Current Rhode Island Legislative Issues

RIAPTA Legislative Action Committee

 

Find your state legislator and senator: https://vote.sos.ri.gov/

 

                                                   2019 Committee Initiatives on behalf of RI APTA

Summary of initiatives.  Please refer to left tab box for more information on each bill

  1. Copay subcommittee report
  • 2.5.19 Initial Copay hearing for H5229 to introduce legislation that would limit copays, coinsurance or office deductible for services of a physical therapist to the amount authorized for PCP or medical osteopathic physician office visits proposed by RI APTA  LAC via Mayforth Group

 

  1. Imaging subcommittee report
  • 2.6.19 Initial Diagnostic Imaging hearing for H5142 to introduce legislation regarding the practice of physical therapy ordering diagnostic images and studies provided they are performed and interpreted by other licensed health proposed by RI APTA  LAC via Mayforth Group
    • http://webserver.rilin.state.ri.us/BillText19/HouseText19/H5142.pdf
    • Presented by Sponsor Rep. Bennett (District 20/ Warwick)
      • Introduced By: Representatives Bennett, Edwards, McNamara, McEntee, and Jacquard
      • Date Introduced: January 17, 2019
      • Referred To: House Health, Education & Welfare (HEW)
      • Senate Bill should be posted in the next week

 

 

  • Summary
    • Level of education of PTs is much higher than what many people in statehouse realize and much higher than when initial practice act was written
    • DOD/Military PT’s Privileges for over 40 yrs
    • Research is solid and positive with a low 8% utilization rate with other Medical professionals much higher
      • Imaging ordered by PTs has good proportion of “appropriateness” (i.e., the imaging that was ordered should have been ordered) even compared to other healthcare professions with ordering privileges
      • Other Organizations that have granted Imaging Privileges for PTs
        • Georgetown University Hospital Jan 2012
        • Kaiser‐Permanente Northern California, a large nonprofit managed care organization, has provided imaging privileges for PTs for 20 yrs
        • The University of Wisconsin Hospital and Clinics has also extended the professional privilege of plain radiography to PTs.
    • Blue Cross NHP
      • Opposes
      • BCBS recommending further discussion with RIAPTA
      • Blue Cross considers PCP to be “Gatekeeper”, but research shows PCPs are not as cost effective at keeping overutilization of MSK imaging down.
    • Utah and Wisconsin has passed legislation and others have proposed legislation
    • Our position is focused on educating why it is necessary as HC providers to be allowed to order appropriate imaging and why it’s cost effective for insurers, consumers and healthcare
      • PT’s are capable of recognizing the need for imaging in patients for optimal decision making and management upon initial patient contact as a necessary component of direct access, which exists to an extent in all jurisdictions in the United States
      • PT’s are capable of incorporating imaging results into initial and subsequent clinical reasoning processes in patient care toward more informed decision making on an on‐going basis
      • PT’s provide expert clinical examinations to determine whether imaging is necessary to drive the diagnostic process during patient care
      • PT’s are capable of utilizing imaging in a safe and efficient manner to reduce potential risks from exposure to ionizing radiation, to lower patient care costs, and to minimize the risk of iatrogenic sequelae of unnecessary early imaging in the course of a condition
      • PT’s have the capacity to supplement their clinical examination procedures with real time ultrasound imaging and to develop this capacity with certification under the auspices of an independent, multidisciplinary entity advocating the safe and effective use of ultrasound; and
      • PT’s can utilize imaging to the benefit of the individual consumer without compromise to safety in patient‐centered care and to society by efficient and economical use of medical resources

 

  1. School-based subcommittee Report
  • Issue
    • Currently our Practice Act states that whenever a patient seeks or receives treatment from a PT w/o referral the PT must refer patient to a MD, osteopath, dentist, podiatrist or Chiropractor within 90 days after the treatment commenced
    • Physical therapy (PT) is one of the related services under Part B of the Individuals with Disabilities Education Act (IDEA) and is provided to support the Individualized Education Program (IEP) for students ages 3-21, who have a disability that interferes with their educational performance and ability to benefit from their education program. When the student’s IEP identifies PT as a needed resource, physical therapists will be integrated as members of a multidisciplinary school team during the school year (180 days).
    • Concerns
      • Impacts School based PT/private institution of Higher ed
      • Students with IEP are seen over a school year and from year to year
      • Not realistic to have a provision that requires referral within 90 days
      • Solution
        • Remove this provision from practice act
    • Action
      • Meeting set with Senator Hannah Gallo, SLP in Cranston school district
      • Will have meeting with her to discuss options, support and next steps.
      • Need language similar to Kansas
      • Dept. of Ed says we may not need to do this legislatively, may be able to do it through rules change
        • Pro: likely an easier route
        • Con: this would apply only to school-based, not all other areas of PT practice (i.e. we would fall short for progress towards unrestricted direct access)
          • 18 states have unrestricted access, including Massachusetts
          • Note: people in RI can go to a PT over the border in MA and not follow restriction we have

 

APTA

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