California Kickbacks

What makes California different?

What is it about the physical therapists in California that puts them in the national spotlight? Is California larger than everybody else? Does California have more physical therapists?

Not according to Dave Powers, Chairman of the California Private Practice Section.

California has therapist leaders that are more committed, more serious and better informed about their rights under the law than many states. They are, incidentally, paying personally to fund the fight against California kickbacks to physicians.

According to Mr. Powers, "We've dug deep into our pockets - this stuff isn't cheap."

The 2003 Moscone-Knox Act is California's version of the professional corporations act that prevents physical therapists from working for physicians, chiropractors, podiatrists or other professions.

Professional corporation acts exist in every state to prevent undue influence over professional behavior by non-professionals. Only physicians can own physician practices and only lawyers can own law practices.

For instance, physicians are not allowed to own physical therapists' practices, according to the Moscone-Knox Professional Corporations Act in California.

Professional Corporation Acts are legal vehicles that prevent improper influence of professional decisions by non-professionals.

Professional corporation acts are relatively new to physical therapists' collective consciousness according to Peter McMenamin, PT. Mr. McMenamin first wrote about this issue in the December 2001 issue of IMPACT, the magazine of the Private Practice Section of the APTA.

Mr. McMenamin studied the issue in his own state of Illinois. He found that Professional Corporations Acts range from Strong to Weak in different states. Physicians and attorneys tend to have Strong versions of the law. Physical therapists and Occupational Therapists practice acts tend to have Weak versions of the law to protect the practice of physical therapy from ownership by non-professionals, like in Mr. McMenamin's home state of Illinois.

Dave Powers met Peter McMenamin a few years ago during a seminar when Mr. McMenamin advised his audience to examine their states' Professional Corporations Act to see if their existing laws were Strong or Weak.

It turns out that California has a Strong law protecting physical therapists.

The September 2010 California Legislative Council decision upholding the California Physical Therapists' Association view of Moscone-Knox affirms that physical therapists are prevented from being hired by non-professionals, including physicians, chiropractors and podiatrists.

In February 2011, Mary Hayashi (D-Hayward) sought to overturn the Moscone-Knox law as it applies to physical therapists with AB 783, a new law that specifically allows physical therapists to work for podiatrists and physicians.

The Quality Issue

PTManager.com has re-posted a patient testimonial from the StopPOPTs.org website of a POPTs patient testimonial.

The patient talks about a physician directing his patient to his own therapy center ostensibly for better communication and oversight. Yet, in her own words, the physician was never in the physician-owned physical therapy clinic.

However compelling this patients' testimony about the poor quality of her physical therapy at the physician's clinic, I believe the patient's message detracts from the central issue facing California physical therapists - cost.

The Cost Issue

It's not about quality, its about cost.

Peter McMenamin says in Exclusive Physical Therapist Ownership of Physical Therapist Services: Economic Foundations for Professional Autonomy :

"...the POPTs issue got sidetracked into issues of ethics and restraint of trade becasue the issue was never analyzed within the historical context of autonomy as practicved by other professions."

Money will resonate the loudest in Sacramento where the state Assembly meets March 23rd, 2011 and Mary Hayashi's AB 783 will be 'fast tracked" to ensure passage.

If the Assembly passes AB 783 it will go to the California Senate where oddsmakers place it at 50-50.

Jeff Worrell of PT Talker.com interviews Paul Gaspar, DPT of Doctors of Physical Therapy in San Diego, California about AB 783.

California has a $25 billion dollar deficit that state lawmakers need to cut. The story that California physicians are receiving kickbacks from owning and referring patients to physical therapy clinics is attracting attention in Sacramento, and from national news organizations.

Overuse of surgery and inappropriate diagnostic imaging litter the headlines of internet blogs and newspaper headlines

You can support the California Private Practice Section (CPPS) in its fight against Hayashi and the physicians' efforts by signing this petition.