Modality Jiggery Pokery*
by Rebecca Barnett
You may have noticed there is a Federal election looming. You may also have noticed that, as part of the lead up to said election, the Department of Health is rolling out a suite of reforms related to private health insurance on April 1 (story starts at 17.52).
What you may not have noticed, however, is the rather curious circular that the Department of Health quietly released late last year in relation to the provision of “banned” natural therapies as an element of another treatment after the April 1 deadline for their removal.
The scenario that the Department focuses on in its advice is physiotherapists providing Pilates-based exercises within a treatment. Here is an excerpt:
The Department considers that an insurer may lawfully pay benefits if a physiotherapist, providing services to a patient within the accepted scope of clinical practice, uses exercises or techniques drawn from Pilates as part of that patient’s treatment as long as the exercises or techniques are within the accepted scope of clinical practice.
AMT was curious about how this advice might apply to remedial massage therapists providing, let’s say, Pilates-informed exercises in the context of a remedial massage treatment plan. We wrote to the Health Minister, Greg Hunt, seeking clarification. While we were on the case, we flagged the seemingly anti-competitive nature of the application of the new private health insurance rules, which appear to unfairly impact on certain types of health practitioners, and flagrantly disregard the original intent and purpose of the Natural Therapies Review.
In the context of these new private health insurance rules, it would seem that all non-evidence based therapies are equal but some non-evidence based therapies are more equal than others depending on the context in which they are delivered. (Apologies to George Orwell.)
Here is AMT’s letter to Minister Hunt and the response from the Minister.
Confused? To ensure that you remain compliant with this advice from the Department of Health, as well as the private health insurance rules and the conditions of the various funds, ask yourself these questions before issuing a health fund receipt for remedial massage:
- Do I meet AMT standards, as articulated through the AMT Code of Practice (of particular relevance here are the AMT standards for record-keeping, receipting and informed consent).
- Was that a remedial treatment I just provided?
- have I clearly identified a presenting condition? (this could include presentations such as chronic stress, insomnia, mood-related disorders etc, however these sorts of conditions should always be treated with a multi-disciplinary approach. Referrals from GPs and other allied health practitioners should be noted in the client notes)
- have I conducted a clinical assessment and negotiated a treatment plan with the client to address the condition?
- have I reassessed the client during and/or post-treatment, and documented progress and changes?
- have I recorded all of the above in the client file?
In other words, a remedial massage is not defined by the techniques you use in the treatment but rather working within the remedial massage scope of practice to assess the presenting condition, and then use this information to establish and carry out a treatment plan, and then reassess. You can still use/recommend Pilates-based exercises or yoga but you can’t run a claimable group class.
*Not the same as modality hokey pokey which may or may not routinely occur after the AMT Annual Conference dinner.
As the self-titled accidental CEO of AMT, Rebecca Barnett clearly also suffers from a terrible case of impostor syndrome and should really stop apologising for her position. She remains a fiercely loyal champion of massage therapists in spite of this.