Legislation introduced to address Physical Therapy Claims & Coverage in NJ

NJSIPT Press Release

 

Legislation introduced to address Physical Therapy Claims & Coverage in NJ

 

A3790 Reforms review, processing, and payment of insurance claims.

 

    Sea Girt NJ, December 15, 2006:

   

   Assemblyman Neil Cohen (D-20) introduced legislation on December 11, 2006 to address concerns brought to his attention by the New Jersey Society of Independent Physical Therapists (NJSIPT).  “This landmark legislation will address a multitude of issues that our colleagues have encountered in the handling of claims for physical therapy services by NJ insurers”, said NJSIPT President Mark Schwall, PT.  The goals of this consumer-friendly legislation include ensuring that:

  

·                   Physical therapy services are only reimbursable when rendered by qualified providers;

·                   Coverage for physical therapy services is determined by medical necessity and patient status, and not arbitrarily limited by the financial desires of payers;

·                   Minimum standards of coverage and payment adhere to accepted standards of care, and;

·                   Regulate review of the care provided for consumers

 

“Successful passage of this legislation will create greater protection for physical therapy consumers and also offer added protection for payers who may question the treatment or care of their subscribers and policy holders”, added Ken Mailly, PT, NJSIPT Professional Affairs Representative.  The bill is anticipated to be heard in Committee when the Legislature reconvenes in January, at which time a Senate companion bill is to be introduced.

 

The mission of the NJ Society of Independent Physical Therapists (“the Society” or “NJSIPT”) is to; advocate for, promote, and protect the independent practice of Physical Therapy in the State of New Jersey. NJSIPT strongly supports limiting ownership of physical therapy services to licensed physical therapists exclusively; to both protect the integrity of these professional services, and to ensure accountability for them to consumers.

NJSIPT Press Release: Physical Therapists - The First Choice in Treatment

NJSIPT Press Release: Physical Therapists - The First Choice in Treatment

Date: Monday, January 15 @ 15:03:11 EST

Topic: NJSIPT Press Releases

Sea Girt, NJ, January 13, 2006  There is an increasing amount of evidence that the first choice in treatment for musculoskeletal movement disorders such as neck and back pain should be your Physical Therapist. This assertion is supported in the front page article of the January 12, 2007 edition of the Wall Street Journal “A Novel Plan Helps Hospital Wean Itself Off Pricey Tests”. Seattle’s Virginia Mason Medical Center, in an arrangement with insurers and large employers in the region, discovered that it was far more efficient and cost effective to have patients with certain complaints and injuries, such as back pain, seen by a Physical Therapist first. 

During the Virginia Mason Medical Center experience, it was discovered that by having patients see a Physical Therapist first, employers’ and insurers’ costs were substantially diminished due to avoiding unnecessary expensive testing such as MRI’s, as well as decreasing the wait times for evaluation and treatment. By doing so, there was a significant decrease in the amount of time patients lost from work as well as overall cost savings.

“Physical Therapists have long asserted that for musculoskeletal movement disorders such as neck and back pain, we  should be the consumers’ first choice for evaluation and treatment of such problems.” said Mark Schwall, PT, and President of the New Jersey Society of Independent Physical Therapists (NJSIPT). “Evidence to this fact in the peer-reviewed literature is growing, and is increasingly compelling. Experiences such as the one at Seattle’s Virginia Mason Medical Center are bringing that evidence to the real world.” 

In order in to improve consumer access and insurer coverage of Physical Therapists services, NJSIPT has sought the assistance of Assemblyman Neil Cohen in introducing legislation in NJ to address these issues. This legislation (A-3790) seeks to mandate that insurers abide by a number of consumer protection measures, which will help to ensure proper access to legitimate physical therapy providers. It will also help to ensure that physical therapy benefits are not squandered by payers or providers, and that all parties will have to abide by the same rules when it comes to physical therapy services and benefits. 

The mission of the NJ Society of Independent Physical Therapists (“the Society” or “NJSIPT”) is to; advocate for, promote, and protect the independent practice of Physical Therapy in the State of New Jersey. NJSIPT strongly supports limiting ownership of physical therapy services to licensed physical therapists exclusively; to both protect the integrity of these professional services, and to ensure accountability for them to consumers. For more information about the NJSIPT or for a clinic directory of NJSIPT member clinics visit www.njsipt.com.