Will Health Care Reform Benefit Massage Therapists?

As the American Medical Association stated in its AMA News: "Your guess is as good as anyone's." Well if they don't know, I'm sure I don't know. However, I am trying to keep you in the loop as much as I can in these early stages of health care reform.

First, I want to thank all of you wonderful readers who have taken the time to correspond with me in reference to my articles. Next I want to thank Massage Today for allowing me to share insurance and other business-building ideas as a columnist since its January 2001 inception. Also, I wish everyone a beautiful, safe, healthy, successful and happy new year.

Reading, studying and watching every health care news article, subscribing to dozens of Web sites and health care reform outlets and sitting in on many conferences to keep up on this health care reform stuff has been overwhelming, and I am ready to pull out my hair. But I love it, what can I say? I love trying to find any and all loopholes we might possibly be able to crawl through. About three of the health care reform bills state that discrimination will be eliminated. This means that all state-licensed or certified health care providers will have to be recognized and reimbursed. The House and Senate bills may ultimately not be our answers, even though some information like this may be extremely helpful. Then again, what would be their definition of "health care provider"?

I will be asking for assistance with some projects from each of you who really want to increase your clientele and your income as you move ahead in the health care arena. It will not be easy. It will be fun, rewarding and time-consuming. Are you willing to help? If so, send me an e-mail at vivmahoney@aol.com . I will save your e-mail after I read it and will be back to you with any updated news and with information on the help we need to move us forward.

Will Health Care Reform Benefit Massage Therapists? Today, I attended an hour-long health care telephone conference on the federal ERISA Guidelines. ERISA (Employee Retirement Insurance Security Act) is the federal act that governs many issues of employer and employee finances. For us it means that if we are not allowed to be insurance company "in-network" providers who will reimburse for services in employer group plans, we are losing hundreds of thousands of client prospects and income dollars because the majority of those covered by insurance are through their employer group plans. Since ERISA is a federal law, it supersedes state laws that require insurance companies to reimburse massage therapists, such as in Florida and Washington.

In reflecting on the ERISA call, it seems that hour and 10 minutes was much of a waste. The presenter (though obviously extremely knowledgeable on ERISA), was speaking in what seemed to be a foreign language. He also had to present a week's class in an hour. Needless to say, he rushed through it so fast that it was not only impossible to understand him, but it was impossible to keep up with the presentation he zipped through with only one or two seconds per slide. I have downloaded some of that presentation that was sent in advance and try to match my seven pages of written notes to the 165 slides in the presentation.

However, the good news is that he allowed us to ask questions. I and one other gentleman had the only two questions he accepted. My question: Why doesn't the ERISA Self-Insured Employer Group Health Plans directly reimburse health care providers who are state-licensed and/or certified? Meanwhile, ERISA is willing to reimburse other health care providers, often costing more, who in turn hire the state-licensed providers to do the actual work?

His answer, the best I could decipher it at high speed and in a foreign accent was this: "They [ERISA] will pay for the services a state-licensed provider provides, but if you are not a provider in the network, they will send the patient the money. The patient will then most often take the money and run." He then added, "You can get the patient's credit card on file. Then, if the payment is sent to the patient and they don't bring in the check, you can charge their credit card."

The best part of that conference is now I have his e-mail and phone number. He told me to contact him off line and he will discuss it more thoroughly. Time allowing, I will get to that this before my next article.

I want to always be sure that we as a profession can find any loophole to slide through and not be eliminated as practitioners who are directly reimbursed for the services we perform.