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  • SC Supreme Court Ready to Weigh in on Physician-Owned Physical Therapy Services

    Amid increased national attention on the issue of physician self-referral—and some high-profile support for tightening restrictions on the practice—the South Carolina Supreme Court is scheduled to hear arguments in a case that challenges a prohibition on physician-owned physical therapy services (POPTS) in that state.

    The Joseph case, scheduled to be heard by the high court on February 19, is an appeal of a decision made by the state circuit court last year that ruled in favor of the South Carolina Board of Physical Therapy Examiners (SCBPTE) and the South Carolina Chapter of APTA (SCAPTA). The case was brought against SCBPTE by 2 medical doctors and a physical therapist (PT) who sought to extend the state's ban on PTs working for physician-owned groups to PTs working in PT-owned group practices.

    In its summary judgment (.pdf) issued last year, the state circuit court upheld the ability of PTs in physical therapist-owned group practices to receive payment for treatment of patients referred by another PT in the practice, and kept in place the prohibition on POPTS in the state. The state's high court has agreed to hear an appeal of this case, and its decision could overturn the POPTS prohibition or impact the ability of PTs to operate in group practices in South Carolina.

    APTA provided significant legal, financial, and staff resources both to SCAPTA and the individuals who intervened in the case on behalf of SCBPTE after its motion to dismiss the case was denied in December 2012. The chapter also received support from individual members and some APTA components.

    The upcoming case arrives on the scene at a time when the issue of physician self-referral is receiving increased attention thanks in large part to the efforts of APTA, the Private Practice Section (PPS), and a coalition of other professional groups organized as the Alliance for Integrity in Medicare (AIM).

    Most recently, these efforts were boosted by the American Association of Retired Persons (AARP), which voiced its official agreement (.pdf) with the elimination of loopholes in the Stark law originally designed to tighten up restrictions on self-referrals under Medicare. Currently, physical therapy is among 4 services that are considered "exceptions" to the restrictions.

    Earlier in 2014, President Obama established the administration's support for closing the loopholes through a proposed federal budget that would eliminate exceptions that now apply to physical therapy, radiation therapy, anatomic pathology, and advanced imaging. The Office of Management and Budget estimates that eliminating the exceptions would provide a savings of just over $6 billion over 10 years.

    APTA is awaiting the President's next budget submission, scheduled for winter release. The association recently met with administration officials to advocate for the President's continued support on this issue.

    Find out more about self-referral on APTA's self-referral webpage, and take action now by asking your legislators to close the self-referral loophole. Contact the APTA advocacy staff for more information. Members wishing to provide support to SCAPTA may do so online.

    Comments

    • As a life member(50 consecutive years)of the APTA we are still fighting the old medical model of the master/servant relationship! All the legal & fiduciary paper trail we have documented to justify our rule of law to practice independently throughout these fifty states is being compromised by self serving entities! Fight on APTA/SC chapter

      Posted by Ralph F. Lucarelli, PT,Ed.MS on 1/13/2015 12:59 PM

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