A.B.3014, a bill designed to define "Asian massage," is making its way through the California legislature and may end up on Governor Schwarzenegger's desk soon.The bill, introduced by Assemblyman Paul Koretz on Feb. 24, 2006, would amend Business and Professions Code Section 4937, the Acupuncture Licensure Act. While the bill has gained the support of such national and state organizations as the AAOM, AOM, AIMS and CSOMA, one California acupuncture organization has joined unlikely partners the California Physical Therapy Association and the California Chiropractic Association in opposing the legislation.
In a statement to AT, Sandy Carey, a representative for the Council of Acupuncture and Oriental Medicine Associations (CAOMA), alleged that the bill "does nothing to correct in statute an exemption which allows anyone to practice this massage' procedure without training or licensure, can suggest that this untrained and unlicensed massage' procedure is somehow connected to Oriental Medicine and can then qualify for medical insurance reimbursement." CAOMA offered amendments to correct this and other concerns, but according to Carey, "The author agreed to part of our amendments, rejecting others because of a stated concern that other health care professions may oppose the bill if modified. They then rejected all amendments." CAOMA suggested the following changes to the current code (italicized text delineates the deleted copy, while the suggested text is in bold):
Section 4937 of B&P Code, (b) To perform or prescribe the use of, among other procedures, Asian massage, acupressure, TuiNa (as defined in subsection (f) herein), breathing techniques, exercise, heat, cold, magnets, nutrition, diet, herbs, plant, animal, and mineral products, and dietary supplements to promote, maintain, and restore health. Nothing in this section prohibits any person who does not possess an acupuncturist's license or another license as a healing arts practitioner from performing, or prescribing the use of any modality listed in this subdivision.
(f) For purposes of this section, "Asian massage" TuiNa is defined as, but not limited to, Manual Traction, Myofascial Release/Soft Tissue Mobilization, and Joint Mobilization. means the use of pressure techniques, including myofascial release and, or manual therapy, as it relates to soft tissues, through massage and mobilization of the skin and muscle for the therapeutic objective of stimulation of proper body function.
"This particular bill addresses the scope of practice for acupuncture," stated AAOM Treasurer Shane Burras LAc, DNBAO. "It does not address the scope of practice for anything else. It does not speak to any other profession. We created this language that actually defines what Asian massage is, with a little bit more rigor, and put some ability to actually look at that previous Eastern term with Western terminology and create common language so that we can discuss it with our patients, so that we can discuss it other providers, and so that we can discuss it with the third-party reimbursement system."
A.B.3014 would define Asian massage as follows:
"Existing law, the Acupuncture Licensure Act, provides for the licensure and regulation of acupuncturists by the Acupuncture Board. Existing law authorizes the holder of an acupuncturist's license to engage in the practice of acupuncture and various other forms of treatment, including Asian massage. Existing law specifies that the act does not prohibit a person who is not a licensed acupuncturist or licensed healing arts practitioner from performing or prescribing Asian massage. This bill would define Asian massage for purposes of that provision."
"'Asian massage' means the use of pressure techniques, including myofascial release or manual therapy, as it relates to soft tissues, through massage and mobilization of the skin and muscle for the therapeutic objective of stimulation of proper body function, so long as the pressure techniques or manual therapy are consistent with the training requirements specified in the board's regulations."
Section 4937 of the California Business and Professions Code currently reads, "An acupuncturist's license authorizes the holder thereof ... to perform or prescribe the use of Asian massage." A.B.3014 would only give further definition to an already accepted practice. Until last August, the code originally read "Oriental," but after A.B.1117 passed, a bill sponsored by CAOMA, all instances were changed to "Asian," the wording they are now arguing against.
The bill will clarify what is legally included in an acupuncturist's scope of practice by codifying the definition of Asian massage and not expand upon it. With the impending American Medical Association "Big Brother" legislation recently introduced into Congress (H.R.5688; see "Stonewalling Patient Choice" on page 1 of this issue), any clarification of what services acupuncturists provide can only strengthen their position in the health care industry. Asian massage was considered by many as too general. Certain policies and procedures that are involved, including myofascial release and manual therapy, were not included in the Business and Professions Code.
"The AOM Alliance strongly supports AB 3014," stated Leslie McGee, RN, LAc, Alliance president, in an e-mail to AT. "Bodywork techniques have always been a part of Chinese medicine practice. This bill will help clarify our use of manual therapies and will help acupuncturists be properly reimbursed for these services."
The bill has passed through the Assembly Business and Practices Committee and the Senate Business, Professions and Economic Development Committee, and is in its third reading with the Senate as of press time.