"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, April 4, 2012

South Dakota Passes Patient Protection Law Limiting Physical Therapy Copayments

From the American Physical Therapy Assoication (APTA) Press Release:

Last week, South Dakota became the latest state to improve consumer protections from excessively high physical therapy copays when Gov Dennis Daugaard signed House Bill 1183, legislation promoted by the South Dakota Chapter.
HB 1183 limits the amount a health insurer may charge a patient for an out-of-pocket copayment or coinsurance amount when he or she visits a physical therapist or occupational therapist.

After the bill takes effect July 1, those copayment and coinsurance amounts cannot be higher than those charged when a patient visits a primary care physician or practitioner.

Health insurers often categorize physical therapy as a "specialty" service, and typically require higher copays than primary care services—sometimes as high as $60 or more for a single visit.
"Legislators saw that this bill was all about patient access and affordability," said Ronald Van Dyke, PT, OCS, president of the South Dakota Chapter.  
"They wanted to make sure the people of South Dakota could access the physical therapy and occupational therapy care they need at a fair cost."
Hopefully, other states will follow the lead of South Dakota, Kentucky and New York in 2013 - now is the time to start preparing your legislative agenda for next year.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.