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EXTRA!Ohio is one of 12 states debating direct access to physical therapists this legislative session, according to the AAFP Government Relations Division. Only Louisiana has addressed patient safety concerns by requiring close physician involvement. Legislators in both houses there approved a bill that limits direct access to those patients for whom a diagnosis has already been made. The bill also requires PTs to provide a plan of care to the diagnosing physician within 15 days of the first treatment.
Connecticut's proposal skirts the patient safety issue by allowing direct access only for wellness care.
Other states barely address physician oversight or patient safety concerns. A new law in Oklahoma allows children direct access to PTs under the Individuals with Disabilities Education Act Amendments of 1997 and the Rehabilitation Act of 1973.
The Michigan House Committee on Health Policy is mulling over a bill that would eliminate the requirement for a physician's prescription for physical therapy. The New York Assembly has approved a bill that stipulates PTs must practice for three years before treating without referral. It would also limit the therapy to 30 days or 10 visits, whichever came first.
The most liberal of the direct access proposals passed in the Oregon Senate but died in the state's House of Representatives. Had it succeeded there and received a gubernatorial thumbs-up, the bill would have amended existing law by giving patients indefinite direct access to PTs as long as neither patient nor therapist submitted a bill for treatment to an insurer.
By providing information on other states' initiatives, the AAFP has assisted constituent chapters in combating direct access to PTs. Questions? Contact David Reynolds in the AAFP Government Relations Division by calling (888) 794-7481, Ext. 2550, or by e-mailing dreynold@aafp.org.
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Copyright © 2003 by
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