Governor Signs Physical Therapy Bill

by Bob Norberg, California Healthline Contributing Reporter

The long-standing requirement that patients must get a medical diagnosis to receive treatment from a physical therapist was eliminated Monday in a bill signed into law by Gov. Jerry Brown (D).

Assembly member Bob Wieckowski (D-Fremont) said his bill, AB 1000, allows patients to get treatment without unnecessary delay.

"With this historic compromise, we are putting patients first," Wieckowski said in a statement.

The new law allows a patient to see a physical therapist for 12 visits or 45 days before having to go to a physician for an examination.

The bill was supported by the California Physical Therapy Association and the California Medical Association.

"It is a great law … it allows people of California access to physical therapy without delay," said James Syms, president of the California Physical Therapy Association and an assistant professor at Loma Linda University in Loma Linda.

Its opponents, however -- some of whom who are also physical therapists -- said the new law has too many pitfalls and doesn't help those with private physical therapy practices.

While patients can go to a physical therapist for treatment on their own, they are not covered by health insurance without a physician's referral, said Paul Gaspar of Encinitas, president of the Independent Physical Therapists of California.

California Workers Compensation patients are also excluded from seeing a physical therapist for treatment without a physician's referral, Gaspar said.

"We can treat people, the problem is we cannot get paid for it by insurance companies. The people have to pay cash," Gaspar said. "The net effect is the bill doesn't help practicing physical therapists."

The new law also allows physicians for the first time to establish their own physical therapy practices and then refer patients to them, which is not a good idea, Gaspar said.

Syms said his organization also opposes self-referral and supports legislation now being proposed to eliminate just such practices. The new state law requires that the patient at least be notified of the financial interests, Syms said.

George Lauer
Editor's note: This story has been changed to more accurately portray existing law.
Sturdy McKee
The very first sentence: "long-standing requirement that patients must get a physician's referral first to receive treatment from a physical therapist" is inaccurate. A referral was not required under California law. A medical diagnosis was required, not under the practice act, but under an interpretation in an AG's opinion from 1965 http://www.ptbc.ca.gov/forms/ag_opinion_65_21.pdf. A referral may or may not have been required by an insurance carrier to pay for treatment, but a referral was never required under the Physical Therapist Practice Act.

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