AMTA-WA March 2023 Public Policy Report

Prepared by Leslie Emerick, Lobbyist

Legislative Landscape 

We are on day 73 of the 105-day legislative session!  The last day of the legislative session is April 23rd , so one more month to go! We were tracking 33 bills for AMTA-WA that impact health care in general and massage therapy specifically and we are now down to 16 bills after the cut-offs. Currently, the bills that are still moving are in the opposite house being heard. (Senate bills are in the House and House bills are in the Senate.) Yes, its complicated! Here is a good link to help understand all the hoops a bill has to go through before it passes: Overview of Legislative Process

The next big bill cut-off is on March 29th for a bill to get out of the opposite house policy committees on April 4th to get out of a fiscal committee. Bills must pass out of the opposite house by April 12th to keep moving this session. If a bill was amended in the opposite house, it may have to go to conference committee to assure that both houses support the amendments in the bill…otherwise it goes to a Dispute Committee to work out. Once a passes both houses and they are in agreement on amendments, it goes to the Governor for signature.

Many more bills will still die this session, but because it’s a biennial legislature, they may come back next year. On occasion bills are considered “necessary to implement the budget” and may be brought back up to match a budget proviso that requires legislation to implement.

The state operative budget proposals come out this Friday starting in the Senate and next week the House will release their budget. The states revenue forecast was not too optimistic, but they did over project the amount of revenue that comes into the state. I do not expect any cuts to services at this time.

Department of Health (DOH)

Board of Massage: Met on March 10, 2023. Here are the things of note from the meeting according to Megan Maxey, Massage Board Program Manager:

For the health equity CEs, the board decided on 4 hours per reporting period.  There was also a “Special Meeting on Tuesday, March 21st that authorized Megan to move forward to the CR-102 phase of the rulemaking.  The education and training rulemaking will include both inclusion of multicultural awareness and addressing possible parameters around online/virtual education.

The rules petition regarding waiving some or all of the CE for LMTs who have been practicing for 25+ years was denied. At the May meeting, the FSMTB will come do a presentation about the MBLEx; our military liaison will come present about licensure by endorsement for military and military spouse applicants. 

CR-101 filed for massage therapist licensure by endorsement rule: On March 10, 2023, the Board of Massage (board) in conjunction with the Department of Health filed a CR-101 as WSR #23-07-064 with the Office of the Code Reviser proposing to consider amendments to WAC 246-830-035 Licensing by endorsement for out-of-state applicants. This initiates a new rulemaking process for licensing out-of-state applicants. The rules workshop will be held at their May 5th meeting.

CR-103 filed for chapter 246-830 WAC: On March 10, 2023, the Board of Massage (board) in conjunction with the Department of Health (department) filed a CR-103 as WSR #23-07-065 with the Office of the Code Reviser, adopting updates to existing sections of the massage therapy chapter. The updated rules go into effect April 10, 2023.  The CR-103 provides the revised rules language.

The Concise Explanatory Statement summarizes differences between the proposed rules and adopted rules and the response to public comments. The updated rules:

• Corrects the name of the national examination,
• Clarify the training requirements for somatic education and intraoral massage education,
• Clarify and modernizes the language in the equipment and sanitation rule,
• Clarify and modernize the language in the hygiene rule.

For more information on these rules, you can email The revised language will also be on the massage therapy webpage at

Bills of High Interest or Concern

ESHB 1508 Improving consumer affordability through the health care cost transparency board. We signed in as Con. We were also on the health care provider letter opposing the bill, but they have amended it to address some of our concerns. ESHB 1508 Bill Report

Here’s the short version of what the bill does: Authorizes the HCCTB to require that payers (insurers) or health care providers that frequently exceed the health care cost growth benchmark without a reasonable justification submit a performance improvement plan or pay a civil fine unless the health care provider is composed of 25 or fewer health care professionals. The amendment that exempts providers with 25 or fewer health care professionals was meant to appease the fourteen or so groups that signed onto a letter mentioned above, raising concerns with the legislation. I have been working with some other lobbyists and they are still concerned even with the amendment.

 The problem with the exemption appears to be twofold. While it appears to be a nice gesture, it’s more or less meaningless because the HCCTB never had smaller provider groups in their sites. The other problem is that this exemption really doesn’t protect smaller providers. That’s because if the HCCTB is able to issue fines to payers if they are unable to control health care costs. In order to avoid fines, those payers may cut networks, raise deductibles, lower contract payments, increase prior authorization requirements, etc. Bottom line all health care providers will get hurt whether they are small or large. The exemption for smaller providers simply won’t protect them from the downstream effects of the bill. And smaller providers tend to have less ability to negotiate anyway. The bill is opposed by both WSMA and WSHA.