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APTA Calls For CMS and Congressional Action to Prohibit Unqualified Personnel From Providing Physical Therapy Services
Date:8/10/2009

rection and supervision of a physical therapist. APTA urges Congress to take action to remove physical therapy as an 'incident to' service in physician offices and to tighten Stark II referral-for-profit regulations to eliminate financial incentives that contribute to high physician billing of physical therapy services."

In the report's executive summary, the OIG says, "Services performed by unqualified nonphysicians represent a risk to Medicare beneficiaries. . . We are concerned about the potential scale of this problem."

OIG recommends that physicians only bill for services provided by nonphysicians who have the necessary training, certification, and/or licensure pursuant to state laws and Medicare regulations, and that claim forms reflect that physicians are billing for services only provided by nonphysicians with the appropriate qualifications. It also recommends that CMS take appropriate action to address claims for "rehabilitation therapy services performed by nonphysicians who did not have the training of a therapist." APTA strongly supports these recommendations to ensure that Medicare beneficiaries only receive physical therapy services from licensed physical therapists.

The sample for the report included only those physicians who billed for more than 24 hours of services in a day. "However, we have no reason to believe that the issues identified in this review are unique to these physicians," said the OIG.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility -- in many cases without expensive surgery or the side effects of prescription medications. APTA represents more than 72,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide. Its purpose is to improve the health and quality of life of individuals through the advancement of physical therapist
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SOURCE American Physical Therapy Association
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