Nine human hands, palms out, are shown in front of a U.S. flag, with the word Minnesota spelled out on the palms, to illustrate legislation for Minnesota massage therapists.

On February 24, a bill was introduced in Minnesota — and if passed, state licensing of Minnesota massage therapists will be mandatory.

This is significant because Minnesota is currently one of just four U.S. states — the others being Kansas, Vermont and Wyoming — that does not maintain statewide regulation of massage therapists.

Bill HF 3575 had its first reading in February and is now in committee.

Authored by Representatives Debra Kiel (R) and Dave Pinto (DFL), HF 3575 will establish state licensure, set associated fees, and provide criminal penalties (unspecified, so far) for massage therapists working in Minnesota.

Patchwork Regulations for Minnesota Massage Therapists

Since 2000, most of Minnesota’s practitioners of complementary health care have been governed by the Minnesota Complementary and Alternative Health Care Freedom of Access Act, signed into law in 2000.

Massage therapists in several municipalities, including St. Paul, Hopkins and Burnsville, are required to work under licenses.

But for the rest of the state, it’s currently the client’s responsibility to make sure a massage therapist has the appropriate training and experience. Although the state does govern complementary therapies, including massage – that authority is only exercised when consumers file a complaint.

Regulations currently in place already specify a broad range of services massage therapists are prohibited from providing.

According to the Minnesota Department of Health (MDH), Health Occupations Program, these include:

• Manipulating or adjusting bones of the spine

• Dispensing prescription medications

• Providing a medical diagnosis

Client Bill of Rights

Additionally, all unlicensed complementary and alternative health care providers need to comply with Minnesota statute Chapter 146A, which mandates that practitioners provide each patient with a client bill of rights before service and keep a copy posted prominently in their place of business. Clients must also sign a statement confirming that they received a copy.

The purpose of this is to provide all clients access to relevant information about the “complementary and/or alternative service” they will receive, and how a complaint can be filed if they’re dissatisfied, according to the Minnesota Department of Health.

Proposed Requirements for Minnesota Massage Therapists

Should the bill be signed into law, Minnesota massage therapists will be required to fulfill requirements that include:

• Undergoing a criminal background check (at their own cost)

• Showing proof of completing their training at a school that fulfills state requirements

• Having professional liability insurance coverage

Massage therapists who apply for licensure on or after January 2024 will need to complete a minimum of 625 hours of education and training that includes professional ethics and business and legal practices related to massage therapy.

This bill will also provide title and practice protection for Minnesota therapists, by stipulating that only qualified persons are permitted to practice, and specifically addresses how massage therapists with prior experience can comply.

To be eligible, applicants must submit proof of experience in the practice of massage therapy or Asian bodywork for at least two of the five years preceding the application date, and within two years after the date applications are first made available.

Exemptions for other Health Care Providers

The bill allows exemptions for non-resident health care providers.

Non-residents will be exempt when they’re engaged in temporarily providing complementary or alternative health care that includes movement or somatic education or therapy that is:

• Not designated or implied to be massage therapy or Asian bodywork

• Not advertised or implied to be provided by a Minnesota licensed provider

• Incidental to certain events like an athletic contest

• Instruction of continuing education courses

Also exempted are services provided by students practicing under supervision, and those provided by employees of the U.S. government or any federal agencies.

Creation of a Massage Therapy and Asian Bodywork Advisory Board

Under the proposed legislation, an advisory board will be established which is composed of five members. All board members will be required to have resided in Minnesota for at least three years to qualify for appointment.

The board will consist of two public members, two who are licensed massage therapists, and one who practices Asian bodywork therapy. No more than one member of the council is allowed to own or administer a massage therapy or Asian bodywork education provider.

Initial appointees will also be removed if they aren’t licensed within “a reasonable time after licensure procedures are established.”

Is Licensing Necessary?

Understandably, there is disagreement about whether state licensing of Minnesota massage therapists is a welcome development.

The Minnesota Natural Health Legal Reform Project (MNHLRP) position is “We have continued to oppose licensure or registration for massage therapists,” because they consider the practice of massage therapy to be safe and gentle, and not requiring a “higher degree of regulation than what already exists.”

However, experts insist that mandated licensing offers important benefits for practitioners, and the industry as a whole.

“I think the benefits outweigh any reason to not move forward. The only problem I can see for the therapist is the cost,” Donna Chang, RN, Medi-Spa Director at Mercy Medical Center in Baltimore, which employs massage therapists, told Massage Magazine.

Chang explained that massage therapists generally are independent contractors, so they carry all the extra costs of running a business. However, they are also “out there on their own, so having licensure is much-needed protection for them.” 

Standardized Requirements

Licensing of Minnesota state massage therapists will provide for the standardization of educational and other requirements, say its proponents.

“In Minnesota … most massage therapists are regulated by local municipalities, which often have different licensing requirements, standards for practice and fees,” wrote Michele Maiers, DC, MPH, Phd, executive director of Research and Innovation at Northwestern Health Sciences University, headquartered in Bloomington, Minnesota, in a position paper

“In essence, the current arrangement regulates these professionals as business entities rather than health care providers,” she added.

Maiers emphasized that this creates wide variability in educational requirements, practice standards, fees paid by practitioners, and an unnecessary administrative burden on cities.

She said she also believes the current system provides “an opportunity for illicit activity to occur under the guise of massage therapy. This is a disservice to the public, patients, and other health care professionals who work with massage therapists.”

About the Author

George W. Citroner is a freelance health journalist and author who covers breaking news in medicine and health for a broad range of publications.