The Affordable Healthcare Act and the Massage Profession

This is the information that I got from attending the WA State AMTA Convention on April 26 from their Government Relations Presentation from Barbara Fly from the Insurance Commissioners office and David Madison who is a consultant for the AMTA WA.

The Affordable Healthcare Act was a bill created by President Obama that was signed into law on March 23, 2010.  This Act will make almost everyone in the US be enrolled in a heath insurance plan. If you are in the low income bracket and can’t afford insurance, there will be options for you to get insurance.  If you were ever denied coverage due to previous conditions, there will be help for you.  There are things like tax deductions and also benefits for people under age 26 will be able to get coverage under their parents plans.

Each state is required to set up their own insurance exchange system to provide low cost insurance or they can participate in the Federal Governments System. You can find out what your state has decided to do on the www.healthcare.gov website.  If your state has elected to create their own insurance exchange, it is important that you find out what needs to be done to make sure that massage therapy is on the list of allowed providers.

Nationally, Here is the big part of this: 80% of this has already been implemented.  That means if the Supreme Court rules to repeal this act, everything that has been completed may have to be reversed! (There is a group of Republicans who are claiming that the Act is unconstitutional and they are fighting it in Court – see NY Times article)

From a previous blog post I wrote about what little info I had on the Healthcare Act:

On March 23, 2010 President Obama signed HR 3590, the Patient Protection and Affordable Care Act into law. As it stands now, here is the excerpt from the health care reform bill passed:

“The provider non-discrimination provision (Section 2706) to be enacted into law reads in part: ‘A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.’”

This basically sounds much like the WA State Every Category Law that was created in 1996 and implemented in 1999.  Currently in WA State, massage is covered when medically necessary.  It does not cover preventative work.

After doing some searching online for more information on massage and the Affordable HealthCare Act, I found some information from ABMP.  There is a chance that massage could also get into the preventative care section that is being created.  ABMP wrote a Position Statement A comment on the Prevention Strategy
of the National Prevention, Health Promotion, and Public Health Council
December 2010 and submitted it to the Prevention Council created by the US Surgeon General.

So after 2 hours, I still do not know what that all really means for the profession.  There are many things still to be determined by the States and Federal Government, but I know that massage therapists need to be in contact with their legislators and insurance commissioners to even be considered.

Everything you need to know to get you started in massage insurance billing is in my Book/Ebook “Insurance Billing 101 for Massage Therapists“  (PDF, Kindle, Paperback)

Comments

  1. says

    Thanks! I am going to look into this in TN. Much of it all seems speculative right now. I am looking for ways to support this statement in the ABMP article you linked to…”There’s an opportunity to influence the kind of sinew put on the bones of “prevention,” “wellness,” and “integrated” approaches to health care that form the core structure of a reformed health care system.”

  2. Julie Onofrio says

    Yes it is all really up in the air right now with states scrambling to figure it out. Now is the time to get into healthcare if it is going to happen. I am creating a forum that will hopefully get more people sharing what is going on in each state – http://www.massagepracticebuilder.com/forum

  3. says

    This is eye opening information. If this is true and the language is in the health care act as stated then it could be a bonus for massage therapist. I would put up this WARNING. Currently in Washington State many insurance companies get around Washington’s Every Category Law by using The Employee Retirement Income Security Act of 1974 (ERISA). They do this by saying that ARISA is federal plan that does not recognize every provider. That ERISA trumps the state law. The reasoning for leaving out Massage Therapist is that every state does not have as high of licensing standard as Washington State. As long as there are states that do not have what the Federal Government feels is adequate to protect consumers the federal government will not pay for Massage Therapy even with such language. If the federal government pays for a service in one state it must pay for it in all states. So the federal government does not pay for services that DO NOT HAVE CONSUMER PROTECTIONS in place in all 50 states. I see the KEY to getting Federal Dollars in place is getting licensing standards in all 50 states equal or higher to those found in Washington State. I would also WARN that with Washington States recreational marijuana use law that most other states consider Washington State to full of drug addicts and should ignored.

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