coalition on Homeopathic and Anthroposophic Medical Products, editor. Third ed. Brussels: ECHAMP E.E.I.G.; 2011.
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.
189. WHO; European Observatory on Health Systems and Policies. The Health Care Workforce in Europe; Learning from experience. The United Kingdom by The Cromwell Press, Trowbridge, Wilts: World Health Organization, 2006.
190. Dr. Gabrielle Germanavicene. Email: CAM in Lithuania. 2012.
191. Ministry of Health Lithuania; the Seimas. Resolution 1999. 5 February. No. 62 List of personal health care subspecialty of medical practice; Based on the Ministry of Health Resolution 1999 No.01 21. 3; and the performance of medical licensing and certifications. Vilnius 1999.
192. The Parliament of Lithuania. The Medical Practice Act (Official Gazette Valst., 1996, no. 102-2313, 2004, Nr. 68-2365). EUROPA 2004 [cited 2012 22 April]; Available from: www.rppc.lt/files/323/sveikatos%20prieziura.pdf.
193. Order of the Minister of health care V-364 of 14th May 2004: list of out-patient health care services which require a licence given by State service for accreditation in health care; Official Gazette “Valstybės žinios” No 86-3152 on 28th of May 2004, (2004).