Must Louisiana's massage therapy board report license denials and discipline to the National Practitioner Data Bank?

Plain-English summary

Counsel for the Louisiana Board of Massage Therapy asked whether the board had to report denials of new and renewal license applications or disciplinary actions to the National Practitioner Data Bank. The attorney general said no.

The opinion read the federal Data Bank rule as covering actions against health care practitioners and entities. It then reviewed Louisiana's definition of massage therapy, which excluded diagnosis and treatment of illness or disease and services requiring licenses in medicine, chiropractic, physical therapy, or podiatry. The board also did not regulate massage services performed in state-licensed hospitals. On that statutory reading, the office concluded that the board did not regulate the health care practitioners or services to which the reporting duty applied.

What this means for you

Louisiana Board of Massage Therapy

The opinion said the board was not required to send its new-license or renewal denials or disciplinary actions to the National Practitioner Data Bank under the reporting framework analyzed. Its answer depended on the scope of practice and board authority described in Louisiana law.

Massage therapists and applicants

The attorney general's conclusion concerned whether this board had a Data Bank reporting duty. It did not decide the validity of any particular licensing denial or disciplinary decision.

Licensing officials

The opinion compared the Data Bank's health-care-practitioner definition with the profession the Louisiana board regulated. It specifically distinguished hospital-based services, which the board did not regulate under the statute it cited.

Common questions

Q: Does Louisiana's massage board have to report discipline to the National Practitioner Data Bank?
A: The attorney general said no, because the board did not regulate the health care practitioners or health care services covered by the reporting rule it analyzed.

Q: Must the board report a rejected massage license application or renewal?
A: The opinion said no for both new and renewal application denials, as well as disciplinary actions.

Q: Did the opinion decide whether hospital massage services are reportable?
A: It said the massage board lacked authority over services performed in state-licensed hospitals. It did not decide a reporting duty for a different hospital regulator.

Background and statutory framework

The opinion quoted federal Data Bank reporting provisions at 45 CFR 60.9 and a definition of health care practitioner at 45 CFR 60.3. It then examined La. R.S. 37:3552's massage-therapy scope and La. R.S. 37:3553's exclusion for services in licensed hospitals, along with state definitions of health care services. From those provisions, the office found no reporting obligation for the Louisiana massage board's identified licensing and disciplinary actions.

Citations and references

• 45 CFR 60.3 and 60.9 (federal Data Bank definitions and reporting rule quoted)
• La. R.S. 37:3552 (massage-therapy scope)
• La. R.S. 37:3553 (hospital-service exclusion)

Source

• Landing page: https://www.ag.state.la.us/Opinions
• Original PDF: https://www.ag.state.la.us/Opinion/Download/24-0067

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain; the linked PDF is authoritative.

STATE OF LOUISIANA
DEPARTMENT OF JUSTIEF:
OF11c’F: OF TFIE ATTORNEY GENERAl.
P.O. Box 94005
B\Tox RoLx;E, LA
70801-9005

Lz MLTRRILL
ArrolNEY GENERAL
May31, 2024
OPINION 24-0067

Ms. Sheri M Morris
. 63-B LICENSING - FOR PROFESSIONS OR
General Counsel
OCCUPATIONS

     Louisiana Board of Massage Therapy                            La. R.S. 37:3552               La. R.S. 37:3553
     Daigle Fisse & Kessenich                                          R.                         La. R.S. 22:242

8900 Bluebonnet Blvd.
Baton Rouge , La 7081 0 The Louisiana Board of Massage Therapy is not required to
. report denials of new and renewal applications or disciplinary actions to the National Practitioner Databank.
Dear Ms. Morris:

You submitted an opinion request raising the question whether the Louisiana Board of Massage Therapy (“Board”) is required to report denials of new and renewal applications and disciplinary actions to the National Practitioner Data Bank (“NPDB”). For the reasons that follow, we find that the Board is not required to report such denials or disciplinary actions.

The National Practitioner Data Bank (NPDB)1 is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers. Established by Congress in 1986, it is a tool to help prevent Medicare, Medicaid, and Insurance fraud and waste by tracking medical practitioners with malpractice and disciplinary actions.

The NPDB is governed by various laws,2 including C.R.F. Title 45, Subtitle A, Subchapter A, Part 60 (“National Practitioner Data Bank”). Regulation 45 CFR 60.9 provides:

(a) What actions must be reported. Each state is required to adopt a system of reporting to the NPDB actions, as listed below, which are taken against a health care practitioner, health care entity, provider, or supplier (all as defined in §60.3 of this part).

“Health care practitioner” is defined in 45 CFR 60.3 as “an individual who is licensed or otherwise authorized by a state to provide health care services (or any individual who, without authority, holds himself or herself out to be so licensed or authorized).”

1 https:/Iwww. npdb.hrsa.gov/
2 Among the laws governing the NPDB are: (1) Section 6403 of the Patient Protection and Affordable Care Act (P.L. I 1 1-1 48); (2) Title IV of P.L. 99-660, Health Care Quality Improvement Act of 1986, as amended;
(3) Section 1921 of the Social Security Act (Section 5(b) of P.L. 100-93; (4) the Medicare and Medicaid Patient and Program Protection Act of 1987, as amended; (5) Section 11 28E of the Social Security Act (P.L. 104-191, the Health Insurance Portability and Accountability Act of 1996); and (6) C.R.F. Title 45, Subtitle A, Subchapter A, Part 60 (“National Practitioner Data Bank”).

Page 2

Ms. Sheri M. Morris
Opinion 24-0067
Page 2

By contrast, Louisiana massage therapists are not authorized to provide health care services as defined by Louisiana law. The definition of the practice of massage therapy in La. R.S. 37:3552, and the specific terms therapy and therapeutic, when used in the context of massage therapy, specifically exclude “diagnosis, the treatment of illness or disease, or any service or procedure for which a license to practice medicine, chiropractic, physical therapy, or podiatry is required by law.” Further, La. R.S. 37:3553(B)(1 ) exempts “services performed in hospitals licensed by the state” from the Board’s regulatory authority.

Moreover, the Louisiana Insurance Code in La. R.S. 22:1009 defines “health care provider” as “a physician licensed to practice medicine by the Louisiana State Board of Medical Examiners, a dentist licensed to practice dentistry by the Louisiana State Board of Dentistry, orother individual health care practitioner licensed, certified, or registered to perform specified health care services consistent with state law.” The same statute then defines “health care services” as “services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.”

In addition, La. R.S. 22:242(5) defines “health care services” as:

[AJny services rendered by providers which include but are not limited to medical and surgical care; psychological, optometric, optic, chiropractic, podiatric, nursing, and pharmaceutical services; health education, rehabilitative, and home health services; physical therapy; inpatient and outpatient hospital services; dietary and nutritional services; laboratory and ambulance services; and any other services for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability.

Finally, La. R.S. 46:460.51 defines “healthcare services,” for the purposes of Medicaid Managed Care, as, “the services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.”

Based upon these definitions, the Board does not regulate “health care practitioners” or “health care services,” and therefore, is not required to report disciplinary actions to the NPDB.

This is consistent with the NPDB’s purpose. Massage therapy is not covered by Medicare.3 It is also not generally covered by Medicaid, although it may occasionally be covered as part of hospital treatment.4 However, as noted above, the Board cannot regulate services performed in hospitals. Thus any reports from the Board would be superfluous to the NPDB’s purpose.

See https://wwvv.medicare.gov/coverage/massage-therapy. See https://wwvv.Idh.Ia.gov/page/medicaid-services.

Page 3

____

Ms. Sheri M. Morris
Opinion 24-0067
Page 3

Because the Louisiana Board of Massage Therapy does not regulate “health care practitioners” or “services performed in hospitals,” it is not required to report denials of new or renewal applications or disciplinary actions to the NPDB.

We trust that this adequately responds to your request. However, if our office can be of further assistance, please do not hesitate to contact us.

Yours very truly,

LIZ MURRILL
ATTORNEY GENERAL

By: açihelle R.L. Hair
Asstant Attorney Generl