2706 Details

What does Section 2706 mean?

I spoke on the phone this weekend with Judge Deborah Senn, former WA insurance commissioner who helped to design the Every Category law that covered CAM providers in her state. She explained to me the meaning and intent of Section 2706 of the ACA, and what it means for both insurance policies and providers.

[Health insurance] shall not discriminate…against any health care provider.

This law is specifically written to cover providers, not services. That means that insurance policies can no longer cover massage therapy only when performed by a chiropractor or doctor, which is something that they love to do. If massage is indicated, any provider who is licensed to perform massage will be covered. That means us.

If a client wants to use health insurance to get a massage, he or she may be required to get a doctor’s referral first. If a doctor determines that massage therapy is a good course of action for the diagnosis given (eg, back pain, neck pain), then insurance will have to cover the massage, regardless of the type of practitioner that gives it (given, of course, that said practitioner is working within his or her scope of practice).

Massage therapists will have to be credentialed with insurance companies in order to work with them, and although this can be tiresome, it has significant benefits (which I will explain later). Beyond that, the new law makes everything pretty straightforward. If your doctor says you should get a massage, insurance will cover it. Simple!

That said, you can be absolutely sure that insurance companies will only comply with this while kicking and screaming. As the ACA rolls out in full at the beginning of 2014, the first few months especially will be rather frustrating. It will be up to us, the providers, to make sure that both our clients and ourselves can get the most benefit out of Section 2706.

I hope that this blog will be able to serve as a guide to dealing with insurance companies – beyond getting credentialed and billing for services, I want to show you the ways that these companies will try to deny your claims. I want you to know your rights under the law. I want to teach you navigate the waters of insurance and get yourself paid. It’s going to take some extra effort, and I know that not every LMT will want to deal with the extra hassle. But the more massage therapists who do, the greater our rewards will be.

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6 thoughts on “2706 Details

  1. So a few questions: what about states that don’t have licensing for massage therapists? States are creating exchanges to implement this. Here in WA the OIC has picked one plan to be the health exchange – a Regence Innova plan from what I have heard. How will it affect all the other plans and companies?

  2. LMTs in states that don’t have state-wide licensing or credentialing will not be able to utilize this new law. Hopefully, though, it’ll motivate those states to start the process of licensing. And as far as I know, this law extends to all private insurance, not just the ones in the exchange.

  3. Pingback: Trigger Point Massage Therapy Portland Oregon - Natalie Weintraub, LMT » Massage Therapy and PT

  4. Pingback: Oregon and Rhode Island News | IHPC - Integrative Health Policy Consortium: Massage Outreach

  5. How do you get credentials for insurance. I am a LMT for a Chiropractic office in Pa. I am trying to find out if massage is covered by me, in the chiropractic setting. The Doctor here keeps telling me only if done by him. Help I’m trying to get answers and getting now where fast. Hope you can help. Thank you in advance.

    • Hi Kim – Which insurance companies to you want to get credentialed with? Pick a few companies, and then call them to ask if they accept massage therapists in their network. If they do, ask them how to get credentialed (it involves paperwork). If they don’t, ask if you can still bill them as an out-of-network provider. For most insurance companies, you should at least be able to do that.

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