September 2021 AMTA-WA GOVERNMENT RELATIONS UPDATE
By: Diana Thompson, LMT and Susan Sherman, LMT, Co-Chairs
New massage rules take effect September 1, 2021. In our January 2021 Government Relations update, we wrote extensively about the new massage rules. It’s important for licensed massage therapists (LMTs) to read this overview in detail because it includes topics of importance to all LMTs such as standard of practice limitations and requirements for additional training; continuing education requirements and proof of documentation; as well as aligning recordkeeping and record retention with national standards.
One of the most significant changes is to increase the number of education hours from 500 to 625 to be consistent with the ELAP recommendations. An important check and balance concerning education quality is that the hours must be completed in no fewer than 24 weeks. However, in recognition of the fact that there are multiple states that still have the 500 hour education requirement, the Board of Massage created a credentialing by endorsement option for LMTs with 500 hours of education, two years of experience, and 24 hours of CE within the previous two years.
Governor’s vaccine mandate for all health care providers. On August 9, the Governor issued Proclamation 21-14 requiring that all health care providers be fully vaccinated against COVID-19 by October 18, 2021. That means that the second shot of a two-dose protocol or a single shot in a one-dose protocol must be received by October 4, 2021.
The Department of Health, at the request of AMTA-WA and other provider groups, issued FAQs to help health care providers navigate this mandate. Information is included in the FAQs concerning exemptions for sincerely held religious beliefs and disability related reasonable accommodations.
Board of Massage continuing education waiver for in-person direct supervised CEs. At its recent meeting, the Board of Massage voted to continue the waiver of WAC 246-830-475(1)(a) which is the requirement for eight hours of in-person direct supervised massage skills training. This waiver is in effect through December 31, 2021, or until the declared state of emergency is rescinded. The Board’s policy statement reads in part:
“To renew their massage license, a massage therapist must complete twenty-four hours of continuing education every two years.
- A minimum four hours must be in professional ethics, communication, or Washington state massage laws and regulations. Two of these hours must include professional roles and boundaries.
- The eight hours of direct supervised massage skills training required in WAC 246-830-475(1)(a) may be waived and instead 20 hours, rather than 12, may be met by completing any combination of the subjects listed in subsection (2) of WAC 246-830-475.”
Payment for PPE. As you know, the 2021 legislature passed SSB 5169, requiring state regulated insurers to pay health care providers $6.57 per in-person visit (CPT code 99072) for PPE for the duration of the public health emergency. Unfortunately, there have been challenges. Note, this legislation does not apply to self-insured plans, union-negotiated plans, personal injury protection, or worker compensation. While the information below was posted earlier to the AMTA-WA Facebook page in July, we include it again in case PPE reimbursement problems with insurers persist.
AMTA-WA joined together with the Washington State Medical Association, the Washington State Chiropractic Association, the Washington State Nurses Association, the American Physical Therapy Association-Washington, and others in a letter to the Office of the Insurance Commissioner (OIC) in June. The letter asked the OIC to issue “…guidance for insurance carriers so there is a common understanding of the law and its requirements.” “In addition, we would be grateful for the OIC to include in that communication that carriers must respond to provider requests for clarity as to whether a plan is state regulated, or not, which will more easily identify if a plan is subject to SSB 5169.”
While we never received an official reply to that letter, we are aware that the OIC is reaching out to individual health carriers concerning provider concerns. As a result of that outreach, we have received some additional information that we hope will be helpful:
- Many health carriers have told the OIC that they would prefer providers submit PPE claims for all consumers (patients) regardless of the health plan, and that the plan status questions (whether or not subject to SSB 5169) would be sorted out in the claims handling process. In addition, billing for all consumers saves the provider the step of contacting the health plan to determine plan type and covers all the bases in the event the consumer changes plans. Should you choose to contact a health plan, the following information should be helpful:
- Key contact number of Cambia Health Solutions:
- Regence Provider Contact Center: 1 (800) 253-0838
- Asuris Northwest Health Provider Contact Center: 1 (888) 349-6558
- BridgeSpan Health Provider Contact Center: 1 (855) 522-8894
- Contracted providers are directed to the provider website to look up eligibility information for members. In the Washington region, eligibility information includes whether the member is on a fully insured or self-insured plan. There is an Eligibility Inquiry Tool at the following link: https://wa-provider.kaiserpermanente.org/provider-manual/coverage/member-id
- Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. administer self-funded plans.
- Premera Blue Cross
- The funding arrangement displays in the benefits and eligibility tools on both the Premera Blue Cross and Availity (provider portal) websites.
- Additionally, the ID cards for self-funded groups include language that is not present on the fully insured ID cards. The language says: Premera Blue Cross provides administrative services only and does not assume financial risk or obligation with respect to claims.
- Providers may also contact customer service by calling the number on the back of the ID card to speak to a representative who can confirm whether the plan is self-funded or fully insured.
- Providers can call either call our service numbers (1-800-878-4445 or 503-574-7500) or look members in up in our provider portal, ProvLink (https://phpprovider.providence.org/portal/login).
Finally, as we stated in our earlier posting to you—if you are not getting reimbursed as required by SSB 5169, please know that you always have the option to file a complaint with the OIC. LMTs filing complaints lets the OIC know that there is a problem that needs to be solved.
Public Employees Benefits Board (PEBB) and School Employees Benefit Board (SEBB) Increase Benefit Limits for Massage, Chiropractic and Acupuncture beginning January 1, 2022, for the Uniform Benefit Plan (UMP). AMTA-WA recently learned that the PEBB and SEBB voted to increase the visit limits for massage, chiropractic, and acupuncture for state and school employees enrolled in the UMP to 24 per plan year, effective January 1, 2022. For massage, that’s a 50% increase over the current limit of 16 visits!
This change resulted from PEBB and SEBB member feedback. This is an important reminder that you client’s/patient’s input matters! While the benefit limits have increased, PEBB and SEBB needed to do it in a manner that was budget neutral. As a result, there is a now a $15 co-pay for each visit. It’s our understanding that once the out-of-pocket maximum is reached, the member co-pay no longer applies, and the plan pays 100%.
It’s important to remember that coverage for massage is limited to in-network providers only. If you have been unable to get in-network status, and you want to be reimbursed for providing care to a PEBB or SEBB member, please encourage them to contact PEBB/SEBB re expanding the network. Also, providers can find specific information on contracting and credentialing here: Join our provider network (regence.com). For questions, contact details are provided here: Contact us (regence.com).
More massage rules. In April of this year, the Board of Massage filed a CR-101, which is the first step in the rule adoption process. In the previous rules project, completed earlier this year, several WAC sections where changes were already agreed to could not be included because of technical reasons.
This latest rules filing is about making a number of technical changes such as: updating the rules to correct the names of national examinations; clarifying the training requirements for somatic education, and intraoral massage education; and clarifying and modernizing the equipment and sanitation, and hygiene rules. If you would like a copy of the draft changes that were discussed at the July Board of Massage meeting, please contact Board of Massage Program Manager, email@example.com
Board of Massage Legislation for 2022 session. We believe that legislation will be introduced by the Department of Health in the 2022 legislative session that will raise the amount paid to Board of Massage members from $50 per meeting to $250. The Department of Health is proposing this change for all boards. Currently, commission members (MDs, DO, Nursing, Chiropractic) are all reimbursed at this rate. This increase is a long time in coming and will hopefully help the Board fill its long-standing vacancy for a public member as well as more fairly compensation Board of Massage LMT members for their time.
In addition, the legislation will increase membership on the Board of Massage from five to seven members. Five must be LMTs with at least three years’ massage experience. One must be a consumer whose occupation does not include health care. Finally, one must be a massage educator or massage school owner with at least three years’ experience in teaching or administration of direct student learning of the practice of massage.
Thank you for taking the time to read our report. For questions please contact us at:
Diana Thompson, firstname.lastname@example.org
Susan Sherman, email@example.com