August 2020 Government Relations Update

By Susan Sherman, LMT, and Diana Thompson, LMT, Co-Chairs
August 6, 2020

The following is an overview of key issues for licensed massage therapists (LMTs) during the summer of 2020. It includes Board of Massage rulemaking; continuing education waiver for hands-on training; continuing education audit failure rate; new LMT identification requirements; new prior authorization legislation; and grassroots.

Board of Massage Rules. The Board of Massage (Board) recently filed proposed rules for a hearing before the Board on August 21, 2020. As a part of that rules filing, Board and Department of Health staff prepared a Small Business Economic Impact Statement. It is exceptionally well done, and it clearly explains the rationale behind many of the proposed amendments, as well as expected financial impacts on massage schools/programs.

AMTA-WA was the lead organization that worked collaboratively with the Board and its staff on these rules, and we are pleased with the results. These rules, taken as a whole, improve public protection through increasing the number of hours of massage education and training, as well as provide additional clarity to LMTs, which in turn also protects the public. In addition, these proposed rules will strengthen LMT’s role as recognized and respected health care providers in the State of Washington.

AMTA-WA submitted written comments in support of the proposed rules. The comments included restating our rationale for certain key rules, as well as some technical suggestions. At this point in the rules process, the Board will only consider technical suggestions. If any substantive change is deemed necessary, then the Board must refile the rules, and schedule a new hearing.

At the hearing on August 21, the Board will consider an effective date. AMTA-WA has suggested one year from the date the permanent rules are filed. This one year delay should give massage schools and well as LMTs sufficient time to be educated about the new rules and adapt.

There are two ways for AMTA-WA members to participate in the rule-making process:

(1) Submit written comments to Megan Maxey at Megan.Maxey@doh.wa.gov . If you do submit written comments, we would appreciate receiving a copy. Our email addresses are at the end of this article. The deadline for comments is August 14.

(2) Testify at the April 21 rules hearing. If you want to attend virtually, via the GoToWebinar©, you will need to preregister. The meeting will start at 9am. Anyone who wants to testify will have one opportunity to do so. Rules adoption hearings are not a time for back and forth discussions. Participants make their comments, and the Board will decide what changes it will accept, if any, to the proposed rules.

 LMT Licensure Renewals. We just wanted to remind you that the Secretary of Health has extended health profession license expiration dates for licenses up for renewal between April 1 and September 30, 2020. For more details, see DOH’s Licensure Expiration Extension FAQs webpage.

Continuing Education (CE) Waiver for Hands-On Massage Training. On July 21, 2020, the Board emailed all license holders concerning in person CE requirements. That email contained a link to a Board Policy Statement (BOM 20-01) that allows LMTs to replace the eight hours of hands on massage training with any combination of the subjects listed in WAC 246-830-475(2). While AMTA-WA advocated for this policy to be in effect through 2021 due to the pandemic, others thought that was too long, and the Board decided the policy will be in effect through December 31, 2020. Please note that an LMT, whose license expiration date does not fall within the effective dates of the policy, will not be found non-compliant with their CE requirement if they obtain their CE hours in accordance with the policy during the months when it is in effect.

At this time, with the pandemic not abating, we would expect the Board to extend the policy at its November meeting. AMTA-WA will again advocate for giving LMTs a waiver for in person massage skills training for all of 2021. While we value hands on CE, the pandemic has turned the world upside down, and we do not believe hands on classes should be required while the pandemic shows no signs of abating. Safety first is our motto!

 CE audit failures. AMTA-WA spends a lot of time thinking about continuing education (CE) because unfortunately, LMTs have the highest CE audit compliance failure rate of any health care profession. Every week, DOH sends out a list of disciplinary proceedings, and almost without fail, there is one at least one LMT on the list—often more. We cannot ignore this. Not only is it a problem for those LMTs who fail the audit because it often triggers a licensure suspension, but a 50% failure rate drives up licensure fees because of the costs involved.

We believe that some of the problems related to CE concern the lack of clarity in the current rule language. To deal with that, AMTA-WA worked diligently with the Board and its staff on amendments to the CE rule. However, if you have any ideas as to how AMTA-WA can help LMTs increase compliance with the CE requirement, please let us know.

LMTs and Identification. In the 2020 session, the Legislature passed SB 5097 which amended RCW 18.108.045 as follows (new language is underlined). This legislation was effective June 11, 2020.

Sec. 1. RCW 18.108.045 and 2016 c 41 s 5 are each amended to read as follows:

(1) A massage therapist licensed under this chapter or a reflexologist certified under this chapter must conspicuously display his or her credential in his or her principal place of business. If the licensed massage therapist or certified reflexologist does not have a principal place of business or conducts business in any other location, he or she must have a copy of his or her credential available for inspection while performing services within his or her authorized scope of practice.

(2) A massage therapist licensed under this chapter or a reflexologist certified under this chapter must have government-issued photo identification on his or her person or have it be available for inspection by city, county, or state law enforcement or department personnel at all times he or she practices massage therapy or reflexology. The name of the massage therapist or reflexologist on the government-issued photo identification must match the name on the massage therapy license or reflexology certification.

As you may recall, this legislation was first introduced in 2019 at the request of the City of Vancouver. Vancouver had been working diligently to try to shut down illegal/illicit massage, but because LMT licenses don’t have pictures, it was difficult to determine who was a legitimate massage therapist.

While AMTA-WA supported the legislation, it was with some reluctance because no one wants their profession singled out for “special” treatment. However, we thought it was important to support law enforcement because their efforts in shutting down illegal/illicit massage benefits the entire profession. In addition, this requirement, while annoying, is much less draconian that what some cities and counties have been considering, which includes limits on hours of operation, requirements that doors be unlocked at all times, etc. However, if you believe that this new requirement is being unfairly utilized, we want to know.

Prior Authorization. For those of you who have been able to go back to work, you’ll want to be reminded about SB 5887, passed in the 2020 legislative session. While AMTA-WA strongly supported this legislation and AMTA-WA lobbyist Melanie Stewart testified in support, special thanks and credit goes to Lori Grassi with the chiropractors. Thank you, Lori!

This legislation states that a health carrier or its contracted entity may not require utilization management or review of any kind, including but not limited to, prior, concurrent, or post-service authorization, for initial evaluation and management visits and up to six consecutive treatment visits for new episodes of care of chiropractic, physical therapy, occupational therapy, Eastern medicine, massage, or speech and hearing therapies. Visits for which prior authorization is prohibited are subject to quantitative treatment limits of the health plan. For visits for which utilization management is prohibited, a health carrier or its contracted entity may not deny or limit coverage on the basis of medical necessity or appropriateness; or retroactively deny care or refuse payment for the visits. A health carrier is not prohibited from denying coverage based on insurance fraud.

Grassroots. Grassroots is a term used to describe the power of the electorate. Be sure to take these steps to assure that you’re exercising your grassroots power:

1. Register to vote, and if you are registered be sure your address is up to date. The Secretary of State’s website is the place to go for information: sos.wa.gov . October 26 is the deadline for online voter registrations.
2. Vote! August 4 was the Primary Election. If you voted, thank you! With Washington’s two top system, voting in the Primary is more important than even. Currently, in a race for the 10^th Congressional district, the contest is very close between #2 and #3. Bottom line, every vote matters! The General Election is November 3^rd. And Washington State makes it easy with mail-in voting. They even provide the postage.
3. Who represents you? Know who your legislators are at the state and federal level. Just insert your address into this link, and up pops your three state legislators (two Representatives and one Senator). Also, see the option for “Congressional” right below the “Find My District” tab.

That’s all for this segment of grassroots. In every newsletter, our goal will be to include more information to help you better understand our political system. At the heart of every democracy is participation. Our goal is to empower you to participate.

Our thanks. Finally, our thanks to you, AMTA-WA members, for supporting our important work on behalf of the massage profession, together with lobbyists Gail McGaffick and Melanie Stewart. If you have any questions or comments, please contact Diana at soapsage@comcast.net or Susan at s_sherman@earthlink.net .