AMTA-WA December 2023 Public Policy Report

Prepared by Leslie Emerick, AMTA-WA Lobbyist             

Legislative/Political Landscape       

Legislators were in Olympia for the Fall Legislative Days at the end of November and the first week of December. I met with many members of the House and Senate Health Care Committees to discuss our legislative agenda for the 2024 session. Legislators are already pre-filing bills for the next session and I will begin tracking bills that impact massage therapy related issues.

Session begins on January 8^th, 2024 and the 60-day short session of the legislature goes quite quickly so its nice to get these meeting scheduled now.

The Senate Health & Long Term Care and the House Health Care & Wellness committees met.They had a worksessions on telemedicine and the health care workforce and more!

2024 Bills Potentially Still under Consideration from 2023 Session

HB 1655 AN ACT Relating to provider contract compensation: AMTA-WA supported this bill during the 2023 legislative session and will continue to support in the 2024 session. It would require insurers to give providers who are not attached to a hospital, or hospital affiliate, fee schedule increases related to the Consumer Price Index. We are trying to address the low reimbursement rates which pushes some providers out of the insurance system to taking only direct reimbursement from their patients. I am participating in a coalition of health care providers to support this legislation.

HB 1437 – 2023-24 Concerning the interstate massage compact

Sponsors: Kloba, Ybarra, Leavitt, McEntire, Reeves, Jacobsen, Ryu, Caldier, Macri, Reed

Why AMTA Opposes the Interstate Massage Compact (IMpact): For the past several years, AMTA has been actively participating as part of the Technical Advisory Group (TAG) to help guide the direction of the Interstate Massage Compact (IMpact) legislation. The IMpact’s purpose is to support the mobility of licensed massage therapists across the country and to ease the existing burdens of license portability. All along the way, AMTA’s position has been to allow our membership, on a state-by-state basis, to guide our involvement in supporting and advocating for the enactment of the IMpact. During this time, we have heard many issues of concern and/or outright opposition to the IMpact from our chapters, regulatory board members and others.

While AMTA supports greater mobility for massage therapists through use of an interstate compact, we are concerned with the barriers and restrictions currently in the IMpact that could impose unnecessary hurdles and exclude many licensed massage therapists from immediately participating in it. For these reasons, AMTA currently opposes the IMpact until substantial changes are made to the legislation to benefit a larger majority of massage therapists across the U.S.

AMTA strongly believes the following issues need to be addressed during the legislative process, before the IMpact moves into the rulemaking phase. See their full statement on the issue of the IMpact

• Requiring 625 Clock Hours of Education: The 625-hour education requirement creates a restrictive pathway for many massage therapists to participate. Nearly 70% of states have an education requirement of 600 hours or below, with 22 states only requiring 500 hours. Therefore, the IMpact could exclude licensed massage therapists in these states from immediately participating.
• Continuing Education as a Condition for License Renewal: Requiring continuing education may prevent participation from massage therapists in the five states without CE requirements. Massage therapists should not be excluded from participating due to regulations in their home state.
• Multistate License (Exam) Requirements: It is unreasonable to ask any massage therapist who is licensed, and in good standing, in their home state to take an entry-level exam as a condition to apply for a multistate license. A massage therapist who is already licensed and in good standing in their home state should be sufficiently qualified to participate.

National Licensing Examination: The definition of “National Licensing Examination” as a requirement in the legislation is too narrow and restrictive. The law must be revised to redefine “National Licensing Examination” to retain the focus on an exam with fair, valid, and reliable results, but remove the condition that such an exam be developed by a “national association of massage therapy regulatory boards,” since only one exists. Including clearly defined and flexible provisions in the IMpact is necessary for providing an effective basis for the regulations.

Board of Massage (BOM)

BOM meeting was on November 9, 2023, Hybrid Virtual and In-Person: (Report from Megan Maxey, DOH Massage Therapy Program Manager) We had a presentation from our Equity and Social Justice Strategistregarding the work that was done to create the model rules for the health equity CE. Shari Aldrich shared her attempt at introducing health equity in the classroom along with the challenges for the school, teachers, and students.  The board invited her to attend the next education and training committee meeting.  This hasn’t been scheduled yet.

For the Education and Training Committee reported out on their committee meeting regarding hybrid/virtual education.  Based on comments they received from the public after the committee meeting, they changed the recommendations for certain topics.  They asked for another committee meeting to be scheduled and a survey sent out to schools regarding synchronous vs asynchronous learning in hybrid massage programs.  I sent the survey out but, due to the holidays, was not able to get a committee meeting scheduled.

For the License by Endorsement Rules Workshop, they reviewed comments from WSMTA.  The board asked for program staff to work with Kristi regarding some of the concerns presented in WSMTA’s language.  There is a committee meeting scheduled for December 21^st for the committee to continue discussion.

The board discussed topics to include in a newsletter including:

For future agenda items, they asked to start a high-level review of the school review process in January.  There will also be a presentation for FSMTB regarding the massage compact and a presentation by the Workforce Training Board about their jurisdiction and role in school approvals.

License by Endorsement committee meeting: Join us for the Board of Massage’s Licensure by Endorsement committee meeting on December 21, 2023, being held via Microsoft Teams at 9:00 a.m. PST.

A link to attend the committee meeting is available on the agenda. The agenda and meeting packet will also be available on the Massage Therapy webpage under the Board Meetings tab. There will also be a presentation on 2SHB 1724.  It was passed this past legislative session. The rulemaking for this bill has not started yet. The bill makes several changes that apply to all professions including: 

• Requiring disciplining authorities to waive education, training, experience, and exam requirements for applicants credentialed in another state with substantially equivalent standards. It also allows waiving requirements for applicants who have achieved national certification. 
• Removing DOH’s authority to screen applicants before scheduling them for exams. 
• Granting the department authority to contract with third parties to review applications. 

Upcoming BOM Meeting information

Department of Health (DOH)

HELMS Project Continuation (waiting to see if it’s in the Governor’s budget): DOH is requesting additional one-time spending authority to extend the Health Care Enforcement and Licensing Management System (HELMS) project by four months for work that is necessary for completion. HELMS will provide the licensure for all professions at DOH! Without additional spending authority, DOH will be forced to stop the project or significantly reduce the project scope. Stopping the project at this stage would result in a loss of $21.3 million in investment in the project and require licensees to pay for those costs without any return. I did get an update from DOH on HELM’s last week…this system could significantly raise provider fees if the state does not help subsidize…more to come!

Office of the Insurance Commissioner

Revising the prior authorization process rulemaking: E2SHB 1357 (Chap. 382, Laws of 2023) alters prior authorization requirements for commercial health plans under RCW 48.43 (leg.wa.gov). The new guidelines change prior authorization decision timelines, electronic and non-electronic submission standards, and communication and reporting requirements. OIC rulemaking is necessary to effectuate the bill’s language related to prior authorization timelines and processes and to address any inconsistencies between the bill and current rule language. The rules will facilitate implementation of the new law by ensuring that all affected entities understand their rights and obligations. 

General Information Regarding Massage Therapy Regulation in Washington State

Massage Therapist Website at DOH: Massage Therapist | Washington State Department of Health

To get notifications directly from DOH regarding Massage Therapists or the Board of Massage, sign up at: https://public.govdelivery.com/accounts/WADOH/subscriber/new

Also check out HEAL-WA which provides Massage Therapists with evidence-based data and articles that you pay a $16 fee in your license renewal to access the University of Washington HEAL-WA health resources website.

The RCW and WAC that directly relate to Massage Therapists:

• Revised Code of Washington: RCW Chapter RCW 18.108
• Washington Administrative Code: WAC 246-830