2019 RIAPTA Legislative Update
9.12.2019
2019 RI APTA Legislative Update
By: Jason Harvey PT, MSPT – RIAPTA President
Exception for School Based Physical Therapists to the 90-day Physician Order requirement.
In the current state practice act, any Physical Therapist who treats a patient, without a physician referral beyond 90 days must secure a physician order to continue care. School Based Physical Therapists are often treating patients based on an Independent Education Plan (IEP) throughout the school year. In some cases, children may not require Physical Therapy throughout the school year, but many cases require a continuation of care for the entire 10 months of the school year. In those cases, Physical Therapists were concerned about the fact that they were treating children in the school without a Physician Referral beyond the 90-day practice act requirement.
Our Lobbyists, Rick McAuliffe and Jeff Taylor, introduced this issue to legislators who had a history in education to generate a sponsor. We were able to secure a sponsor in both the Senate and House. The bills were then heard in the respective Senate and House subcommittees without opposition. The bills were introduced late in the session by the time the language was drafted. The bills were moved out of committee during the last week of the session.
Diagnostic Imaging and Fair Copays
The sponsors of the House bill and the Senate bill all agreed to reintroduce the Fair Copay legislation this session. The House bill was heard in subcommittee early in the session. The Senate bill was eventually heard in subcommittee later in the session. We were able to bring a former patient to help testify on behalf of the Fair Copay legislation. We were also able to secure letters of support from the American Medical Society, Rhode Island Academy of Family Physicians, and the Rhode Island Orthopedic Academy. In the end, the legislature did not have an appetite for creating what they consider a health insurance mandate this session.
We were able to discuss the Imaging and Fair Copay bills with the House and Senate leadership. Rick and Jeff were able to secure meetings with Joe Shekarchi (House Majority Leader) and Dominick Ruggerio (Senate President). These meetings gave us a platform to make them aware of both pieces of legislation. This occurred very late in the session but was an important step toward moving this legislation.
The Imaging Bill was met with strong opposition from the Health Insurance Industry. We had some great testimony on this bill throughout the session. Blue Cross engaged us in communication to amend the legislation so that Physical Therapists would be allowed to order x-rays but not MRIs. In the end, we agreed to the concession and the legislation was amended. The legislation was then voted out of both sub-committees and moved to the Senate Floor during the last week of the session.
Diagnostic Imaging and School Based Exception made it to the Senate Floor.
During the last week of the session, congress must take a vote to suspend the normal rules of the house so that legislation can be voted on before the end of the week. A typical bill cannot be heard on the Senate or House Floor until 48 hours have passed after each stop. In order to have the bill come out of committee, leave the Senate Floor, and then be voted on in the House, the rules would need to be suspended because there was not enough time in the week to go through the normal time frame. It is typical to suspend rules during the last week so that several pieces of legislation can be voted on. In order to suspend rules, the House Speaker needs two thirds of congress to agree to suspend rules or get the agreement of the Minority Party Leader. In the end, the Speaker was unable to secure the votes necessary to suspend the rules thus halting approximately 80 pieces of legislation. Two of the pieces were the Diagnostic Imaging bill and the School Based Exceptions Bill.
We got very close to passing two pieces of legislation. We will be continuing to fight for these pieces during the fall session. If they do not move in the fall session, we will be introducing them early and pressing to get them voted on earlier in the session.
Mark Bastan, Greg Doucette, and Jeff Taylor will be attending the APTA State Policy and Payment Forum in Arlington, VA in September. They will be able to discuss more legislative issues during the forum with fellow members from all over the country.
Feel free to join our legislative committee. Meeting dates are on our Chapter Events calendar.
