An image of a collage of politically related words, with the word "Legislation" bigger and bolder than all the rest, is used to illustrate the concept of new legislation in the massage therapy industry.

Current U.S. state legislative sessions have seen the introduction of many bills that, if signed into law, could affect massage therapists.

Bills to create state licensing of massage therapists have been introduced in Kansas and Minnesota. In New York, an act would establish a chronic-pain-management, education and training council comprising both Western and complementary practitioners. In Nebraska, a bill would require members of many health professions, including massage therapy, to complete annual training in implicit bias or diversity, equity and inclusion. And several states have introduced legislation to adopt the Interstate Massage Therapy Compact.

These are just some of the 20 bills noted below that could affect massage therapists introduced so far in 2023. (We have included write-ups of two bills that were signed into law in late 2022, due to their significance to the massage profession.)

Arkansas: SB58 would create both student and apprentice levels of licensing in the massage therapy profession. Anyone enrolling in a massage school’s course of study or an apprenticeship program would undergo a state and federal background check. They, as well as anyone applying for massage licensure, would have to affirm they had not been convicted of, nor entered a no-contest plea to, an offense that would constitute a felony. The state would issue a “massage therapy learning permit” to anyone enrolled in a massage school or apprenticeship program; that permit would expire six months after completion of the school course or apprenticeship. In January this bill was referred to Public Health, Welfare and Labor. (Source: Arkansas State Senate.)

Arkansas: HB1115 would raise the required continuing education hours from 125 continuing education (CE) hours to 300 hours of “advanced coursework in massage therapy as part of an Associates of Applied Science degree of massage therapy approved by the department” for master massage therapists. This category of massage therapist may instruct CE programs approved by the department, and instruct, as directed by a massage therapy instructor, basic curricula in a massage therapy school. This bill was introduced in January and was referred to Public, Welfare and Labor Committee. (Source: Arkansas State Senate.)

Georgia: HB153 would mandate adoption of the Interstate Massage Therapy Compact. This bill was introduced in January. (Source: Georgia State Legislature.)

Indiana: HB1235 would allow massage therapist licensure by endorsement. A massage therapist who is licensed, certified or registered in another state would receive an Indiana license by endorsement if the other state’s credentialing standards are substantially equivalent to or exceed the credentialing standards in effect in Indiana at the time that the individual’s license, certification or registration was granted in the other state. This bill was introduced in January and was referred to Employment, Labor and Pensions. (Source: Indiana General Assembly.)

Iowa: House File 2168 provides that massage therapists who treat children or dependent adults must complete mandatory reporter training, as opposed to only those therapists who work in certain settings, and further provides that mandatory reporter training shall count toward a licensed massage therapist’s continuing education requirements. (Source: Iowa State Legislature.)

Kansas: SB111 is a bill to institute state licensing of massage therapists and establish a board of massage. The bill stipulates a 625-hour in-person course of massage study and passing a national exam in order to apply for licensure. Any individual who meets those requirements and others by July 1, 2024, may apply to be grandfathered in. This bill was introduced in January and referred to the Committee on Public Health and Welfare. (Source: Kansas State Senate.)

Minnesota: SF967 would require the creation of a state board of massage and licensure of massage therapists and practitioners of Asian bodywork. It mandates 625 hours of education and requires liability insurance. The bill states that practitioners of certain bodywork therapies, including structural integration, energy work and reflexology. This bill was introduced in January and referred to the Senate Human Services Committee (Source: Minnesota State Senate.)

Nationwide: The U.S. Congress passed the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (HR3259/S586) in late December. This act “addresses outdated federal reimbursement policies that inadvertently incentivize opioid prescribing … [and] will expand patient and provider access to FDA-approved non-opioid pain-management approaches in all outpatient surgical settings beginning in 2025; and also require a report to Congress on limitations, gaps, barriers to access, or deficits in Medicare coverage or reimbursement for therapeutic services.” (Source: Voices for Non-Opioid Choices Coalition.)

Nebraska: LB280 would mandate adoption of the Interstate Massage Therapy Compact. This bill was introduced in January. (Source: Nebraska State Legislature.)

Nebraska: LB291 would require members of many health professions, including massage therapy, to complete annual training in implicit bias or diversity, equity and inclusion. This bill was introduced in January and was referred to Health and Human Services. (Source: Nebraska State Legislature.)

New Hampshire: HB341-FN would require any massage business in which two or more massage therapists work for the same employer to become licensed by the office of professional licensure and certification. This bill was introduced in January and referred to Executive Departments and Administration. (Source: New Hampshire State Legislature.)

New Hampshire: HB554, an act relative to treatment alternatives to opioids, creates a voluntary process wherebya health care practitioner may refer or prescribe to a patient any of the following treatment alternatives before starting a patient on an opioid: chiropractic, physical therapy, occupational therapy, acupuncture, auricular therapy, massage therapy, osteopathic manipulation or naturopathy. The bill would also require that group health insurance policies cover a broad spectrum of pain-management services. This bill was introduced in January and was referred to Health, Human Services and Elderly Affairs. (Source: New Hampshire State Legislature.)

New Hampshire: SB212 requires licensure and inspection of establishments for massage therapy, reflexology, structural integration and Asian bodywork therapy. The bill establishes a new classified position of investigative paralegal in the Division of Health Professions within the Office of Professional Licensure and Certification. The fee for massage establishments would be $300 for two years. This bill was introduced in January and referred to Executive Departments and Administration. (Source: New Hampshire State Senate.)

New Hampshire: HB303-FN requires insurance coverage for pain-management services, and includes massage therapy in this service. Under this bill, “every insurer that issues or renews any individual policy, plan or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for a broad spectrum of pain-management services, in addition to currently covered pharmacologic and interventionalist treatments. Such services shall include: (a) behavioral health interventions, including but not limited to pain self-management training, cognitive behavioral therapy, acceptance and commitment therapy, mindfulness or other meditation training, support groups, and pain education; (b) manual treatments, including, but not limited to: chiropractic treatment of spine, peripheral joints, and soft tissues; osteopathic manipulation of joints and tissues; and massage therapy and manual physical therapy treatments; and (c) movement therapies, including, but not limited to therapeutic exercises administered by physical therapists and chiropractors, independent therapeutic exercise, aquatic therapy, yoga, qi gong, and tai chi.” This bill was introduced in January. (Source: the General Court of New Hampshire.)

New York: AB273 is an act to amend the public health law, in relation to consideration and prescription of non-opioid treatment alternatives for treatment of neuromusculoskeletal conditions. This act stipulates that any medical practitioner shall consider, discuss with the patient, and, as appropriate, refer or prescribe non-opioid treatment alternatives, based on the practitioner’s clinical judgment and following generally accepted national professional or treatment guidelines. The alternatives named in the act include acupuncture, chiropractic, massage therapy, physical therapy, occupational therapy, cognitive behavioral therapy, non-opioid medications, interventional treatments and non-clinical activities such as exercise. This bill was signed into law in December by Governor Kathy Hochul. (Source: New York State Senate.)

New York: AB3405 would require the licensing and regulation of the profession of reflexology, described in the bill as “a protocol that is applied to specific reflex areas to stimulate the neural pathways linking body systems.” The bill would require applicants to have graduated from a school or institute of reflexology with a program registered by the department, or its substantial equivalent in both subject matter and extent of training. This bill provides for a three-year grandfathering period with specific requirements. This bill was introduced in 2023 and referred to the Assembly Committee. (Source: New York State Assembly.)

New York: AB348 is an act to amend the public health law and the education law, with the purpose of improving quality of life for pain patients. This act would establish a state chronic- pain management, education and training council composed of 25 members and drawing from professions including medicine, psychiatry, nursing and other Western medical fields, as well as from such complementary fields as chiropractic and massage therapy. This act was introduced in January and referred to Higher Education. (Source: New York State Assembly; Legiscan.)

New York: AB658 would enact the Healthcare Nondiscrimination Act of 2023, which would prohibit health insurance plans from discriminating against licensed, nonpharmacological-based  health care  providers—including massage therapists, chiropractors, acupuncturists and others—regarding fee reimbursement or payment; ensure the state promotes such health care providers to make sure the public has full access to such health care; and require that all state residents have equal access to such health care. This bill was introduced in January and referred to Insurance. (Source: New York State Assembly.)

Oklahoma: SB633 authorizes the State Board of Cosmetology and Barbering to issue massage establishment licenses. The bill also requires disclosure of certain crimes, and removes the necessity for liability insurance. It also prohibits a person from practicing massage unless licensed, while maintaining title protection. This bill also removes a provision requiring any person who instructs as a massage therapist to do so only within the scope of curriculum at a licensed massage therapy school. This bill also creates a new law whereby the board may issue temporary work permits, which would authorize the recipient to practice massage therapy under the direct supervision of a licensed massage therapist in accordance with rules promulgated by the board. This bill provides for additional administrative changes. This bill’s first reading was scheduled for Feb. 6. (Source: Oklahoma State Legislature.)

Washington: HB1437 would mandate adoption of the Interstate Massage Therapy Compact. This bill was introduced in January. (Source: Legiscan.)

About MASSAGE Magazine

Established in 1985, MASSAGE Magazine has been in publication longer than any other massage magazine and is the preferred trade publication for massage therapists. MASSAGE Magazine publishes articles on technique, business, news, self-care, research and more. MASSAGE Magazine is the parent company of Massage Magazine Insurance Plus, which offers liability insurance and member benefits. Additional award and other programs established by MASSAGE Magazine include its now-retired All-Stars program and its Massage Therapist Appreciation Week, held in January every year.