By: Elizabeth Jane Brooks, LMT, BCTMB

Recently, there has been some concern regarding whether or not non-participating spouses should be included when reporting at least 25% ownership of a business entity for FinCEN. Since WA State is a community property state, the assets acquired during the course of a marriage are generally acknowledged to be equally owned by both spouses. In light of FinCEN reporting, it is then likely that a spouse, even if they have no participation in a business entity, will need to report being a beneficial owner in the business entity. FinCEN has not yet specifically stated this to be the case, but it is implied and clarity is likely coming in the near future. Knowing this, you may want to include community property ownership as additional beneficial owners.

Full FinCEN Reporting article link from April 21, 2024

https://www.mywsmta.org/CPP-News/13346226

Are you looking for a way to give back to/promote the massage profession in Washington State (and make a few bucks on the side)? If you have skills in marketing, business administration, sales or school admissions, then WSMTA is looking for YOU. 

The WSMTA Board of Directors is looking for a Membership Program Director (see position description here, Volunteer Position Descriptions You will be able to help create WSMTA’s Membership Program from the ground up. You will be a primary “face” of the organization, interacting with massage schools, current members and potential members. When certain membership goals are attained there will be a financial benefit for you!

If you are interested in being our Membership Program Director contact Marybeth Berney, WSMTA President, at mberney@mywsmta.org.

If you are curious about joining our band of passionate volunteers in clinical practices, government relations, editing and social media or as a Director– please email info@mywsmta.org and put “volunteer” in the subject line.  

By: Elizabeth Jane Brooks, LMT, BCTMB

What is FinCEN?

Originally established in 1990, the Financial Crimes Enforcement Network is a bureau of the United States Department of the Treasury. Fundamentally, FinCEN is a network connecting law enforcement, financial, and regulatory agencies. Its purpose is to both gather and analyze financial information to fight against financial crimes (such as domestic and international money laundering, and the financing of terrorists).

FinCEN reporting went into effect on January 1, 2024 pursuant to the Corporate Transparency Act. It is important to consider whether your business must file this report regarding Beneficial Ownership Information (BOI).

What types of entities must file the FinCEN BOI report?

There are two steps in deciding whether or not a BOI report needs to be filed.

First, determine the type of entity of your business. Domestic companies that are required to report include corporations, limited liability companies (LLCs), professional limited liability companies (PLLCs), limited partnerships, or any other entity created which was filed with the secretary of state or a similar office. In addition, similar entities formed under the law of a foreign country and registered to do business within the United States are also required to file this report. Moreover, under some circumstances limited liability partnerships and business trusts need to file as well—for this, checking with your accountant is advised.

The second step is checking if your entity is one of the 23 types that are exempt from having to file, although the vast majority of massage practices will not qualify for these exemptions. (www.fincen.gov/boi-faqs). FinCEN provides a useful Exemptions Checker Tool to assess your qualification (www.fincenfetch.com/boi-report-exemptions/).

Important dates to c  onsider

If your company was created or registered prior to January 1, 2024, you will have until January 1, 2025, to file your initial BOI report. However, if your company was created or registered anytime in 2024, you will have just 90 days to file your initial report after receiving notice that your business entity is legally recognized. This is important as you may be liable for significant penalties (and possibly even jail time) when failing to comply with the registration requirements. This can include filing false information or filing incomplete information. If you have missed a deadline for filing you may be able to explain your reasons and get a reduced penalty.

Additional links:

For more information: https://www.fincen.gov/

To file your report online: https://boiefiling.fincen.gov/

Filing dates graphic: https://www.fincen.gov/sites/default/files/shared/BOI_Reporting_Filing_Dates-Published03.24.23_508C.pdf

A YouTube walkthrough for online reporting: https://www.youtube.com/watch?v=5xOsSiQI-C8

Elizabeth Jane Brooks, LMT, BCTMB

WSMTA Board Director

Clinical Practices Committee

Washington State Massage Therapy Association

Visit us at: mywsmta.org

We wanted to give you a heads up as the 2024 Legislative session grows closer (session begins 1/8/2024) that we will likely be reaching out to you to answer A Call to Action about one bill for sure.

The “for sure bill" is, HB1655 (and its Senate companion) An act relating to provider contract compensation. Informally this bill has been referred to as the COLA bill. If passed it would require health carriers to adjust reimbursements for those providers not affiliated with hospitals or their affiliates (think LMTs and Chiropractors as well as others) at the same level as the cost of living. To see more about the 2023 history of this bill click here. https://www.mywsmta.org/CPP-News/13245226

WSMTA works for YOU, licensed massage therapists in Washington state, Advocating for Massage Therapy as a Recognized and Respected Health Care Profession. Stay tuned!

A WSMTA Clinical Practices Committee member, Julie Johnson, conducted an all-volunteer audit of the Regence Provider Directory from all over Washington. We wanted to have a focused effort to confirm what we’ve been hearing for years from our members and clients/patients – the medical insurance directories are inaccurate. With seventeen LMT volunteers (THANK YOU!), we could only confirm 176 individual licensed massage therapists out of 1078 directory listings were actively taking Regence in November of 2022. To read about the audit, our findings and what the OIC said, check out our article Massage Therapy Insurance Provider Directory Audit (link to https://www.mywsmta.org/page-1075480)

Julie Johnson, LMT, ACOM
Clinical Practices Committee
jjohnson@mywsmta.org
 
Washington State Massage Therapy Association
Visit us at: mywsmta.org

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New LMT Support Group starting in November:

Many of us are working in isolation. Even in clinics with multiple practitioners, schedules usually leave little opportunity to connect with other therapists. WSMTA’s Clinical Practices Program will start offering monthly meetings to inform, discuss, vent, problem solve, and support each other. Meetings will happen on Zoom on the 1st Monday of each month, starting November 6th 2023, from 7 to 8:30pm.

Meetings are open to members, and non-members. Depending on topics, CE credits will be available for free to WSMTA members.  Non-members may join WSMTA to receive free credit as well.

Please email Dagmar Growe at dgrowe@mywsmta.org to receive the zoom link before the meeting. Due to a prolonged absence, expect to receive the zoom link the day before the meeting.

WSMTA Clinical Practices Program also offers “Best Practices”, a support group for therapists and clinic owners which takes place every other month Wednesday 8 - 9am. Please email srosen@mywsmta.org if you would like to be included on the invitation list. These meetings are held on Zoom.

By Dagmar Growe, LMT

When WSMTA was founded in 2015, two of our goals were to work with insurance companies toward making processes less cumbersome for LMTs and patients, and to work toward a badly needed increase in reimbursement rates. Most of our founding members had been around since the late 1990s when insurance companies sought out their advice on how to implement the new requirements to cover massage therapy and we were hoping to build on those relationships.

Almost immediately after our founding, we had to face some difficult facts, WSMTA learned that advocating for a rate increase as an organization would be a violation of antitrust law. We also learned that insurance companies were not at all interested in communicating with anyone to help solve problems with procedures. Provider reps changed frequently so we were not able to build consistent relationships. Supervisors made themselves unavailable. In fact, with some health insurance companies, it seemed that not resolving problems was part of a strategy to discourage enrollees from using benefits, and to encourage massage therapists to withdraw from networks.

WSMTA had to change strategies, so we started to focus on alternative payment options and the issue of provider network adequacy - or the lack thereof. We focused on the following:

• Educating massage therapists about accessing patient benefits and payment through their flexible health savings accounts.

• Encouraging massage therapists to do a cost analysis so that individual businesses could assess if being a provider for a health insurance company was economically viable for their business.

• Educating massage therapists about contract violations. For contracted providers, it will generally be a contract violation to deny appointments to insured patients while offering them to non-insured clients.  We encouraged massage therapists to choose between either honoring their contracts or canceling them in order to avoid violations.

• Encouraging massage therapists to have their patients complain to their HR Departments and the Office of the Insurance Commissioner (OIC) if they were unable to obtain treatment in a reasonable timeframe.

• Conducting an audit last fall, with a handful of dedicated volunteers, of one insurance company’s massage therapy provider directory.  WSMTA found that the directory was inflated due to duplicate provider listings, listings of providers no longer contracted or not taking insurance any more, and retired LMT’s. We shared our findings with that insurance company, the OIC, and all legislative representatives on healthcare committees. And, we informed a number of other companies that we were planning on conducting similar audits of their directories.

And finally, this summer, everyone’s efforts have started bearing some fruit. After years of mainly decreasing rates, Kaiser announced a rate increase. Regence has also announced a rate increase, (although they moved all 3 CPT codes that LMTs were using to the same reimbursement level so therapists who were eligible to use and have been using 97112 will not see much of an increase). 

We are proud of this achievement which is shared by WSMTA and all massage therapists who did their own homework, said no to unsustainable rates and decided for themselves what worked best for their business. For many, this meant taking what could feel like a risky step by canceling their contracts rather than continuing to hold out in hopes that things might somehow get better on their own. Thank you also to massage therapy patients who lobbied their insurance carriers to increase treatment access. It is our hope that the remaining health insurance companies will realize that they cannot find providers unless they are willing to reimburse us at an acceptable rate.

These changes did not happen because insurance companies saw the light and wanted us to receive fair pay. It happened because LMT’s educated themselves and took action. Thank you to all of you who have worked behind the scenes for these changes. And, if you are not yet a member of WSMTA, I do encourage you to join today both as a member and a volunteer. Improvements happen, but they do not happen unless we are willing to fight for them!

• In the 2023 legislative session, the Washington State Chiropractor’s Association (WSCA) helped to initiate and heavily pursued HB1655, the Cost of Living Allowance (COLA) bill, which would require health insurers to include a COLA increase in provider fee schedules for those not attached to hospitals or hospital affiliates.
• When WSCA put out the call to action to its membership to get involved, WSMTA picked up on the information and passed it forward to massage therapists in our state, but it was too late in the process to provide any substantial support.
• Although the bill was well-received; there just was not enough grassroots support for it to move out of committee.
• In the 2024 legislative session, WSCA will be seeking a companion bill in the Senate to increase the chances of success for COLA as well as pursuing it again in the House.
• Currently, massage therapists are in a different place than chiropractors.  Recently, health insurance companies have made substantial improvements to reimbursement rates for massage therapy services.  However, chiropractors have not had any substantial change for about 20 years.
• Over the next several months we will keep massage therapists updated about COLA as well as to provide recommendations on what massage therapists can do to promote COLA with legislators.
• For information about the 2023 COLA bill, just click on this link:  https://app.leg.wa.gov/billsummary?BillNumber=1655&Year=2023

By Dagmar Growe, LMT

I have been honored to serve my profession and my fellow massage therapists for the past 7 years as a board member of WSMTA. I love the connection to the amazing people who are leading this organization, and our members. When I started I didn’t know what a WAC was (the rules that govern our profession), or how to find them. My insurance billing was based on a mixture of rumor and guessing. And I felt a sense of isolation, as I was practicing mostly on my own. Stepping up and volunteering for WSMTA has been a huge benefit for me.

I am now in what I hope will be a drawn out final stage of a 30+ year career. As I am shifting my focus to things other than work and family, I have decreased my work time and canceled my health insurance contracts. I am traveling a lot and keep missing WSMTA meetings. I am losing my enthusiasm for taking on insurance companies.

Many of the folks who guide and protect our profession through their volunteer service for WSMTA, AMTA-WA, or the Board of Massage, have done this for 30+ years. They have brought us from being an obscure profession with a dubious reputation into the 21^st century: We are accepted as healthcare providers, our patients seek our expertise for their health issues, doctors refer to us, and yes, well, insurance companies reimburse for our services – kind of. None of this has come easy, every step was fought for, and there is a constant pressure all around us to reverse this progress. Municipalities write codes that discriminate and aim to limit our scope of practice in the name of fighting human trafficking. Insurance companies try to limit coverage for massage therapy, or to make processes so cumbersome that we would give up and go away. I believe massage therapy as a healthcare modality does not have a future unless we keep fighting for it. There is an urgent need for younger therapists to be trained to step in to take our place as this current generation of therapists transitions out.

I have therefore decided to step down from my position as a WSMTA Board member and make room for someone who has a longer professional life ahead of them, and more energy and investment. Please notice that I did not mention “more time”, as just about nobody I know has extra time on their hands. However, a wise friend of mine once told me: “I don’t have time, I make time. For what’s important to me.” And my profession has always been important to me. I am planning to continue to be involved actively, mentoring younger therapists, giving more of my attention to South Sound LMTs, a local networking group that I have been part of since I first got licensed, and you might see the one or other article I feel compelled to write for WSMTA. As a lifetime member I will continue to be part of it, giving my time to the occasional project.

What does this position entail? Board members are also part of one of our programs (in my case Clinical Practice, there are also Membership and Government Relations). That’s 2 phone or zoom meetings a month, a total of about 4 hours, which count towards your continuing education hours. Whatever board members contribute beyond those meetings is mostly based on their interests and the time they are able to make available. My contribution has mostly consisted of writing articles, researching information, answering member questions, and taking minutes at meetings.

If you do care about our profession, and want to see it thrive in the future I very much encourage you to start volunteering now. Bylaws require that members serve actively for 6 months on one of the programs before being eligible to serve as a director. Please do not hesitate to nominate yourself or contact us to let us know in what function or area you would like to volunteer. Your service is needed to ensure the viability of our profession in the future.

REGISTER HERE

This is an affordable opportunity for a group legal consult with John Conniff, a highly knowledgeable and experienced healthcare attorney. John provided a comprehensive review & analysis of the Regence Provider Agreement in 2022.

This webinar is interactive, focusing on our shared concerns as well as your specific questions regarding the Regence Provider Agreement.

Our goal is to understand the provisions and requirements stated in a provider agreement before we sign it and gain knowledge to question provisions that are not in our best interests or even legal.

An example is Regence declares the contract itself is "confidential and proprietary", it is not. In addition, there is contract language that conflicts with Washington State law. Washington State law supersedes the contract language.

Please join us for an interesting and useful workshop on a topic that affects all insurance providers.

This webinar satisfies the Washington State 4-hour ethics requirement.

Dates: Monday, September 18th, 2023 from 7 - 9pm for Session 1 and TBD for Session 2. Registration closes on September 11th.

Location: Live Webinar via Zoom

Cost: $120 for those who have already purchased the Regence Provider Agreement review done by John Conniff.  $220 for those who have not previously purchased the review document – the price includes the $100 review document.

CE Hours: 4 

Register Here

by Elizabeth Jane Brooks, LMT, BCTMB

If you have contracted with an insurance carrier there may come a time when you wish to terminate that contract. Following are some suggested steps for getting this accomplished.

1. Obtain access to your contract

When the decision has been made, you need to look at the requirements in your specific contract. If you have a copy of your contract, this is easy. For many, you will need to obtain a link from the insurance carrier with an access code to open the contract file online. Contacting your insurer’s representative, or your Provider Relations Representative (if they have one), is an effective way to do this.

2. Locate termination requirements

Once you have your contract, locate the section on terminations to find the exact requirements. Some things you need to know are:

    Do you need to send a certified letter?

    What needs to be stated in your letter?

    Where to send your letter?

    To whom should this letter be addressed?

    How much notice must be given?

Keep in mind, termination must be done in writing. For this, sending it by Certified Mail is a great way to prove the writing was both sent and received. In addition to notifying the insurance carrier, if there is an administrator for the insurance, such as Tivity/WholeHealth or Community Health Plan, they will also need to be notified.

Below is a sample letter that you can tailor to your situation and use for termination. It has not been reviewed by an attorney, however, it is what a current member used to successfully terminate their own contract. Remember, your contract will tell you exactly what needs to be included in your letter of termination.

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Attn: [Department, representative, etc.]

BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED

To Whom It May Concern:

This letter constitutes notice that I am voluntarily terminating my contract with your company and all its affiliates at the earliest date allowed by the contract. [Reason for terminating.] Thank you for the many years of partnership. My NPI number is [XXXXXXXXXX].

Immediately upon the effective date of this termination, I will then be out of network with your company, and all patients in your plans will be expected to pay my out-of-network fees.

Please let me know promptly if you have any additional requirements concerning my contract termination.

Sincerely,

[Full name], LMT

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WSMTA hopes you find this information useful, and we acknowledge that understanding contracts can be challenging. If you still have questions or concerns regarding terminating properly, it would be wise to consult your attorney.

We at WSMTA do our best to stay on top of the latest news in massage, especially as it relates to laws, insurance, and business. We hope you find the articles on the website helpful (mywsmta.org). We also hope that you will consider joining us as a volunteer—you will make strong connections, gain support, and be at the forefront of the massage industry!

___________________

SAVE THE DATE

Understanding Healthcare Contracts

New May TBD via Zoom

2 CE's

Excellent opportunity to consult directly with John Conniff, healthcare attorney, who provided a comprehensive review of the Regence Provider Agreement. Get your questions answered, understand provisions and requirements included, some of which are not enforceable. More information to follow. The Regence contract review can be purchased on our website.