The Commission on Massage Therapy Accreditation (COMTA) was created in response to massage therapy and bodywork educators' desire that rigorous standards be applied to institutions of massage therapy and bodywork. COMTA has conducted accrediting activities since 1992. In 1996, an elected commission was seated. Since 1996, COMTA has granted accreditation to 61 institutions and six programs located in 25 states, the District of Columbia, and Canada. As an institutional accreditor, whose accreditation enables the institutions it accredits to seek eligibility to participate in the federal student financial aid programs administered by the Department of Education, the agency must meet the separate and independent requirements. The agency was originally recognized in 2002 and last recognized in 2004. At that time, the Secretary granted the agency recognition for a period of five years and granted the agency's request for an expansion of scope to include its accreditation of academic associate degree programs in massage therapy. COMTA requested in April 2009, in accordance with the requirements of the Higher Education Opportunity Act, that distance education be added to its scope of recognition. There several compliance issues concerning COMTA. This report presents the compliance recommendations made by staff of National Advisory Committee on Institutional Quality and Integrity (NACIQI) for COMTA.