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The practice of physical therapy is governed by various sets of laws, regulations, policies, and guidelines. It is important for physical therapists and physical therapist assistants to be familiar with them and to understand when each is applicable to a given practice setting and/or specific patient. They include:
State Law. The practice of physical therapy is legally regulated at the state level. In Michigan, the Public Health Code is state law. The Administrative Rules written by the Michigan Board of Physical Therapy provide details and interpretation of legislative intent, and are as binding as state law. Compliance with both is required for all settings and patients at all times. Violations of state law can result in sanctions against your license.
Michigan Public Health Code General Provisions:
Michigan Public Health Code Part 178, Physical Therapy: http://www.legislature.mi.gov/(S(s1hvtjgnvvp2pive3db5cuzd))/mileg.aspx?page=getObject&objectName=mcl-368-1978-15-178
Michigan Board of Physical Therapy Administrative Rules: https://aptami.org/pdfs/General Rules Dec2019.pdf
Information on filing a complaint against another licensee:
Third Party Payer Regulations/Contracts. Billing a third party payer for care provided to one of its beneficiaries explicitly attests to your compliance with all of the third party payer’s regulations. The penalty for inappropriately billing for services is insurance fraud. Some consider this the most challenging aspect of practice given the wide variety of payer regulations and contracts. Below are links to key regulations for Medicare and Medicaid. Be sure to be familiar with all private payer contracts to whom you bill for services.
Medicare Benefit Policy Manual (See especially Chapter 15, Sections 220 and 230, as well as other Chapters relevant to your specific setting)
Michigan Medicaid Provider Manual (see especially Outpatient Therapy Section 5.2 as well as therapy sections for other settings)
Reporting Medicare Fraud and Abuse:
Reporting Michigan Medicaid Fraud and Abuse:
Professional Practice Standards. The American Physical Therapy Association (APTA) is the exclusive professional association that supports the profession of physical therapy. It sets forth policies and positions regarding best practice and helps establish the prevailing practice standards. Although adherence to all APTA policies and positions is not required, it is strongly advised. In the event of a complaint or lawsuit filed against you, APTA policies and positions will be used to judge your actions by the Michigan Board of Physical Therapy and in a court of law through expert witness testimony.
Facility Policies. Each practice setting/facility has policies and procedures for the provision of care to patients. As with professional practice standards, facility polices are not legally binding. However, if there is a malpractice claim against you, your deviation from any established policies or procedures will be used to judge your actions.
Your Personal Scope of Competence. Although this is addressed in the General Provisions of the Michigan Public Health Code and is therefore a legal requirement, it bears repeating: No matter what your license allows you as a PT/PTA to perform legally, you should not perform any aspect of physical therapy practice that you personally are not trained or competent to perform.