When I heard that the California legislature not only passed AB 1000, but did so by a landslide vote of 72-0, I was more than a little upset. In fact, I am downright angry—and as a member of the rehab therapy community, you should be, too.

Sponsored by the California Physical Therapy Association, this bill essentially trades small gains in direct access for legalization of physician-owned physical therapy services (POPTs).

Specifically, it allows patients to independently seek therapy treatment for a period of 45 days and 12 visits. After that, patients are required to undergo a physician evaluation and plan of care approval.

I think we can all agree that direct access to physical therapy services is good; it can decrease healthcare costs by eliminating unnecessary medical office visits while simultaneously offering patients the quickest, most efficient route to receiving therapy treatment. I am happy that CAPTA leaders recognize the value of direct access enough to push legislation that permits it, but I do not believe those leaders were serving our best interests when they agreed to make concessions in other areas—namely, POPTs—to make a little bit of headway in the fight for direct access. I would not be as frustrated if the bill had passed without quid pro quo.

By legalizing POPTs, the California Assembly has essentially allowed physicians to, in a very literal sense, take ownership of rehab therapy. Giving the green light to POPTs ultimately will result in fewer referrals for independent therapy clinics because physicians will begin referring exclusively to their own therapists—thereby ramping up their own revenue. This is not acceptable. We are not physicians’ musculoskeletal sidekicks, or, in the language of AB 1000, “healing arts professionals.” We’re fully competent, doctorate-level therapists capable of making our own clinical decisions. While I’m sure there are some effective physician-therapist partnerships out there (and I’d be willing to bet those therapists enjoy a high degree of autonomy), overall, I believe this sort of arrangement negatively impacts the therapy industry.

What good is direct access if these POPTs end up running you out of business? How do you expect to get paid for the 12 direct access visits when most payers require diagnosis from a medical professional who is authorized to complete a claim form? (PTs currently don’t fall into that category in most states—we’re fighting that battle with slow, minimal progress.) Considering that physicians can now own PT practices, does it not seem rather coincidental that after a patient reaches the maximum of 12 therapy visits, a PT must refer back to a physician to continue treatment? This only perpetuates the vicious cycle. Plus, POPTs take away therapists’ power to treat as they see fit by forcing them to work under someone else’s control, and that’s detrimental to our ultimate goal of gaining autonomy with direct access. It also undermines our efforts to raise brand awareness for physical therapy as a whole; the brand now becomes even more muddled.  

If the implications of this law don’t alarm you—or worse yet, if you are apathetic toward them or have never even heard of AB1000—then we have serious work to do. Changing the way the general public thinks about rehab therapy—i.e., its value as effective stand-alone treatment—starts with changing the way we think about ourselves and our willingness to be outspoken and fight for our beliefs.

As I read through the forums and posts for and against AB1000, it became increasingly clear that by supporting this bill, the CPTA blatantly misrepresented the interests of its constituency. But who was really out there on the front lines fighting for our profession? There are 26,000 registered PTs in California. However, according to the APTA, only 5,439 of them were CAPTA members as of June 3, 2013. Does that mean that only 20% of PTs in California actually care about what happens in their state? Or perhaps it’s just that California PTs see no reason to waste money paying dues to an organization that doesn’t represent their interests anyway. And honestly, the numbers are not that much different on a national level.

Things are moving fast with national health care reform and the Affordable Care Act set in motion; now, more than ever, is a time to unite and stand our ground before losing more of what we have fought so hard for in years past. We are a diverse group that needs to unite behind a common professional brand that effectively represents all PTs. Together, we can drive our profession forward in a way that promotes our value, relevancy, and the amazing patient outcomes we achieve every day. There is strength in numbers; our voice is louder when everyone shouts at once. 

The State of Rehab Therapy in 2018 - Regular BannerThe State of Rehab Therapy in 2018 - Small Banner
  • articleNov 8, 2010 | 1 min. read

    It is Illegal for PTs to be employed by Professional Corporations in the state of California

    California based physical therapists must make sure their business arrangements are very clear. The California Physical Therapy Association is available to assist in defining new business arrangements that comply with the laws. The State of California Legislative Counsel has rendered an opinion that it is illegal for PTs to be employed by any professional corporation except for those owned by physical therapists and Naturopaths. In its opinion, the Legislative Counsel confirms that, because the existing California Corporations …

  • This Week in PT News, March 28 Image

    articleMar 28, 2014 | 2 min. read

    This Week in PT News, March 28

    S. 2110 Vote The Senate is scheduled to vote on the Medicare cap this week, so it’s your last chance to contact your local representatives and ask them to vote “yes” for the Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2110). Find your senator’s contact information here . HR 4302 Vote Yesterday, the House of Representatives passed by voice vote a proposal (HR 4302) to delay for 12 months a scheduled 24% cut to Medicare …

  • webinarAug 13, 2013

    Rehab Therapy Industry News

    In July, we hosted a webinar focused on rehab therapy industry news. This session covered an array of newsworthy and timely topics, including: Functional limitation reporting and other Medicare regulations Changes to HIPAA regulations Direct access Branding PT to general consumers ICD-10

  • Common Questions from our Cloudy with a Chance of Reform Webinar Image

    articleFeb 13, 2017 | 13 min. read

    Common Questions from our Cloudy with a Chance of Reform Webinar

    In our first webinar of 2017 , WebPT’s co-founder and president, Heidi Jannenga, teamed up with CEO Nancy Ham to discuss the current and future healthcare trends that will impact PTs, OTs, and SLPs. (Missed it? No worries; you can view the complete recording here .) As always, we received quite a few questions during the presentation—way more than we could address live. So, we’ve put them all here, in one handy Q&A doc. Scroll through and …

  • Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs Image

    articleNov 9, 2016 | 8 min. read

    Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs

    Halloween may be over, but if you didn’t get your fill of scares, I’ve got the perfect activity for you: reading through 1,401 pages of pure Medicare gobbledygook. Screaming yet? (Or should I check back at around page 500?) I kid, of course; there’s no need for you to slog through this year’s extra meaty Final Rule —which details the Medicare fee schedule and other important Medicare regulatory and reimbursement changes for physical therapy, occupational therapy, and …

  • Go, Go, ACO: Making Sense of Medicare’s New Alternative Payment Rules Image

    articleJun 30, 2016 | 5 min. read

    Go, Go, ACO: Making Sense of Medicare’s New Alternative Payment Rules

    Earlier this month, CMS laid down a final rule that rewrote—or at least revised—the book on accountable care organization (ACO) participation. We’ll dive into the deets in a minute, but the key takeaway here is that this rule represents yet another leap toward the transition to a value-based healthcare payment environment. We’ve said it before, and we’ll say it again: when it comes to pushing the healthcare system to deliver more and spend less, the federal government …

  • Why Physical Therapists Should Support the CONNECT for Health Act 2017 Image

    articleAug 14, 2017 | 6 min. read

    Why Physical Therapists Should Support the CONNECT for Health Act 2017

    The US Senate recently introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act 2017 (S.1016) . If passed, the CONNECT for Health Act would remove several barriers to utilizing telehealth with Medicare patients—which would present a valuable opportunity to the physical therapy profession. Here’s why PTs should strongly consider supporting it: It will allow PTs to deliver, and receive reimbursement for, physical therapy telehealth services. As it stands, Medicare only provides …

  • How the Affordable Care Act Impacts Patient Payment Collection Image

    articleMay 16, 2016 | 5 min. read

    How the Affordable Care Act Impacts Patient Payment Collection

    You take the good; you take the bad. You take ’em both, and you have healthcare reform. Like most government-led initiatives, healthcare reform in general—and the Affordable Care Act (ACA) in particular—has inspired a lot of passionate debate. And that’s because, while it has expanded health coverage to millions of previously uninsured people (woo-hoo!), it also has given way to some less-than-positive consequences. One such effect: the trend toward increased patient financial responsibility (whomp, whomp). Out-of-Pocket Overload …

  • Senate Repeals SGR in Landslide Vote Image

    articleApr 15, 2015 | 1 min. read

    Senate Repeals SGR in Landslide Vote

    Well, folks, the fix is in—the fix for the sustainable growth rate (SGR), that is. In a 92 to 8 vote, the Senate approved the SGR repeal bill, called HR2. In addition to an SGR repeal, the bill also officially extends the therapy cap exceptions process until December 31, 2017. This result is better than no therapy cap exceptions process at all; however, it’s disappointing to know that we came so close to achieving a full repeal …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.