Happy Tur... Direct Access Day!!!

Yes, today is the day that Direct Access goes into effect here in New York State... I wanted to pass along the message from the president of the NYPTA chapter in regards to this great day:

As most of you know, effective November 23rd, those PTs who have 3 or more years experience will be permitted to treat patients for 10 visits or 30 days without a referral.

We have celebrated this huge victory, but we have more work to do.

READ THIS FIRST BEFORE YOU START PRACTICING WITHOUT REFERRAL UNDER OUR NEW LAW

Direct Access does not Guarantee Reimbursement under Direct Access.
We are reviewing state insurance law now to be sure that there is nothing in the law that would stop an insurance company from paying us. Initial reviews seem to indicate that there is nothing there to stop companies from paying us for direct access services . Once this is completed, we will let you know of our findings.

I have spoken with PT leadership both at APTA and in states that already have direct access as to their experience in getting reimbursed. It appears that they have achieved reimbursement primarily through going to each company and negotiating approval for the reimbursement of services under direct access. We are gearing up now to start this process and will also give you this information as soon as we have it. It is important to note here that these agreements must be made with the decision-makers of these companies. We will be asking everyone's help with this when we start.

New Notice of Advice Requirement.
As you will see when you read the new law, those practicing under direct access are required to give a notice of advice to the patient informing them that their insurance may not cover services when rendered without a physician referral. This will not require a separate form and the notice can be included in current forms you use in your clinics. The chapter is working on sample language for your use and will have that for you very soon.

Regulations and Guidance information from the State Education Department is in process and should be completed and on the NYSED Office of Professions Website very soon.
While we all agree that our new Direct Access law is about as clean a bill as we could have hoped for, the State Education Department has to further clarify wording in the law, essentially defining the intent of the law, in order for the State Board and the Office of Professional Discipline to have a clear understanding in the event that complaints are filed.

The regulations are completed, with many of you seeing them at our Issues Forum at the conference last month. However the guidance information was just completed on Friday, November 17 th at the State Board Meeting that I attended. There are elements of the guidance information on which we will continue to work with the State Education Department. We are in contact with the State Board Secretary and will continue to pursue language that we feel is reflective of our practice.

Before you start to provide care under Direct Access, I urge everyone to do the following FIRST!
Read the Law
Read the Regulations
Read the answers to the Guidance Questions

The last thing our profession needs after this great victory is for our colleagues to go about treating under direct access in a manner that is not consistent with the law, regulations and guidance information from the State Education Department.

Education on the New Law and Regulations.
Your chapter Board of Directors has passed a budget that includes monies for audio conferences in 2007. Some of these will be for presentations from chapter and State Board leadership on the new law and how we need to practice in order to minimize the risk of doing so outside the regulations and guidance information.

If you have any questions, once you read all the material that, again, should be up on the State Education Office of Professions Website in a week or so, please direct your questions or comments to the State Board for Physical Therapy at the contact info below. If you e-mail, please cc your comments to me so we can track the issues you have and include them in our ongoing discussions with the State Board.

I thank you again for your membership and support of physical therapy in New York, and on behalf of the office staff, Officers and Board of Directors, I want to wish you all a safe and peaceful Holiday Season!I thank you again for your membership and support of physical therapy in New York, and on behalf of the office staff, Officers and Board of Directors, I want to wish you all a safe and peaceful Holiday Season!

Jim Dunleavy, PT, MS
President, New York Physical Therapy Association
800 459-4489
jimdpt@aol.com

New York State Board for Physical Therapy
518-474-3817, ext. 180
e-Mail:ptbd@mail.nysed.gov
Website:
http://www.op.nysed.gov/pt.htm