Federal Priorities

Learn about our advocacy efforts at the federal level. 

Federal priorities include advocating for massage therapy as a covered healthcare benefit, increasing the use of massage therapy as a nonpharmacological therapy and engagement with Congress and agency stakeholders. 

Update on the NOPAIN Act

AMTA is excited to share that Congress passed the NOPAIN Act in late December 2022. The NOPAIN Act is a huge win for our massage therapy community, which aims to make a significant impact in helping prevent opioid addiction and saving lives throughout the country.

When we asked for your help, you responded by sending over 10,000 letters of support to your respective House and Senate members in Congress, garnering bipartisan support from 62 Representatives and 24 Senators.

The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, H.R.3259/S. 586, first introduced in the 116th Congress (2019-2020), was reintroduced in 2022 by a bipartisan group of U.S. Representatives and Senators.

What is the NOPAIN Act?

The passage of the Non-Opioids Prevent Addiction in the Nation Act (NOPAIN Act) is intended to increase patient and provider access to non-opioid approaches to pain management for those enrolled in Medicare and help stem the opioid epidemic across the nation. Supporting this legislation is part of AMTA's ongoing advocacy efforts at the federal and state levels to enact responsible policies that expand access to massage therapy.

The NOPAIN Act also requires a report to Congress on limitations and barriers to access in Medicare coverage for services supported by the HHS Pain Management Task Force, including massage therapy. For more information, view a one-pager on the NOPAIN Act or see the full bill.

Why does this matter to massage therapists?

Passage of the NOPAIN Act is an important step in fostering access to pain management — including complementary and integrative therapies such as massage. Given the unfortunate rise in opioid addiction in the U.S., a situation largely exacerbated by the COVID-19 pandemic, the passage of this common-sense legislation is more urgent than ever before.

As massage therapy gains more recognition as an important part of integrative healthcare, this can create more opportunities for massage therapists and help elevate the profession.

NOPAIN was passed thanks in large part to members like you.

2022 CDC Clinical Practice Guideline for Prescribing Opioids

As part of the Alliance to Advance Comprehensive Integrative Pain Management (AACIPM), AMTA weighed in on a letter to the CDC on the 2022 Clinical Practice Guideline for Prescribing Opioids.

The letter mentions a number of therapies (including massage therapy) that are discussed by the CDC as alternatives to opioids in many pain-related guidelines but often remain inaccessible for people who can benefit from them. The AACIPM provides a series of recommendations to help increase insurance coverage, remove barriers and broaden access to these non-opioid therapies.

Why is this important? 

Alternatives to opioids in pain management are often inaccessible for various reasons including they are often not approved for reimbursement by the Centers for Medicare & Medicaid Services (CMS), even when the care is within the provider’s scope of practice. Increased insurance coverage would increase access to non-opioid alternatives – including massage therapy.

What is AACIPM?

AACIPM is a multi-stakeholder collaboration comprised of nonprofit organizations, government agencies, people living with pain, public and private insurers, patient and caregiver advocates, researchers, purchasers of healthcare, policy experts, and 37 professional and trade organizations representing the full spectrum of healthcare providers.

Letter to FDA: Provider Education and Opioids

AMTA submitted a comment letter encouraging the FDA to strengthen health care provider education for opioids to ensure that more patients have access to the full range of treatment options – including integrative therapies such as massage to address pain-related issues.

What is a Comment Letter?

Federal agencies encourage and accept public comments for set periods of time during the rule-making process.

Why is this important? 

Increased health care provider education on opioids would help increase access to non-opioid alternatives – including massage therapy.

CMS 2022 Payment Policies

AMTA submitted a comment letter, along with the Alliance to Advance Comprehensive Integrative Pain Management (AACIPM) and other health care leaders to offer feedback to the Centers for Medicare and Medicaid Services (CMS) on the 2022 Payment Policies under the Physician Fee Schedule and other changes to Part B Payment Policies proposal.

What is a Comment Letter?

Federal agencies encourage and accept public comments for set periods of time during the rule-making process.

Why did AMTA do this?

Since massage therapy is a widely recognized, safe, and effective option for helping patients with managing painAMTA encouraged CMS to take steps to address existing coverage gaps in Medicare Part B for massage and to recognize the role licensed massage therapists play as complementary and integrative care providers.

AMTA is encouraged that the CMS MPFS (Medicare Physician Fee Schedule) recognizes that adequate treatment of pain is a significant public health challenge, and increased emphasis on more comprehensive pain management is greatly needed.

What else is happening around pain management?

AMTA requested in the comment letter that CMS move forward with implementing the Pain Management Task Force’s (PMTF) Report recommendations for coverage and the use of complementary and integrative therapies such as massage for pain management.

The PMTF report focuses on the need for a multi-modal, multi-disciplinary approach to pain treatment and identifies five broad treatment categories, one of which includes complementary and integrative health care approaches and specifically lists massage therapy among the necessary treatment options.

What is next?

AMTA will continue to urge CMS to initiate appropriate coverage and reimbursement policies for massage therapy when provided by a state-licensed massage therapist for pain, address gaps in access to care, and enhance primary care provider awareness on the benefits of massage.

Update on the CARA Act

What is the CARA Act?

The Comprehensive Addiction and Recovery Act (CARA 3.0) would help expand access to comprehensive approaches to pain care – including massage therapy.

The bill would fund new research into non-opioid alternatives and increase continuing education for physicians and providers on these alternatives.

The bill also contains specific AMTA-supported language from the NOPAIN Act that requires the U.S. Department of Health and Human Services (HHS) to report to Congress on identified gaps in Medicare coverage for pain, including massage therapy, and to make recommendations to increase patient access to these therapies.

Why 3.0?

The first Comprehensive Addiction and Recovery Act was signed into law on July 22, 2016. The most recent bill comes after two previous and ultimately unsuccessful attempts to pass CARA 2.0 in February of 2018 and December of 2020. The COVID-19 pandemic brought to light new challenges and a surge in overdose deaths. CARA 3.0 bill would strengthen the 2016 CARA Act to address this, and add additional funding.  

Why does this matter to massage therapists?

Much like the NOPAIN Act, CARA 3.0 would help increase access to and continuing education for health care providers on non-opioid alternatives – including massage therapy.

AMTA's Interactions with Federal Oversight Agencies

  • AMTA submitted recommendations to the U.S. Agency for Healthcare Research & Quality’s (AHRQ) Noninvasive Nonpharmacological Treatments for Chronic Pain report.

  • AMTA responded to a Request for Information (RFI) by the House Ways and Means Committee to assist the new Rural and Underserved Communities Health Task Force answer questions regarding rural access to care and nonpharmacological treatments.

  • Read AMTA's statement in support of the U.S. Senate's hearing on “Managing Pain During the Opioid Crisis.”

  • See AMTA's comments to the U.S. Agency for Healthcare Research & Quality’s (AHRQ) Treatments for Acute Pain: A Systematic Review.
  • Read AMTA’s joint letter to the House Energy and Commerce Committee seeking hearings to be held on implementation of the SUPPORT for Patients and Communities Act.

Advocacy Work on Massage for Pain Management