NATA and APTA Reach Settlement
September 24, 2009 — APTA and the National Athletic Trainers
Association (NATA) have settled the lawsuit that NATA filed last year.
The Joint Statement on Cooperation appears below.
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Additional Information About the NATA Settlement
NATA and APTA: Joint Statement on Cooperation
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The National Athletic Trainers' Association, Inc. ("NATA") and the
American Physical Therapy Association ("APTA") have agreed to settle
their legal dispute pending in the United States District Court for the
Northern District of Texas, Dallas Division. This Joint Statement on
Cooperation arises from an effort by both Associations to work together
to resolve differences through dialogue and mutual cooperation.
The Associations
The NATA is the international professional membership association for
athletic trainers ("ATs"). The NATA has more than 30,000 members. The
NATA's mission is to enhance the quality of health care provided by
certified athletic trainers and to advance the athletic training
profession. Information about athletic training and the education,
licensure, and certification of ATs is available on the NATA website,
www.nata.org.
The APTA is the national association for licensed physical therapists
("PTs") and physical therapy assistants ("PTAs"). It has over 70,000
members. The mission of the APTA is to further the role of the physical
therapy profession in the prevention, diagnosis, and treatment of
movement dysfunction and the enhancement of the physical health and
functional abilities of members of the public. Information about
physical therapy and the education, licensure, and specialist
certification of PTs is available on the APTA website, www.apta.org.
The Litigation
The members of the NATA and the APTA share a dedication to improving
the health, functioning, and well-being of their patients and clients.
Over the years, these two organizations have cooperated at times on
certain public policy issues, but they have also disagreed on other
issues.
In early 2008, the NATA sued the APTA, alleging it had violated the
antitrust laws and seeking injunctive and other relief. The APTA denies
any factual basis for these allegations and contends NATA's claims lack
any merit. The federal district court in Dallas denied APTA's request to
dismiss the case, finding that NATA could maintain claims for
declaratory and injunctive relief. The Court also stated, however, that
NATA could not seek damages from APTA. Instead of continuing the legal
dispute, the two sides have decided to enter into a settlement agreement
and to issue this Joint Statement.
Qualifications of Physical Therapists and Athletic Trainers
The APTA and the NATA acknowledge that physical therapists and
athletic trainers are health care professionals authorized to provide
interventions within their scope of practice as defined by applicable
state law and, within that scope, to the extent of their individual
educational/training competencies. The scopes of practice of the two
professions overlap to some extent. The education, qualifications and
training of the two professions are different. The patients and
conditions treated and interventions performed by PTs and ATs are often
different. The professional education of both physical therapists and
athletic trainers calls for competence in some forms of manual therapy,
on which physical therapists and athletic trainers are tested by their
certification/licensure examinations.
Non-Exclusive Procedures
The APTA's longstanding position is that the term "physical therapy"
should be used to characterize health care services only when those
services are provided by a licensed PT or by a PTA acting under the
direction and supervision of a licensed PT. The NATA recognizes that CPT
codes 97001 and 97002 (physical therapy evaluation and physical therapy
re-evaluation) are used to denote services provided by a licensed
PT.
The NATA's position is that the term "athletic training" should be
used to characterize health care services only when those services are
provided by a licensed and/or certified athletic trainer. The APTA
recognizes that CPT codes 97005 and 97006 (athletic training evaluation
and athletic training re-evaluation) are used to denote services
provided by a licensed and/or certified AT.
The NATA and the APTA both believe that the current Physical Medicine
and Rehabilitation codes other than 97001, 97002, 97005 and 97006 are
not exclusive to any one particular health care profession.
PTs are not the "exclusive" providers of manual therapy. Further,
depending on individual qualifications and certification and state
regulations, ATs are qualified to perform certain forms of manual
therapy.
Legal Scope of Practice
The APTA and the NATA agree their members should practice within
their respective licensed or regulated scopes of practice. The NATA and
the APTA agree that the appropriate legal scope of practice for their
respective members, as for any profession, is determined by legislatures
and regulatory bodies. Both NATA and APTA agree it is a priority to
protect the public from harm, and to compete ethically in the
marketplace.
Access to Continuing Education
With respect to continuing education programs offered by PTs or PTAs,
the APTA has agreed to clarify its existing policy on continuing
clinical education for non-PTs. The policy adopted by the APTA House of
Delegates applies only to PTs and PTAs and says that they should
identify the target audiences for continuing education programs and that
course materials should indicate course content is not intended for use
by participants outside the scope of their license or regulation. The
policy also says that, in order to protect the public, physical
therapists should not teach elements of physical therapy patient/client
management to "individuals who are not licensed or otherwise
regulated."
Because athletic trainers in the vast majority of states are licensed
or otherwise regulated, this part of the policy does not apply to
teaching ATs in those states where they are licensed or otherwise
regulated. The House of Delegates policy does not require PTs to make
determinations concerning the scope of practice of individuals who
practice other professions.
The APTA and several APTA Chapters are continuing education providers
approved by the National Athletic Trainers' Association Board of
Certification, Inc. ("BOC"). The Associations agree that PTs and ATs are
free to refrain from teaching certain content to any audience if they
determine that the content is not appropriate for the audience,
including, but not limited to, because someone lacks the requisite
education and training.
The Professions
NATA states: ATs gain professional qualifications after: 1)
graduation from a bachelor's or master's academic program accredited by
the Commission on Accreditation of Athletic Training Education
("CAATE"); and 2) passing a national exam administered by the BOC, the
independent credentialing body for the athletic training profession. The
BOC certification program is accredited by the National Commission for
Certifying Agencies ("NCCA"). Certified athletic trainers are required
to obtain 75 hours of continuing education every three years. Athletic
trainers are licensed, registered, and/or exempt from licensure in the
statutes of 47 states. Athletic trainers serve patients through injury
and illness prevention, clinical evaluation and diagnosis, appropriate
interventions, management, and treatment of emergency, acute and chronic
medical conditions, and rehabilitation.
APTA states: PTs gain professional qualifications by: 1)
graduating from a master's or doctoral academic program accredited by
the Commission on Accreditation in Physical Therapy Education, which is
recognized by the U.S. Department of Education; and 2) passing the
national physical therapy licensure examination administered by the
Federation of State Boards of Physical Therapy ("FSBPT") for all fifty
states. PTs provide clinical examination and evaluation, diagnoses,
appropriate interventions and rehabilitation to individuals of all ages
who have impairments, limitations in activities or participation, or
changes in physical function or health status resulting from injury,
disease, or other causes, and they provide prevention and health
promotion and wellness services.
Truth in Advocacy
The NATA and the APTA agree that decisions about which professionals
should be deemed qualified to provide particular services and which
services provided by such professionals should be reimbursed by insurers
and public programs are issues to be decided in the marketplace by
consumers, insurers, federal and state legislatures, policy makers, and,
in the case of athletic trainers (as dictated by state law), physicians.
Thus, each Association and its individual members are free, like other
citizens, to make truthful statements and to express their opinions
about their professions or about others within the health care
marketplace. That being said, statements made by the APTA and the NATA
about PTs and ATs should not mislead consumers, insurers, physicians, or
the public, and neither organization will make false or deceptive
statements, including false or deceptive statements about qualifications
of PTs or ATs. Specifically, neither organization will make false or
misleading statements referring to PTs or ATs as "non-qualified,"
"unqualified," "not qualified," or any variation of these terms. Nothing
in this Joint Statement shall be construed to impede the rights of
either the APTA or the NATA to conduct all lawful activities, and make
all lawful statements. Members and representatives of the APTA and the
NATA should respect the rights, knowledge and skills of the other
profession and compete honestly and ethically in the health care
marketplace.
Mutual Cooperation
The APTA and the NATA acknowledge many PTs and ATs have established
productive, mutually respectful and collaborative relationships. Such
cooperation should be fostered. The APTA and the NATA will commit, at
the level of the two national associations, to confer periodically on
issues of common interest and discuss inter-professional disputes.
Inter-Association Communication
The NATA and the APTA agree to candidly discuss areas of friction
between the organizations and identify issues on which the organizations
can lawfully and appropriately work together to improve the health,
functioning, and well-being of the communities they serve, including
their patients and clients.
This Joint Statement is hereby signed on this 22nd day of September,
2009.
By APTA:
R. Scott Ward, PT, PhD
President
American Physical Therapy Association
By NATA:
Marjorie J. Albohm, MS, ATC
President
National Athletic Trainers' Association, Inc.
[Last updated: 09/25/09 | Contact: executivedept@apta.org]
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