Washington State Department of Health 2022 Draft Legislative Agenda

The Department of Health (DOH) recently released the draft of their legislative requests for 2022. In this first document (power point) you can see the types of requests that are being proposed and from where within the state budget the dollars would come from. 

Department of Health_2022 Webinar 8-23_Slides.pdf

In this next document you can see a brief explanation of each proposed piece of legislation that DOH is moving forward with at this time. There are three items that are likely most interesting to us as massage therapists.

Enhanced Capacity and Diversity of Health Profession Boards and Commissions. 

This proposal modifies boards and commission statutes in order to achieve consistency, allow for more diversity, and increase effectiveness by:

• expanding the size of membership and number of public members; 
• removing the membership restrictions, such as congressional district or specialty requirements;
• increasing compensation so all boards and commissions are reimbursed at a Class 5 rate ($250 a day).
• removing specific quorum requirements for disciplinary actions and aligning terms requirements.

Improve Credentialing Performance. 

This would have the effect of adding staff to the credentialing unit in order to be able to meet the goal of issuing credentials within 7 calendar days of receiving a complete application.

Complete the HELMS Project.

The new Healthcare Enforcement and Licensing System (HELMS) has had some unexpected delays which will increase costs.

Department of Health_2022 Budget and Legislative Requests_August2021_v4.pdf

Marybeth Berney WSMTA President

Compliance with Proclamation 21-14 Vax Washington

 

The Washington Chiropractic Association (WSCA) has been kind enough to allow WSMTA to share with you the compliance tool that they created for complying with Governor Inslee’s Proclamation 21-14. Please make sure to download both pages.

WSCA -- Proclamation_21_14_Compliance_Document.pdf

First some background on the validity of governor Proclamations. The validity and enforceability of governor issued Proclamations has been upheld in the courts many times over many decades. Those court decisions have, in a nutshell, said that states have the right to infringe on individual liberties in some cases and especially in the case of public health matters. There are several Washington healthcare provider associations and unions that have expressed displeasure with the proclamation, as written, to the Governor’s office. But many attorneys have agreed that any type of prospective legal challenge would have zero chance of success as there is no standing to challenge. Once enforcement begins that may provide some type of standing for a legal challenge.

Please read the disclaimer on page 2 carefully as it contains steps that will help you to fill out the forms completely. This disclaimer page applies to WSCA and WSMTA. If you have questions beyond the scope of this article, please consult your attorney.

Who needs to fill out/maintain these documents

• Every employee, contractor, and volunteer performing any kind of work in the facility where healthcare/massage is offered--whether directly interfacing with patients or not--must disclose the information requested in this document.
• If you operate a massage facility and you have MTs that are independent contractors renting space inside your massage facility you, as the healthcare facility operator, must maintain these documents for those contractors.
• If you employ your child/children to clean, do landscape maintenance or anything else at your healthcare facility they must have this document filled out and maintained by you.
• In short anyone who is in your healthcare facility and is under your control needs to fill out this document and you need to maintain it.
• Any new employees, contractors, volunteers that come to work in your healthcare facility on or after Oct 18, 2021, must fill out this document and you need to maintain it.
•  If any of the information/conditions reflected in these documents changes at any time undated documents and supporting documents must be filled out to replace the outdated documents
• If you are self-employed and are vaccinated, you need only have your vaccination record.  If you are self-employed and are filing a medical or religious exemption/accommodation, fill out the form and sign both as the employer and the employee.

How do I need to maintain the compliance document and supporting documents

• This document and all supporting documents need to be maintained by you until the COVID-19 State of Emergency is ended or Proclamation 21-14 is amended or rescinded.
• These documents should be maintained with the same security as healthcare records.
• This document and all supporting documents need to be maintained at your healthcare facility and be readily available to any inspectors from the Department of Health, Labor and Industries, or any law enforcement agency.

Section 1

• If you are self-employed, you will put your name in as employee and employer,

Section 2

• You have 4 choices. If you/your employee, contractor, volunteer check the “fully vaccinated” box, then move to Section 3.
• If you/your employee, contractor, volunteer check “request a medical exemption” then skip to Section 4.
• If you/your employee, contractor, volunteer check “request a religious exemption” then skip to Section 5.
• If you/your employee, contractor, volunteer check “will not comply with the Proclamation” then skip to Section 6. 

Section 3 - only if fully vaccinated

• Fill in the appropriate dates of vaccination, brand of vaccination and what proof of vaccination was received. Keep a copy of the proof of vaccination with this document.

Section 4 - only when requesting medical accommodation

• This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation from a medical provider with all the information that is indicated on the form.
•  Make sure that the employee, contractor, or volunteer signs and dates this section.

Section 5 - only when requesting religious accommodation

• This section should be filled out by the employee, contractor, or volunteer. Attach supporting documentation that provides all the information that is indicated on the form.
• The religion does not need to be a “named” religion, written documentation from clergy is not required.

Section 6 - only when not complying with the Proclamation

• Make sure that it is understood what the consequences are, have this section signed and dated by the employee, contractor, or volunteer.

Section 7 - to be completed by Employer/healthcare facility operator

• Make sure this section is filled out completely and signed and dated by both parties.

Enforcement

We really will have no idea as to what enforcement is going to look like until it begins to happen. The Washington Department of Labor and Industries (L&I) has the authority to issue fines and shut you down until you come into compliance. The Department of Health has the authority to issue fines and provide other sanctions against your license. Law enforcement has the authority to charge you with a gross misdemeanor. 

The Department of Health has indicated that enforcement will be complaint driven, much like it is with any regulatory issue. Will the Department of Health or Labor and Industries come knocking on your door? We believe this is highly unlikely, but it could happen. Do you have other complaints against you, have you been flagged as a non-complier, then this could be more likely to happen to you. Will law enforcement come knocking on your door? Again, we think this is highly unlikely, but it is possible. If you have all your documentation for yourself, employees, contractors, and volunteers at the ready and you have made a good faith attempt to fully comply with the Proclamation you should be on firm ground from a legal/regulatory perspective.

Miscellaneous

• The Proclamation allows the healthcare facility operator to handle exemptions, in good faith. This means the forms must be completely true and accurate to the best knowledge of those signing the documents.
• When you issue a qualified exemption/accommodation you can impose conditions. For example, if you employ a biller who has requested a religious exemption/accommodation you can have that biller work off-site instead of on-site, or if you have a provider in your facility who is an independent contractor and you have issued a qualified medical exemption/accommodation you could impose the condition of being tested for COVID-19 on a regular basis.
• It is not discrimination to not hire/not contract with someone who is not vaccinated.

We hope that you find this information to be helpful.

Marybeth Berney LMT

WSMTA President

 

As I've mentioned in a prior GR blog, CPR is required for anyone renewing their massage license after September 1, 2021. The new requirement states, "Maintenance of certification in American Heart Association CPR or equivalent".

WSMTA has received questions about a) whether the class has to be in-person or not and b) what does equivalent mean?

The Format of the CPR Class:

Like the ethics requirement, the CPR requirement does not call out a specific mode of education which means that you can fulfill the requirement by taking an in-person class, an online class or a hybrid of in-person and online.  If there are other formats for taking CPR, then it would be acceptable as well.

What Does Equivalent Mean?

The American Heart Association’s CPR is based on the resuscitation knowledge of the “International Liaison Committee on Resuscitation”.  The American Red Cross is an equivalent organization and their CPR methods are based on the "International Consensus on Cardiopulmonary Resuscitation".  If you take a CPR class from another organization, find out what their CPR methods are based on.  More than likely you’ll find that it’s based on one of these two sets of guidelines.  If it is, then it will be equivalent.  Often you can find this information on the website’s FAQs page or on the page that talks about their CPR.  If not, then call them.   If it is not based on one of these two organizations’ resuscitation methods then you’ll need to do some homework to determine if it is equivalent or not.

To read our other blog article on CPR, please click on the following link: https://www.mywsmta.org/gr-news/10443398

WSMTA wants to make sure that you have access to reliable information with which you can create an educated and informed response for yourself, your massage business, your family, friends and your community.

By now most of you are likely aware of Proclamation 21-14 COVID-19 Vax Washington. Here is a link to the Proclamation: https://www.governor.wa.gov/sites/default/files/proclamations/21-14%20-%20COVID-19%20Vax%20Washington%20%28tmp%29.pdf 

We encourage you to read the Proclamation in its entirety, paying particular attention to pages 6-7 which reference massage therapists in particular.

Another document that we encourage you to read in its entity is the FAQ that was just recently released by the WA Department of Health. Here is a link to the FAQ: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/505-160-VaccinationRequirementFAQs.pdf

If you receive email notifications directly from DOH you should have seen these documents in your inbox. 

Since there are differing views amongst the WSMTA board as well as many of our members regarding this topic, WSMTA is choosing a neutral stance. We encourage our membership to avoid the temptation to rely on hearsay and false narratives and to do the research for themselves using reliable and science based resources which will empower them to make the best decision for themselves, their business, their families, friends and communities.

WSMTA Government Relations Program

There is a little known tax that will start for all Washington state employees on January 1, 2022 for the “WA Cares Fund”.  Each employee will be taxed $.58 of every $100 for long-term care insurance.  This is an employee tax, something that comes out of your paycheck, not an employer tax. 

Starting January 1, 2025, employees who have been paying into this fund will be eligible for benefits.  To be eligible, you must be vested in the fund and there are quite a few requirements.  The maximum benefits that any employee can receive is up to $36,500 – about 3-6 months of care, depending on the facility or level of care provided.  It is possible to opt out, but to do so you need to have your own personal long-term care insurance plan in place by November 1, 2021.  If you are self employed and want to opt in, you can do that as well.  For further details, go to: http://www.wacaresfund.wa.gov/

As Washington State reopens, there are a lot changes that have happened.  However, for healthcare providers, there has been no change for us regarding masking and social distancing.  Masking for healthcare providers is still required in our treatment rooms or clinics as is social distancing.  When the new requirements came out earlier in June in preparation for the June 30th reopening, we started to work with the Washington State Department of Labor and Industries (L&I) to get clarity.  Please click on the following link for a one page summary of what the masking and social distancing requirements are and how this applies to massage therapists.  Should you still have questions, at the bottom of the document is the contact information for the L&I contact person to follow up with.

06/30/21 State Masking/Social Distancing Requirements for LMTs

For a sign that can be posted in your massage room or clinic, please click on the following link:

Sign -- Face Masks Still Required

Please click on the link below for a sign that can be posted in your office for your clients/patients to see.  It indicates why face masks and social distancing are still required in the massage room or clinic. 

Sign -- Face Masks Still Required

For more information on masking and social distance requirements, please click on this link:

063021 Masking and Social Distancing for Massage Therapists

The Office of the Insurance Company (OIC) has published information on their website to help healthcare providers make contact with a health carrier to determine which of their plans are eligible or ineligible for 99072 PPE reimbursement.  It still requires us to make contact with the health carrier, so there are no short cuts. To look at the page, click on this link:

How to determine health plan fully-insured status

Some insurance carriers are starting to make payments on just submitted billings for 99072 and some are even going back and paying on older submissions.  If you haven't seen it yet, they are also changing their denial of claims for 99072 to specifically state that denial was due to ineligibility.

For our last blog on CPT Code 99072 PPE Reimbursement,  please click on this link:

Part 2 – PPE Reimbursement (CALL TO ACTION)

If you have been using CPT code 99072 to be reimbursed for PPE, you will probably have noticed that you are not being paid for it.  If you look at the EOB’s, you will generally see a rejection notice that states: “payment is included in the allowance for another service/procedure”, or something similar to this.  Healthcare providers across professions are not being reimbursed at this time.

Senate Substitute Bill 5169 (SSB5169) enables all healthcare providers to seek reimbursement for personal protective equipment during the state of emergency related to COVID-19. This bill became law and went into effect on April 16, 2021 when the governor signed it.  Healthcare providers treating patients in state-regulated commercial health plans who have incurred costs for PPE are able to bill the newly created CPT code 99072 and be reimbursed $6.57 per patient encounter.

The two important things to remember about using 99072 to bill are:

• It only applies to state-regulated commercial health plans which do not include: PIP, ERISA (federal plans such as medicare supplemental plans, or self-insured plans like Boeing or Microsoft), Taft-Hartley plans (trade-union bargained plans) or L&I.

• Only bill exactly $6.57.  Billing anything else gives the insurance companies an excuse to deny payment.

If you are unsure as to whether a client/patient’s plan is eligible for PPE reimbursement, ask your client/patient to contact their insurance company for a “summary plan description” which will indicate the set of laws that regulate it.  By law, the insurance company has to respond to the patient’s request, but it does not have to respond to the same request if it comes from the healthcare provider.

CALL TO ACTION!

If you are being denied the PPE payment, our only recourse is to file complaints with the Office of the Insurance Commission (OIC).  Without these complaints, nothing will be done by the OIC to require commercial health insurance companies to pay.  Each healthcare profession is asking its members to file.  To file a complaint, go to:

www.oic.wa.gov

On the left of this page, below the picture is a link in a green field for “File a complaint or check complaint status”, click on that and then click on the “File Complaint” button on the next screen.  To file a complaint, you need to provide specific information about your complaint.  Provide claim number and date of service, never include the patient name as the complaint becomes public record.  Complaints with patient names will be rejected.  Provide a statement of having billed 99072 for $6.57, that it was rejected and provide the rejection reason.  State that the insurance company is not following the SSB5167 signed into law on 4/16/21 and ask the Insurance Commissioner to make the insurance company follow the law and reimburse you.

Once you have filled out your first complaint and submitted it, if you file others, the form will remember the information from your prior complaint and fill it in, so all you have to do is update the information (claim number, service date, insurance company name etc) for the next complaint. The more complaints you file, the greater the weight is on the Insurance Commissioner to act.  Please only include information for one massage service provided on each complaint.

Thank you for supporting your profession!

To learn more about the details of SSB5167, read a prior posting by clicking HERE.

Annual Business Meeting and Continuing Education

• June 27 2021 at 9:30AM - 2:30 PM
• Zoom attendance is limited to 100 participants.
• Free to members, must be a member to attend. To become a member JOIN HERE
• 4 Continuing Education Credits

Annual Business Meeting

• Results of the 2021 election of Directors.
• Reports from WSMTA Clinical Practices, Government Relations, Membership Programs, and Treasurer. Our team of volunteers have been working especially hard for you and the profession this last year.

4 Continuing Education Presentations

Topic: Sustaining and Growing Your Business in Tough Times: Thinking Outside the Box During the Pandemic

In this live, interactive webinar our presenters will present creative healthcare business models. Thinking outside the box, they will share the benefits and risks of various models as well as the underlying values that inspire them.

Our presenters, from an array of healthcare practices, will inspire you to consider new ideas to grow your practice or recover from the effects of the pandemic with these topics:

• Direct Primary Care (Concierge Service) by Dr. Richie
• Understanding the Alphabet Soup of Supplemental Insurance Benefit Options - Taking Control of How Your Healthcare Dollars are Spent by Jessica Bradley 
• Widening Your Horizons and Adding Additional Services to Your Practice with Leslie Korn
• Developing and Running a Membership-Based Wellness Spa by Nicole Chryst, LMT
  

For full event details, click HERE.