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.