CPTA sold us out

[Azimuthal]

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California AB1000 will allow other health professions to own and operate PT clinics in exchange for another set of "limited" direct access. There goes private PT clinics in CA. I will not be renewing my membership.

One step forward, four steps back.

 

[nangus]

Azi I have been following the twitter chat about the bill. Clearly CPTA doesn't listen to its membership, while provides very little in terms of logical thinking for their decision to combine the bills. The PPS of APTA has come out strongly against it as well as another PP association, but CPTA refuses to listen. Unfortunately, it seems the APTA will not step in to correct this problem. I feel badly for CA, both it's therapists and patients. Hopefully when CPTA has its board elections again some members with more sense will take over!

 

[pubicsymphysis]

California AB1000 will allow other health professions to own and operate PT clinics in exchange for another set of "limited" direct access. There goes private PT clinics in CA. I will not be renewing my membership.

One step forward, four steps back.

Hey azi. Can you explain this more in detail? I'm going to school in California and probably be practicing here. I'm fairly new to the PT world.. At least when it comes to bills/law/legisstical stuff.

 

[Azimuthal]

Hey azi. Can you explain this more in detail? I'm going to school in California and probably be practicing here. I'm fairly new to the PT world.. At least when it comes to bills/law/legisstical stuff.

http://www.ccapta.org/displaycommon.cfm?an=9

 

[atstudent]

How clueless is the CPTA really? Just wow..

 

[okramango]

I've been following this because I plan on practicing in California when I graduate. Very disappointing.

Pubicsymphysis, here's a pdf file from CPTA describing the issue:
http://www.ccapta.org/associations/...nication on Summary of Bills 05 08 13 FIN.pdf

 

[cfandbmw]

So, from what I'm reading, it seems the new bill allows direct access for 45 calendar days or 12 visits, after that they have to see a doctor. I don't understand the corporate part though? Is it saying another health-care corporation can hire PTs to work for them? And will AB 1000 be in effect now?

 

[okramango]

So, from what I'm reading, it seems the new bill allows direct access for 45 calendar days or 12 visits, after that they have to see a doctor. I don't understand the corporate part though? Is it saying another health-care corporation can hire PTs to work for them? And will AB 1000 be in effect now?

Here's a brief summary. Originally these were two separate bills. AB1000 was sponsored by CPTA and would allow a limited form of direct access to PT (as you described). Another bill, AB1003, was sponsored by the American Medical Association, and would allow physician owned physical therapy practices (aka POPTS) to be legal in CA. This is something PTs all over the US have been fighting against. CPTA agreed to allow these two bills be combined into one in order to get the direct access part to pass. So basically they are pushing for a limited form of direct access at the expense of legalizing POPTS. A lot of PTs in CA are disappointed with CPTA for agreeing to combine the bills.

 

[Azimuthal]

Here's a brief summary. Originally these were two separate bills. AB1000 was sponsored by CPTA and would allow a limited form of direct access to PT (as you described). Another bill, AB1003, was sponsored by the American Medical Association, and would allow physician owned physical therapy practices (aka POPTS) to be legal in CA. This is something PTs all over the US have been fighting against. CPTA agreed to allow these two bills be combined into one in order to get the direct access part to pass. So basically they are pushing for a limited form of direct access at the expense of legalizing POPTS. A lot of PTs in CA are disappointed with CPTA for agreeing to combine the bills.

The delegates are using the Apple corporate approach to their decision making. Tell PTs what they want versus asking what they want. Can't wait until the next vote...

 

[kptnau]

So PT's in California now can wait 45 days to walk down the hall to their bosses and get them to sign off on more visits. Ironic.

 

[Azimuthal]

CPTA just reaffirmed their support of AB1000. Someone on their Facebook stated that there was "not nearly as much opposition" during their meeting and "such is democracy", when responding to the bills critics. Looks like this bill will pass. I foresee that PT clinics will be forced to incorporate and share their earnings with non-PT groups or go out of business.

 

[jblil]

Proving once again that we have the best government money can buy...

Azi - sometimes this makes me long for the regimes where you and I came from!

 

[okramango]

Is there a precedent to this? Any other states where POPTS are legal? I'm wondering how it's affected PT private practices or quality of care? It seems private practices will still have the potential to stand out by promoting a very high quality of care and more time with the patient compared with a typical POPTS. They'll have to be very strategic in how they market and promote themselves.

 

[jesspt]

Is there a precedent to this? Any other states where POPTS are legal? I'm wondering how it's affected PT private practices or quality of care? It seems private practices will still have the potential to stand out by promoting a very high quality of care and more time with the patient compared with a typical POPTS. They'll have to be very strategic in how they market and promote themselves.

POPTs are legal in almost every state. SC is an exception, but I am not aware of others.

 

[okramango]

POPTs are legal in almost every state. SC is an exception, but I am not aware of others.

I didn't realize they were already legal almost everywhere. So California is one of the last exceptions? It seems the AMA has sponsored a new POPTS bill every year here in CA.

 

[Kechara]

In Canada, you don't even have to be a health professional to own a clinic.

 

[Azimuthal]

In Canada, you don't even have to be a health professional to own a clinic.

The 51st state is always the odd man out 😉

 

[Azimuthal]

Yesterday, AB 1000 (Wieckowski/Maienschein), Direct Access to Physical Therapist Services: Professional Corporations, was heard in the Senate Business, Professions and Economic Development Committee. Although several Committee members voiced support of AB 1000, a number of questions were raised, which prompted the author to request that the bill be held over one week to address some of the issues before taking a vote The California Physical Therapy Association (CPTA) Board and Government Affairs Committee will be discussing these issues in preparation for next week’s hearing. Below are some of the issues put forward at the Committee hearing:

Committee members voiced their agreement that direct access to physical therapists makes good sense, particularly in response to the impending health care access and efficiency issues.

In response to a question about why AB 1000 and AB 1003 were merged, Assemblymember Wieckowski explained that he and Assemblymember Maienschein introduced the bills separately; however, at the request of Assemblymember Richard Gordon, Chair of the Assembly Business, Professions and Consumer Protection Committee, the two bills were merged.

The California Chiropractic Association, currently opposed to AB 1000, indicated chiropractors are licensed diagnosticians in California and it would be appropriate to add them to the professionals who can sign off on the Plan of Care after the 45-day or 12-visit requirement in AB 1000. Several Committee members discussed this option within the context of health care reform and moving toward an integrated model of care.

Although Committee members were aware that California law prohibits physical therapists from diagnosing disease, confusion existed relative to the ability of physical therapists to assign an ICD-9 code and get paid for treatment. CPTA and the Board leadership have confirmed with the Executive Director of the Physical Therapy Board of California (who consulted with the California Department of Consumer Affairs’ legal counsel) that assigning an ICD-9 code for functional impairment and billing purposes should not be interpreted as diagnosis of disease. Physical therapists currently are required to append ICD-9 codes for the functional impairment, not the medical diagnosis, which they are treating under Medicare. CPTA Board leadership and representatives have made it clear to Committee members that six states have direct access to treatment as well as language that prohibits diagnosis of disease or medical diagnosis (similar to California). These states are currently initiating treatment without a medical diagnosis and billing ICD-9 codes while practicing under a prohibition from diagnosis of disease or a medical diagnosis.

 

[Socrates25]

I dont know what you guys are all upset about.

Right now, in California and in most other states it is absolutely LEGAL for a high school dropout with zero medical training to own and operate a medical clinic. Now, can they prescribe medicines or do surgery? Of course not, but all they have to do is hire a doctor to do so. Shocking, I know.

Take a look at all the urgent care clinics, MinuteClinics, TakeCare, etc. Do you think physicians own those practices? Think again. They are owned and operated by corporate structures with boards and CEOs who have zero medical experience.

Given that is the case, you guys have no reason to have special protection for PT practices. You are very lucky that "only" physicians are being granted ownership privileges, given that California is very prone to letting anybody own or run anything else in terms of healthcare. Be glad that they arent allowing athletic trainers own PT shops, YET.

 

[Azimuthal]

I dont know what you guys are all upset about.

Right now, in California and in most other states it is absolutely LEGAL for a high school dropout with zero medical training to own and operate a medical clinic. Now, can they prescribe medicines or do surgery? Of course not, but all they have to do is hire a doctor to do so. Shocking, I know.

Take a look at all the urgent care clinics, MinuteClinics, TakeCare, etc. Do you think physicians own those practices? Think again. They are owned and operated by corporate structures with boards and CEOs who have zero medical experience.

Given that is the case, you guys have no reason to have special protection for PT practices. You are very lucky that "only" physicians are being granted ownership privileges, given that California is very prone to letting anybody own or run anything else in terms of healthcare. Be glad that they arent allowing athletic trainers own PT shops, YET.

Thank you for your input Socrates25. However, I respectfully disagree in regards to CA.

Medical clinics must be wholly owned and controlled by a physician or physicians (a layperson cannot own a clinic). See Business and Professions Code sections 2400 - 2417 and Corporations Code sections 13400 - 13410 for the requirements on what business structures can be used (sole ownerships, professional partnerships, and professional corporations). Of course there are exceptions for other healthcare corporations to be partial stakeholders under the professional corporation listed in the Moscone Knox Act.