Legislative Hullabaloos in WV and TN

As usual, the opinions on my blog are my opinions and not to be construed as the opinions of anyone else.

I  haven’t had much to say on the legislative front for a few months…when the legislators go home for the summer, not much is happening; then there tend to be shorter sessions in the fall before they take a break for the holidays and not much happens then, either. Well, the break is over, and how.

I received a press release from the NCBTMB yesterday announcing what amounts to a win for them in the state of WV. Here it is:

The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) is pleased to share the news that Nationally Certified Massage Therapists in West Virginia will continue to have their services covered by the Public Employees Insurance Agency (PEIA). Initially, the PEIA Finance Board considered discontinuing massage therapy coverage altogether as a cost-savings measure, but with input from NCBTMB, the American Massage Therapy Association (AMTA) and practicing therapists, it will still cover active employees and non-Medicare retirees who visit massage therapists with national certification.

The new financial plan goes into effect July 1, 2012. Certified therapists must also carry $2 million in malpractice insurance as well as follow treatment guidelines of the AMTA.

“NCBTMB commends the Public Employees Insurance Agency for providing their employees with access to nationally certified massage therapists who commit to a code of ethics, standards of practice and pass a national credentialing exam,” said NCBTMB CEO Mike Williams. “We see this as a win-win situation for both PEIA employees and Nationally Certified Massage Therapists in the state of West Virginia.”

“PEIA has an obligation to state employees to cover necessary medical treatments, but also an obligation to the state of West Virginia to be fiscally responsible,” stated PEIA Executive Director Ted Cheatham. “We stand behind the PEIA Finance Board and its decision to only accept massage therapy claims from therapists who meet the new criteria.”

Disclaimer: I am Nationally Certified myself and have been since 2000. I am not obligated to maintain that; I just do because I want to. When I got licensed, it was also the only option available, as it was in most states for many years, saving those few that have their own exam. As any of my long-time readers know, I’ve had my ups and downs with the NCBTMB, criticized them many times, and applauded them when I thought they deserved it. I am also a  member of AMTA, and due to having  multiple coverage on different policies I have as a business owner and employer, I personally have $12 million of liability insurance. If I lived in WV, I’d be good to go.

My first thought on this was that it will be challenged immediately by the Federation of State Massage Therapy Boards.  I’d  bet the farm on it. West Virginia is a member state of the Federation. The Federation, and thus the member states, own the MBLEx (Massage & Bodywork Licensing Exam) which is accepted by the state of WV, as is the NCB exam. Therapists in that state have a choice of which exam to take in order to get licensed.

This move by the legislature would seem to be an endorsement of the National Certification Exam, as well as an endorsement of AMTA, since one of the other requirements for being able to file insurance is adherence to AMTA treatment guidelines. They don’t come right out and say you have to be a member of AMTA; just that you have to be following their guidelines. It also requires therapists who want to participate in the state employees’ insurance program to have a minimum of $2 million worth of liability insurance.

I personally file a lot of insurance in my own office, and it’s a standard practice for insurance companies not to deal with you unless you carry liability insurance, so no big deal on that front. AMTA’s treatment guidelines are on their website, accessible to the masses, including people who are not their members, so that’s really no big deal either.

What is a big deal here, at least to me, is that even though the state says that passing either exam is adequate for a massage therapist to receive a license, it is now saying that only one of them is adequate for therapists who wish to file state employees’ insurance. To me, that is sending a confusing message to students who haven’t yet taken an exam, as well as to the practicing therapists who chose to take the MBLEx, ignorant of the fact that this new law would be coming down the pike, and even to the massage-consuming public. It’s a statement that basically says “If you’ve taken the MBLEx instead of the National Certification Exam, then you’re good and qualified enough to work on the public, except for the state employees, and you have to be Nationally Certified to work on them and file their insurance.”  It is really stating that one licensee is better than another.

Is there going to be any fallout from this? Absolutely, in my opinion. The Federation, since its inception, has encouraged all member states to use the MBLEx exclusively for licensing purposes, while still stating that certification has its own value as a credential, but maintaining that it should no longer be used as a licensing exam. Since WV has opted not to follow that suggestion, and has kept both exams, massage schools and instructors in WV will now be falling short if they don’t inform their students of this legislation, and will basically be saying “You can take two different exams. If you want to file insurance, take the NCBTMB exam. If you don’t care about that, you can take the MBLEx.”  So two therapists can have the exact same 500 hours of  education that the state requires, and the exact same license that the state issues, but the one who took the MBLEx won’t have the privilege of filing insurance on state employees. The logic here is escaping me. There is one caveat: WV is currently not requiring any continuing education of massage therapists; however, maintaining National Certification requires 48 hours of  continuing education every four years. Still, I don’t think that’s a big factor. As long as you passed the NCB exam last week, you could be accepting the state employee’s insurance, before you’ve ever had a single hour of continuing ed, so I don’t see how that really fits into the picture.

I don’t think this is over, and I’ll try to keep you updated.

WV isn’t the only place where trouble is brewing this week. Therapists in TN are up against HB 2387 SB/2249, which would take the regulation of massage therapy out from under the health care professions and move it to the Department of Commerce and Insurance. That is almost bizarre that it has anything to do with the department that governs insurance–because most insurance companies will not pay for any health care services unless they are provided by a person who is in a licensed health care profession. This move would basically state that therapists are not health care providers. The Department of Commerce and Insurance regulates trades, not professions. For all intents and purposes, this is a statement to massage therapists that “you are practicing a trade, not a health care profession.”

Quite a few states have been on cost-cutting missions during the past few years of recession, combining public boards and even going so far as to disband altogether–or threatening to–but this cannot be construed as one of those cost-cutting missions. Tennessee’s massage board is self-supporting through licensing fees. They do not cost the taxpayers any money.This is not tied to financial impact on the state in any way. In fact, I’m not sure what it’s tied to or what the logic is behind it, other than a slap in the face to the massage therapy profession.

I urge all TN massage therapists to immediately  contact your legislators. Don’t wait until it’s a done deal to express your opinion.

8 thoughts on “Legislative Hullabaloos in WV and TN

  1. Laura Dupler

    Thanks Laura. I have recently moved to TN from IL and am in the process of transferring my license. I was not aware of HB 2387 SB/2249. I am so glad you are around.

  2. Keith Eric Grant

    Laura, if I read your first part correctly this goes beyond what exam you take. It sounds like being eligible for insurance reimbursement requires maintaining NCBTMB certification.

    If such certification required training outcomes specific to orthopedic work (i.e. a specialty certification), this might have a basis for substantiation. That, however is not the case. If WV believes that their requirements for licensure (outcomes and competencies leading to knowledge, skills, and abilities) are deficient, then they should identify the learning gaps and require the additional specific education to fill them.

  3. Keith Eric Grant

    On the TN side, one implication might be taxation of services. It could well be that healthcare services are not taxed but that commercial services are. Even if that isn’t currently the case, it would seem easier to move in that direction with massage if it is classified as a commercial service.

  4. Karen Curran

    You have a pretty accurate assessment of the WV PEIA conundrum. However, WV requires 24 CEs with 3 in Ethics for the 2 year license, which was bumped up to a $200 renewal fee with a $300 initial fee.
    Massage therapy struggles in WV due to the economy, lack of awareness of the benefits of massage, as well as a few bad apples that mark the rest of us. The WV Massage Board was almost going under due to litigation costs, and I believe another fraudulent therapist angered the PEIA (as if there were no bad doctors in WV, Ha!, but that’s another topic.) I hate being lumped in with the crooks, and I am sure they took the required Ethics courses.

    Personally, I take as many classes as I can, especially on the orthopedic and science- based side, but really, working under a chiropractor, I don’t reap great financial benefits from doing that. The patients I work on get real benefits from the knowledge I work for, so that is the satisfaction I get.

    I am NCBTMB, AMTA, but how does that make me better? Just pay your money, and you get more letters. Most people don’t have a clue what those letters mean. If they come up with a new test that means “advanced” I’ll take that, too. That will make me better at massage, maybe.

    I feel that sorting out the bad therapists from the good ones is a job that the paying customer does fairly well. They want results. I’m not convinced that more rules and regs help, especially from the corrupted govermental types that want to make everything look good on paper, but make it hard to practice for the little guy.

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  6. Vivian Madison Mahoney

    wow, I am reading your posts and those who commented over a year ago. Not many are likely to be tuned in to this now. But just in case. I wanted to add that in March I was invited by one of my instructors (a KY and WV LMT) and the Chair of the WV Board of Massage Therapy to come and help provide testimony at the PEIA special meeting where even the Assistant to the Governor attended. I was proud to be asked to attend and provide expert advice on insurance issues. With the efforts of those in attendance we were able to get PEIA to reverse their decision and in July of this year they no longer require WV LMTs to be certified in anything but state licensing to provide treatment and be paid by PEIA for the State of WV Public Employees. This is truly a win for the employees who are in need of physician prescribed treatment by a LMT anywhere in the State of WV and the LMTs as well.
    Thanks Laura also for the info on TN. Since I too live in TN I sure fought like hell here too to prevent this from happening (the move out of the Dept of Health. Thank God we have a Governor unlike the one in FL who took away all we had with auto insurance, a coverage for auto accident victims for 29 years) TN Governor Haslam put a stop to that move out of the Dept of Health!
    Laura keep up the work on reporting such news!!

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