Stay up to date on the latest Michigan Physical Therapy Practice News.

Resources for your physical therapy practice are a top priority for the APTA Michigan. Please email us with suggestions for the information you would like to see added to our APTA Michigan website.

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Practice News:
 

President’s Message on Social (In)Justice on Behalf of APTA MI and the Board of Directors

posted: June 11, 2020

Message from the APTA Michigan President, Michael Shoemaker, on Social (In)Justice on Behalf of APTA MI and the Board of Directors

As we all continue to reflect on the tragic events in Minneapolis where George Floyd has become yet another example of racism and social injustice. We are reminded of other similar tragic losses: Ahmaud Arbery, Breonna Taylor, Michael Brown, and Freddie Gray. It is all too easy for some of us to feel hopeless, remain silent, and fall into complacency.

George Floyd’s tragic death is not just a law enforcement problem. It is a societal problem. APTA’s vision is to transform society. #BlackLivesMatter is a call to all of us to reflect inwardly and respond to our ethical obligation to fight racism.

If you have not yet done so, please read APTA President Sharon Dunn’s address to the House of Delegates (https://www.apta.org/PresidentLetter/2020/5/31/). She concludes that racism “…is a disease of the heart and mind that has infected not just people but customs, systems, and laws. There is no vaccine. We must be the cure.”

I urge you to accept her charge and find your own way to be a part of the cure. Compassion and caring is one of our professional core values. Listen, learn, and follow the lead of those with lived experience with racism. Address your own unconscious bias as you interact with others in your profession, your place of employment, and your community.

Last year, APTA MI commissioned a Diversity, Equity, and Inclusion Committee. Perhaps this is one way you might feel compelled to serve as this Committee develops a roadmap for promoting social justice for APTA MI. Or, perhaps you will seek additional education and training in social determinants of health and how to implement steps in your practice in order to do your part in addressing the ways in which racism and social injustice manifest in our healthcare system. https://learningcenter.apta.org//Student/Catalogue/BrowseCatalogue.aspx?query=social%20determinant The possibilities for you to make an individual difference every day and in every interaction are endless.

The APTA MI strategic plan includes promotion of diversity, equity, and inclusion within the chapter to mirror the communities we serve. The urgency of meeting this objective has never been more important. APTA MI stands with Black, Indigenous, and People of Color and the National Association of Black Physical Therapists and its components. We are a community that condemns racism, discrimination, and violence. We are committed to the pursuit of social justice within healthcare and beyond.

 

 

 

Tricare PTA Services - New Update April 22

posted: April 24, 2020

APTA announced that  the Department of Defense (DoD) released a final rule to add licensed or certified PTAs as TRICARE-authorized providers operating under the same qualifications established by Medicare. Services must be furnished under the supervision of a TRICARE-authorized licensed physical therapist.

This rule says that direct supervision will be required in a private practice setting. General supervision will be required in all settings other than private practice. These guidelines are in line with the Medicare supervision requirements.

The rule is effective on April 16, 2020.

Additional Update April 22:  APTA Advisory: TRICARE Manual Updated to Recognize PTAs as Authorized Providers - April 22, 2020

Don't forget to use the CQ modifier if more than 10% of a service is furnished by a PTA.

TRICARE, the health insurance system used throughout the military, announced that it has officially revised its policy manual to recognize PTAs (and occupational therapy assistants) as authorized providers, outlining the rules and requirements governing assistant qualifications, scope of practice, supervision, and reimbursement.

Now it's up to TRICARE contractors to do the same within approximately 30 days.

As reported earlier, beginning with date of service on April 16, PTAs are recognized as authorized providers under TRICARE and thus eligible for reimbursement for covered services rendered to TRICARE beneficiaries.

Take note: The CQ modifier must be appended to the claim when more than 10% of an outpatient physical therapy service is furnished by the PTA. Check out APTA’s Quick Guide to Using the PTA Modifier.

The presence of the modifier shouldn't impact claims processing. However, if claims are denied, they may need to be resubmitted if the claims are sent to contractors before they fully implement the change.

http://www.apta.org/PTinMotion/News/2020/04/22/TRICAREManualUpdatePTAs/

 

Physical Therapy Administrative Rules - Revised December 2019

posted: December 30, 2019

The Physical Therapy Administrative Rules, which have the weight of law, have been revised and were officially adopted late December 2019. Click here for the new Rules.  Administrative rules are an interpretation and implementation of statute, and are periodically reviewed and revised, even when there has not been a change in statute.

This most recent revision included a variety of clarifications .  Click here for the summary provided by LARA.   One clarification has important implications for supervision of and delegation to an athletic trainer by a physical therapist in a physical therapist practice. The MPTA and the Michigan Athletic Trainers’ Society (MATS) have jointly written an informational memorandum to inform our respective members about this important clarification.

 

 

Public Health Code Amended to Allow Nurse Practitioners to Prescribe Physical Therapy - Effective April 9, 2017

posted: April 24, 2017

The Physical Therapy Section of the Public Health Code has been amended to allow Advanced Practice Registered Nurses to prescribe physical therapy:

 

PUBLIC HEALTH CODE (EXCERPT)
Act 368 of 1978

***** 333.17820.amended THIS AMENDED SECTION IS EFFECTIVE APRIL 9, 2017 *****



333.17820.amended Practice of physical therapy or physical therapist assistant; license or authorization required; engaging in treatment with or without prescription of certain license holders; use of words, titles, or letters.

Sec. 17820.

(1) An individual shall not engage in the practice of physical therapy or practice as a physical therapist assistant unless licensed or otherwise authorized under this part. Except as otherwise provided in this subsection, a physical therapist or physical therapist assistant shall engage in the treatment of a patient if that treatment is prescribed by a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state. A physical therapist or a physical therapist assistant may engage in the treatment of a patient without the prescription of a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state, under either of the following circumstances:

(a) For 21 days or 10 treatments, whichever first occurs. However, a physical therapist shall determine that the patient's condition requires physical therapy before delegating physical therapy interventions to a physical therapist assistant.

(b) The patient is seeking physical therapy services for the purpose of preventing injury or promoting fitness.

 

 

(2) The following words, titles, or letters or a combination of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons authorized under this part to use the terms and in a way prescribed in this part: "physical therapy", "physical therapist", "doctor of physiotherapy", "doctor of physical therapy", "physiotherapist", "physiotherapy", "registered physical therapist", "licensed physical therapist", "physical therapy technician", "physical therapist assistant", "physical therapy assistant", "physiotherapist assistant", "physiotherapy assistant", "p.t. assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.", "m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.", "certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and "p.t.t.".

Section 17201:

Sec. 17201. (1) As used in this part:

(a) “Advanced practice registered nurse” or “a.p.r.n.” means a registered professional nurse who has been granted

a specialty certification under section 17210 in 1 of the following health profession specialty fields:

(i) Nurse midwifery.

(ii) Nurse practitioner.

(iii) Clinical nurse specialist.

PUBLIC HEALTH CODE (EXCERPT)
Act 368 of 1978

***** 333.17820.amended THIS AMENDED SECTION IS EFFECTIVE APRIL 9, 2017 *****

 


333.17820.amended Practice of physical therapy or physical therapist assistant; license or authorization required; engaging in treatment with or without prescription of certain license holders; use of words, titles, or letters.

 

Sec. 17820.

(1) An individual shall not engage in the practice of physical therapy or practice as a physical therapist assistant unless licensed or otherwise authorized under this part. Except as otherwise provided in this subsection, a physical therapist or physical therapist assistant shall engage in the treatment of a patient if that treatment is prescribed by a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state. A physical therapist or a physical therapist assistant may engage in the treatment of a patient without the prescription of a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state, under either of the following circumstances:

(a) For 21 days or 10 treatments, whichever first occurs. However, a physical therapist shall determine that the patient's condition requires physical therapy before delegating physical therapy interventions to a physical therapist assistant.

(b) The patient is seeking physical therapy services for the purpose of preventing injury or promoting fitness.

(2) The following words, titles, or letters or a combination of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons authorized under this part to use the terms and in a way prescribed in this part: "physical therapy", "physical therapist", "doctor of physiotherapy", "doctor of physical therapy", "physiotherapist", "physiotherapy", "registered physical therapist", "licensed physical therapist", "physical therapy technician", "physical therapist assistant", "physical therapy assistant", "physiotherapist assistant", "physiotherapy assistant", "p.t. assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.", "m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.", "certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and "p.t.t.".

 

 


Practice Resources

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:
http://www.legislature.mi.gov/(S(mythcqvglmcecop44qzzz3vd))/mileg.aspx?page=getObject&objectName=mcl-368-1978-15-161

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://mpta.com/pdfs/General Rules Dec2019.pdf

Information on filing a complaint against another licensee:
http://www.michigan.gov/lara/0,4601,7-154-35299_63294_27647---,00.html

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)
http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS012673.html

Michigan Medicaid Provider Manual (see especially Outpatient Therapy Section 5.2 as well as therapy sections for other settings)
http://www.mdch.state.mi.us/dch-medicaid/manuals/medicaidprovidermanual.pdf

Reporting Medicare Fraud and Abuse:
http://www.medicare.gov/forms-help-and-resources/report-fraud-and-abuse/report-fraud/reporting-fraud.html

Reporting Michigan Medicaid Fraud and Abuse:
http://www.michigan.gov/ag/0,4534,7-164-18156_18152-47192--,00.html

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.

American Physical Therapy Association Polices and Positions:
http://www.apta.org/Policies/
*See especially those related to "Practice" (http://www.apta.org/Policies/Practice/)

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.

     

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