Advocacy and Advisories

Pre-Electoral Responses from Party Leaders

As part of MTAM's work with the Manitoba Health Professional Associations Coalition (MHPAC), we participated in a questionnaire directed to the leaders of the political parties in Manitoba in advance of the Provincial election this October.

To date we have heard back from 3 of the 4 parties contacted. The letter and the party responses are linked below.

MTAM reached out to all parties for further clarification on the last question which pertains to the transition of professions into the RHPA and the future regulation of our profession. An invitation to meet was also extended to each party leader. We are awaiting their responses and will post updates here.

MHPAC Letter
PC Party Response
NDP Party Response
Green Party Response
Liberal Party Response

MTAM/CMTA Advocacy for GST Exemption on Massage Therapy Treatments

August 2023 ~ Members of Parliament have begun responding to our advocacy regarding GST/HST exemption on massage therapy treatments.

GST/HST exemption will decrease the overall cost of massage therapy treatments for our clients and give RMTs parity with other regulated health care professions in Canada. While Manitoba is not yet regulated, we have achieved regulation in 5 provinces in Canada which is the minimum number needed in order to apply for tax exemption nationally.

This month MTAM has had its first of 3 planned meetings with Manitoba MPs. We thank MP Ted Falk in the riding of Provencher for his time and look forward to presenting additional information to him in the near future.

It has been recommended that a petitition be created for RMTs and their clients to sign in order to show support for GST/HST exemption. We will advise members when we have more information on this process and how to take part.

Click the links below to view letters to Manitoba MPs and earlier CMTA correspondence with the Federal Government.

For more information on this and other CMTA initiatives visit www.crmta.ca.

MTAM Meets with Manitoba Public Insurance

January 23, 2023 ~ Meeting between Courtney McGill, Manager, Health Care Services and Quality Assurance for Manitoba Public Insurance (MPI) and Tricia Weidenbacher, MTAM Executive Director

MTAM reached out to MPI in January to continue discussion surrounding MPI’s policy regarding the coverage of massage therapy treatments as provided by Registered Massage Therapists (RMTs).

As many MTAM members know, MPI currently only reimburses massage therapy treatments if the treatment is provided by select healthcare providers but not when provided by RMTs. See Section 8 of the Reimbursement of Expenses (Universal Bodily Injury Compensation) Regulation.

The purpose of MTAM’s meeting with MPI was to update them on our progress toward regulation of the profession, remind them of the high standards of practice that MTAM members are required to follow as well as to consider the best interests of Manitobans injured in motor vehicle accidents (MVA).

Many individuals who are injured in MVAs may prefer to have their injuries treated using massage therapy (MT) for a variety of reasons:

Very accessible and non-invasive form of treatment
MT is a safe and effective form of treatment for a variety of soft-tissue injuries commonly resulting from MVAs
MT has been an effective form of treatment for the client in the past
Reasonably easy to get in to see their preferred RMT when they need treatment
They prefer using MT over other modalities

At this time, Manitobans are told that if they wish to have their MVA injury treated with massage therapy and receive reimbursement through MPI that they must go to practitioners who are highly unlikely to provide massage therapy as a treatment modality and who may be less skilled overall at providing massage therapy treatments than an RMT.

MTAM frequently received calls and email from the public expressing their concern and confusion surrounding this policy within the regulation as it negatively impacts a person’s ability to access an effective modality which may also be their preferred form of healthcare to treat their MVA injuries.

MTAM strongly suggested to MPI that it’s time to re-evaluate this regulation so that Manitobans can be better served when recovering from MVAs and able to receive reimbursement for massage therapy treatment provided by RMTs.

MPI asked MTAM to provide current information on our entry-to-practice education and professional development standards, standards of practice, code of ethics and complaint management process as well as an update on our most recent activities with respect to the regulation of the massage therapy profession.

We have been told that the information provided will be reviewed and MPI will reach out with any questions or comments that arise.

MTAM will continue to stay in touch with MPI and advocate for changes to their regulation which are in the best interest of the public and our RMT members who provide massage therapy care to them. MTAM will post updates as new information becomes available.

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MTAM Meets with Manitoba Blue Cross

February 6, 2023 – MTAM met with MBC as part of our regular outreach to maintain communication and our ongoing relationship with MBC.

The meeting agenda included:

Questions on behalf of the MTAM IPM committee
- Clarification on Doctor’s Note requirements for massage therapy coverage
- MBC audit and process update
- Fraud trends to be aware of
Update MBC on our path to regulation

Doctor’s Note/RX requirement for massage therapy (MT) treatments – why is this requirement in place for MT on some plans but not necessarily for other healthcare treatments (ex., physiotherapy)?

Response from MBC – They acknowledge the value of MT for managing and/or rehabilitating many types of injuries and physical health conditions. They recognize that MT can be helpful in managing the physical symptoms of many mental health conditions.

MT differs from other types of treatment in the sense that it is used for both current injury as well as preventative care – Insurance plans generally do not cover preventative care. (Dental coverage is the exception to this rule.)

“Benefits are only meant to be claimed if “medically necessary,” says Shannon DeLenardo director, anti-fraud and electronic claims at the Canadian Life and Health Insurance Association.

Plans are underwritten for treatment of injury (i.e., there is an expected end date to the treatment plan). Prescriptions therefore have an expiration date, and a new Rx would need to be provided once the previous one has expired.

Employers/unions also have a say in how company insurance plans are set up. They may have requested the doctor’s note requirement and MBC must honour those types of requests.

MTAM will continue to advocate for insurers and employers to drop the doctor's note requirement for massage therapy reimbursement on insurance plans.

Have there been any changes to MBC’s audit process since our last check-in?

No. The process remains the same and there has been a slight decrease in the overall number of audits. Refer to the Member Portal under Business Tips & Practice Advice page for information on Insurance Audits.

Eligible MT treatments must follow MTAM standards of practice and include:

Health history intake/update
Relevant assessment/update of treatment plan as needed
In-scope MT treatment for the majority of the treatment and/or overall treatment plan. Complementary modalities may be used as appropriate within the treatment plan.
Recommend home care/remedial exercise, etc. as appropriate
Charting within 24 hours of the treatment
Payment/co-pay/invoice/billing as per Provider Agreement, CLHIA and MTAM standards

Are there new fraud trends emerging or other audit related concerns?

While audits overall have decreased, MBC is noticing an increase “benefit splitting” by dual certified practitioners. Benefit splitting may not be fraudulent in every case. MBC is tracking the trend to better understand any occurrences of fraud.

What is a Dual Certified Practitioner?

A dual certified practitioner is certified in more than one type of practice. For example – an RMT may choose to become certified as a Registered Acupuncturist or a Manual Osteopathic Therapist (MOT). There is also a growing number of Athletic Therapists who are choosing to become trained as RMTs.

What is Benefit Splitting?

Benefit splitting occurs when a client is receiving 2 or more different health care modalities from the same practitioner (who is registered/certified to provide each of those modalities) and the treatments are being reimbursed by the client’s insurance plan.

When is Benefit Splitting fraudulent?

Benefit Splitting becomes fraudulent when the health practitioner misrepresents the treatment provided on the client’s receipt or insurance invoice/direct billing submission.

For example – The practitioner is licensed to practice as both an RMT and an MOT. The client has separate insurance coverage for both MT and Manual Osteopathy (MO). The client receives MT treatments from the practitioner and has exhausted their MT coverage. The client wishes to keep receiving MT treatment and does not wish to have MO treatment or the MO treatment is not appropriate for the client’s needs.

The RMT/MOT continues to provide MT treatment to the client but issues the receipt as MO treatments so that it will continue to be reimbursed by the insurer. This is misrepresentation of the treatment and is a form of insurance fraud.

The scope of practice may overlap between MOT, AT, and RMT but there are distinct differences as well. MBC looks at the chart notes and looks for identifying features of the treatment and feedback from the client to help determine if the treatment was represented properly on the receipt or if fraud is suspected.

Massage Therapy Regulation – MTAM provided a review of the history to date and all communication and steps taken by MTAM in the past 2 years.

As we wait for the government to proceed with the next steps, MTAM continues to do what we can to protect the public and encourage high standards of practice by our members.

MBC was appreciative of the update and looks forward to continuing the open dialogue going forward.

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Advocacy with Integrity

The MTAM is a recognized leader in evidence-based advocacy. Our Association is regularly called upon to provide information and advice on behalf of our members and the profession. We use common-sense and facts in all of the work we do on behalf of members. We work with integrity to ensure massage therapists can help more Manitoban's be healthy and are seen with respect by the public and other health care professions.

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National Survey - Incidence of Assault and Harassment Toward RMTs

Through MTAM’s membership with the Canadian Massage Therapy Association (CMTA), we engaged in a national survey to gather information on the incidence of sexual harassment and assault of RMTs in the workplace. Our goal is to learn more about this so that we can work toward improving safety for RMTs in their workplace.

Survey results and updates on this project are posted on the CMTA website.

MTAM currently offers a free course to members on safe work strategies. They can find a recording of a recent event in the Member Portal and see the Coming Events page for future live courses.

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Supporting Our Members

MTAM undertakes a variety of advice, mentorship and advocacy for our members:

We provided reliable and constant information for members in an ever-changing environment resulting from the COVID-19 pandemic.
- Updates were delivered via email, newsletters and on the MTAM website.
- We delivered live webinars for members on key topics. These sessions also helped preserve our sense of community by allowing members to meet virtually.
- We responded to member needs by providing free access to practice advisors, clinic tools and resources, and webinars.
- We advocated on behalf of members to all levels of government, to public health, and to insurance companies.
- We quickly adapted to ensure all regular membership services and benefits were uninterrupted despite COVID-19-related closures. This meant that Board and committee members volunteered hundreds of extra hours.
We give members step-by-step ways of managing legal challenges, we can help them to find affordable legal help, coach and assist in preparation when then need to testify or hand in their SOAP notes for a case.
We coach clinic owners and individual therapists how to report incidents when they have been propositioned, assaulted, or mistreated by a client.
MTAM has been working with Clinic Owners and Spas to build better employment and independent contractor situations for RMTs and help the organizations manage human resource challenges.
We consult to help businesses improve work situations, treat RMTs more fairly, and to be sure that pay, work conditions and contracts are fair.
Our Associate Membership ($75) is our way of inviting Clinics, Spas, Wellness Centres and other organizations to be a part of this community, to attend select events and take part in key discussions that affect the profession.
MTAM offers practice advice and mentorship to help members with all of their practice-related questions, to review contracts, navigate starting their business, and to mediate challenging situations with co-workers or owners.

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Ongoing work with Health Benefit Providers

MTAM works closely with all major health insurance benefit providers, third party administrators and similar organizations. Each month we send an updated list of our members to all major benefit providers so they are able to quickly and efficiently process claims made by patients. MTAM educates members and helps with individual cases of insurance fraud or suspected fraudulent practices within clinics where our members work.

MTAM places a priority on advocating on behalf of our members, the massage therapy profession and the public. We continue to educate health benefit providers on the benefits of massage therapy which has helped thousands of Canadians remain active, mobile and pain-free, recover from injuries and relieve debilitating symptoms of illnesses.

As most insurance companies are national, we assist the Canadian Massage Therapist Association (CMTA) in advocating for the continued inclusion of massage therapy coverage in extended health benefits plans. The CMTA meets regularly with representatives from the Canadian Life and Health Insurance Association (CHLIA) to provide information and education about the role of massage therapists as health professionals across the country, and the evidence supporting the efficacy of massage therapy.

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National work on Insurance Audits

On a national level the CMTA met with CHLIA to discuss a number of topics including finding ways to ensure audits are more consistent.

The hope is to bring all the information to the table to find solutions to the insurance audit process which currently seems arbitrary and dependant on the individual assessor rather than a coherent, concise, and transparent process. CHLIA has been working to layout a national strategy/criteria for the collection of information, standard recording processes, and standardized practices. The CMTA will send information to assist in that process.

The CMTA also presented a number of other advocacy points to CHLIA — thanks to both of these important groups for their work in helping all RMTs.

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Partnerships

We are all stronger, when we work together. We are proud of the relationships and partnerships we have with other Massage Therapy Association's across Canada and are a proud member of the Canadian Massage Therapist Association.

We work with other health care therapies in this province both individually and collectively as part of the Manitoba Health Professional Association Coalition (MHPAC). MHPAC's purpose is to develop a sustainable coalition or alliance of Manitoba Health Professional Associations who act together and establish relationships that are mutually beneficial. The focus is on interaction and the exchange of information regarding professional issues and interests by attending business meetings and/or other events. This group was established in 2020 and includes more than 15 professional associations. Some of the professions represented and which MTAM meets with as part of MHPAC are physicians, nurses, dentists, physiotherapists, pharmacists, chiropractors, occupational therapists, and athletic therapists.

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Cases in the Media

The MTAM keeps up-to-date on all court cases, incidents, and situations related to massage, massage parlours, body workers, and to cases that involve massage therapy health care practitioners in Manitoba.

When cases are being investigated or are in the court system, we will not comment specifically to respect the integrity of that case or investigation. The MTAM believes it is inappropriate to comment publicly on cases sub judice. Publicly discussing cases sub judice may constitute interference with the legal process.

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