BILL ANALYSIS
AB 3014
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 3014 (Koretz)
As Amended August 21, 2006
Majority vote
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|ASSEMBLY: |41-33|(May 31, 2006) |SENATE: |21-16|(August 28, |
| | | | | |2006) |
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Original Committee Reference: B. & P.
SUMMARY : Defines "Asian massage" as the use of pressure
techniques, including myofascial release and manual therapy,
through massage and mobilization of skin and muscle for the
therapeutic objective of stimulation of proper body function, so
long as these techniques are consistent with an acupuncturist's
training.
The Senate amendments :
1)Clarify that pressure techniques and manual therapy only
constitute "Asian massage" if they are consistent with the
training requirements specified in the California Board of
Acupuncture's (Board) regulations.
2)Require the Board, after consultation with the Board of
Chiropractic Examiners and the Physical Therapy Board, to define
"myofascial release" and "manual therapy" in regulation, by
January 1, 2008.
3)Provide that this bill does not in any way expand or restrict
the scope of practice of acupuncturists.
EXISTING LAW :
1)Establishes the Board that licenses and regulates
acupuncturists. The scope of practice of a licensed
acupuncturist includes the practice of acupuncture, as defined,
and the performance or prescription of the use of Asian massage,
acupressure, breathing techniques, exercise, heat, cold,
magnets, nutrition, diet, herbs, plant products, animal
products, mineral products, and dietary supplements, to promote,
maintain, and restore health.
AB 3014
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2)Defines "acupuncture" as the stimulation of a certain point or
points on or near the surface of the body by the insertion of
needles to prevent or modify the perception of pain or to
normalize physiological functions, including pain control, for
the treatment of certain diseases or dysfunctions of the body,
and includes the techniques of electroacupuncture, cupping, and
moxibustion.
AS PASSED BY THE ASSEMBLY , this bill defined "Asian massage" as
the use of pressure techniques, including myofascial release and
manual therapy, through massage and mobilization of skin and
muscle for the therapeutic objective of stimulation of proper body
function.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal.
COMMENTS : "Myofascial release" is a hands-on technique that
provides sustained pressure into myofascial restrictions to
eliminate pain and restore motion. The fasicia is connective
tissue under the skin that covers and connects the muscles,
organs, and skeletal structure. Together the muscles and fascia
form the "myofacia system." Injury, stress, or trauma may cause
tightness and restriction in the fascia and the goal of
"myofascial release" is to release fascia restriction. "Manual
therapy" refers to a number of hands-on therapeutic techniques
used to treat pain or other dysfunctions.
According to the author, this bill defines Asian massage "so that
California insurance carriers and providers, for the purposes of
reimbursement, know what procedures an acupuncturist can legally
perform under the Acupuncture Act." The author notes that
California law provides that a licensed acupuncturist may perform
Asian massage, but does not define what Asian massage is and
asserts that "some health insurance plans have used this omission
as a way to deny coverage for legal and lawful acupuncture
procedures performed by qualified licensed acupuncturists." In
addition, the author argues that "this bill does not expand the
scope of practice of acupuncturists."
The author has provided letters from the Board addressed to
different insurance carriers that had denied reimbursement for
myofascial release and manual therapy performed by licensed
acupuncturists. The Board's position is that, though they are
Western terms, manual therapy and myofascial release correlate to
activities such as "Tui Na" that licensed acupuncturists perform
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as part of their scope of practice. In these letters, the Board
notes that acupuncturists participating in the workers'
compensation system have used designated codes for these
procedures, along with other physical medicine codes, since 1981.
The Santa Cruz County Oriental Medical Association (SCCOMA) argues
that this bill clarifies an ambiguity in existing law whereby
Asian massage is part of a licensed acupuncturist's scope of
practice, but is not defined. SCCOMA asserts that "these
ambiguities are being used by health insurers to improperly deny
reimbursement for lawful acupuncture procedures performed by
qualified, licensed acupuncturists, thus circumventing the
original intent of the Legislature and the interests of public
health and safety in making this modality available to the
public."
The California State Oriental Medical Association (CSOMA) contends
that this bill "does not expand the scope of practice for licensed
acupuncturists. To the contrary, it clearly defines an otherwise
undefined scope of practice. Asian massage techniques have
historically included and documented procedures that are
encompassed by the terms 'myofascial release' and 'manual
therapy.'"
The California Physical Therapy Association (CPTA) has an "oppose
unless amended" position on this bill and requests that the author
remove the term "myofascial release" from this bill. CPTA
contends that there is no evidence that training to become a
licensed acupuncturist includes "myofascial release" or what would
provide a licensee with "clinical competence to utilize the
techniques." In addition, CPTA asserts that the definition of
"Asian massage" is overly broad and is not a recognized term.
CPTA argues that this bill "appears to be an attempt to create an
umbrella title that could include Shiatsu, Acupressure, TUI-NA, or
AN-MO, or Thai massage."
AB 1549 (Koretz) of 2005, would have defined "Asian Massage" as
the use of pressure techniques through massage, manipulation, and
mobilization of surface tissue and muscle for the therapeutic
objective of stimulation of proper body function and would have
clarified that "manual therapy" and "myofascial release," as used
in western terms and treatment procedures, also constitute "Asian
Massage." AB 1549 failed passage in the Assembly Business and
Professions Committee on January 10, 2006.
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Analysis Prepared by : Pablo Garza / B. & P. / (916) 319-3301
FN: 0016968