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Dear Citizen: Medical Massage Therapists Serving Veterans Are Disputing Payment Terms with the VA. Now, It’s YOUR Problem

For some time now, End Veteran Debt (EVD) has been engaged in making visible an implacable position regarding equitable payment being taken by the VA in a dispute between this agency and Medical Massage Therapists (MMTs). A dispute that, if not settled soon, will cost the veteran dearly in access to a therapy proven to reduce chronic pain as well as reduce or eliminate the need for and dependency on opioids.

This project was taken on by EVD to give the thousands of independent MMTs across the country the exposure they need to get the VA’s attention and to keep this vital service available to veterans. 

In-home and in-office Medical Massage Therapy is offered through the VA as an inexpensive and effective way to both relieve pain and reduce dependency on Opioids. Because it can be delivered in-home or locally in-office for veterans challenged by distance or their physical condition or other factors, it also reduces dependency on unavailable or overtaxed VA hospital resources and confirms our government’s commitment to Community Care.

That’s the good news.

The bad news is that, due to an inappropriate application of a Medicare rule known as Multiple Procedure Payment Reduction (MPPR), the VA reduced a previously set reimbursement rate so deeply that therapists across the country are dropping out of the program. Zeel, the largest vendor with nearly 2,000 of the 10,000 MMTs in the VA program, says that the program has already lost 1,000 healthcare workers who cannot afford to work at a reduced rate. More are “quiet quitting,” by no longer accepting referrals. 

The VA, in response to policymakers who are beginning to question their stand, offers a litany of responses, such as:

“Massage therapists’ issues are not with us, but with the Third Party Administrators.” WRONG. It is the VA that mandates the rules that TPAs must follow in reimbursement. It’s not the TPA’s choice or decision to apply MPPR; it’s the VA behind the curtain.

“Zeel is agitating for this change. No other provider cares.” WRONG. There are 8,000 independents not in the Zeel network who want MPPR resolved. Zeel’s CEO, Samer Hamadeh, is speaking out on the industry’s behalf.

“It’s not our doing. MPPR is mandated by Medicare.” WRONG. Medical Massage Therapy is not a Medicare Service.

Mind you, as a veteran who uses the VA, I am not writing this piece as a “disgruntled user.” I am calling attention to a wrong that needs to be righted, with everyone benefiting. 

Most of all, our veterans and you, the taxpayer

According to the CDC, the value of life lost to opioid use disorder accounted for $471 billion. Over $35 billion of that number was spent on healthcare and treatment. Criminal Justice spending accounted for $14.8 billion. And our veterans? In 2019, 6.2 percent of veterans (1.3 million people) had a substance use disorder. 

In 2020, some 485,000 U.S. military veterans above the age of 26 misused opioids, and 88,000 qualified as opioid use disorder. Think of the thousands of lives improved or even saved. Think of the millions – billions – of dollars that can be redirected to bolster other veteran benefits if only proven alternative forms of pain reduction could reach these people.

The irony of all this is that the VA doctors who have seen the results of non-opioid treatments for chronic and acute pain know the extreme importance of therapies that enhance mobility, mood, and overall health without the risk of deadly addictions. VA’s own research shows that 92 percent of Veterans who receive MMT self-report reduced pain, increased activity, better sleep, and improved mood. Half of those reported a reduction or elimination in both over-the-counter and prescription pain medications.

It takes a campaign to raise a message

The singular way that the public can motivate the VA to go through and accelerate the review steps needed to reverse a policy is through their legislators, policymakers, and VA senior executives. 

This is why our charitable foundation and our support community at Veteran Mission Possible (VMP) formulated and is directing an “Impact Awareness” campaign through ResistBot. This service enables individuals and organizations to compose and send detailed letters to elected officials and others from the cellphone’s messaging app. Or, even through the mail.

Here’s one we crafted titled Don’t Put Veterans Like Me at Risk of Losing Access to Non-Opioid Pain Treatment. Click the link and check it out. If the message resonates and you are a veteran – take it for a spin. Your local legislator just might surprise you in his/her response…and hopefully, even the VA response.

Want to learn more? Enjoy this article for a deeper dive: Medical Massage Therapy for Veterans May Lose its Touch.

Jerry Ashton

End Veteran Debt & co-founder, RIP Medical Debt