resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
August, 2011, Vol. 11, Issue 08
Protect Your Business: Certification & Permits
By Michael R. W. Houston, Esq.
The trend is clear — as massage therapy becomes more popular with consumers and health care professionals, more and more states are regulating massage therapy. Currently, legislation requiring massage therapy licensing or certification has been adopted or is pending in 43 states and the District of Columbia.1 Nearly two years ago, California adopted legislation providing for the voluntary certification of massage practitioners and massage therapists by the non-profit California Massage Therapy Council (CAMTC).Designed to enable consumers to easily identify credible massage therapists and ensure that certified massage therapists have sufficient training from approved schools, California's statewide standards and certification program has been a success, with more than 22,000 applications received and nearly 16,000 certifications approved by the CAMTC as of October 2010.2 For therapists, perhaps the most significant aspect of California's legislation is that it limits the type of restrictions that cities and counties can impose on certified therapists — a significant help to your business.
As a massage therapist or practitioner, you may have already received your state-level certification; a vote of confidence in your training, expertise and professionalism. However you might be unaware that many cities and counties also have laws affecting massage businesses that must be complied with, in addition to state requirements. For instance, you also must confirm that your preferred location is actually zoned for the use, and you might need to obtain a local business license and potentially, a use permit . Local zoning and permitting requirements should not be overlooked, because operating without proper local permits could lead to closure, assessment of fines and even criminal penalties. A business proceeds at its peril if it operates without first determining what local permits are required.
State And Local Regulations
Regulations for therapists vary by state, ranging from licensure to certification or registration. States also usually allow for local regulation of massage businesses. (In California, cities and counties may regulate massage businesses under California Government Code 51030. However, as discussed below, Senate Bill 731 limits the type of regulations that cities and counties can place on certified therapists.) Cities frequently handle business permits differently, creating unique local requirements under which owners of massage therapy businesses must operate.
Cities have broad power to restrict most types of businesses and might even entirely prohibit certain types of businesses. Historically, cities can heavily regulate businesses that have a tendency for criminal activity or social ills, such as bars, gaming establishments and "massage parlors." While licensed and certified massage businesses are usually good corporate citizens, cities usually have common (and often legitimate) concerns with respect to massage businesses (as they do for any other type of business), including:
Understand Permit Requirements
With that in mind, massage therapy businesses must adhere to local zoning and business licensing laws, while ensuring that a city does not take advantage by regulating them too strictly.
Therefore, as a business owner, you need to:
Do Your Homework — Investigate what city permits are needed before signing a lease or buying property. Importantly, don't take a city employee's word about local restrictions. Do the research yourself.
Get Your Permits — Obtain proper approvals before operating. In California, having state certification will facilitate this process. If you need help navigating the myriad of regulations, consider hiring an attorney. Look for a lawyer who specializes in land use and one who is familiar with both state and local requirements.
Know Your State Laws — Don't let the city "over-regulate" your business by making you get unnecessary permits. For example, in California, Senate Bill 731 (adopted in 2008) establishes a state massage therapist certification that, if obtained, protects business owners by prohibiting cities from imposing unique permit requirements on the practice of massage by certificate holders.3 (Cities can still heavily regulate non-certified businesses.) This means that if a massage therapy business is composed of fully certified massage therapists, California cities cannot impose additional permit requirements just because the business provides massage therapy.
Despite your rights in a state like California, prepare for the city to "push back" (either due to ignorance of state law or in hopes that you are ignorant of state law). Consider retaining legal counsel to help educate city officials about state law. A small investment on the front end may save you thousands of dollars on the back end by avoiding delays in opening your business.
Know Your Rights — Know how to respond if a city tries to close you down once you have opened the doors. A permit is a "property right" that a city cannot take from you without following certain rules.
More and more states are passing massage license or certification laws. Generally, such laws help legitimize massage therapy businesses by giving them credibility both with consumers and cities. However, it is unwise to overlook local business licensing and zoning laws. It is imperative that you research local massage therapy and business permit requirements. With the proper paperwork in place, you will be able to focus on your customers and your business.
Additional information can be found at:
Michael R.W. Houston is a partner at Cummins & White, LLP, a business and insurance law firm based in Newport Beach, Calif. Mr. Houston has a practice that involves advising private parties and public agencies on the nuances of developing property in California's complex regulatory environment. He has served as counsel to numerous public agencies and private parties in connection with processing permits for various types of businesses and projects.
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