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APTA's commitment to transparency in digital health is not only generating interest among digital health companies — it's sparking change. The latest win: a decision by UnitedHealthcare and contractor Kaia Health to stop marketing a Kaia app's services as "physical therapy," given that the Kaia digital musculoskeletal pain program doesn't consistently involve licensed PTs.

The shift was brought about thanks to a letter from APTA national to UnitedHealthcare and an accompanying effort by APTA North Carolina that included a complaint filed with the North Carolina Board of Physical Therapy Examiners by several licensed PTs. After reviewing the APTA national letter and the complaint along with a separate letter sent to UHC by the Federation of State Boards of Physical Therapy, the board filed a complaint with the state's Department of Insurance.

The focus of the letters and complaint was on use of the term "physical therapy" to describe the services provided through the Kaia Health Wellness app, even when those services weren't being overseen by a licensed physical therapist.

The licensing board asked that UHC supply a list of the North Carolina-licensed PTs or physical therapy compact holders providing services to North Carolina residents through the app, which is marketed as "proven MSK care that combines human care with superior technology to achieve better outcomes." The board also requested that United provide access to a regularly updated provider list for review.

In its response, UHC said that it couldn't supply such a list because Kaia is a separate entity that UHC contracts with through Optum, its benefit manager. More important, UHC acknowledged that both Optum and Kaia had used the term "physical therapy" improperly, and that all marketing materials would be revised to eliminate that term.

Mary Hannah, PT, DPT, president of APTA North Carolina and a signatory on the complaint letter, said the success of the effort was largely due to member engagement and the examining board's follow-up.

"APTA North Carolina members keep their eyes open for infringement of our legally protected terms and let the board of examiners know when we notice improper use," Hannah said. "We appreciate the licensing board's work keeping citizens in North Carolina safe, as well as safeguarding the term 'physical therapy' for licensed professionals."

The win for the profession is also consistent with APTA's Digital Health Transparency Campaign, an initiative to bring together leaders in the profession and digital health care to demonstrate a shared commitment to transparency. That demonstration includes signing onto a pledge that digital physical therapy must be "performed or directed by licensed physical therapists in accordance with all regulations and APTA's Standards of Practice for Physical Therapy."

APTA's commitment was articulated in an April 2022 statement from President Roger Herr, PT, MPA, that included recognition of digital platforms’ "great potential" to increase access to care, along with the association’s assertion that care must be consistent with laws and professional regulations, include a high level of consumer protection, and "advance quality practice provided by licensed health professionals in accordance with their professional obligations and state defined scope of practice."

[Want to learn more about digital health care and physical therapy? Check out "The Digitally Enabled Therapist: An APTA Foundational Paper," a new APTA resource that explores the current digital health landscape.]


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