TMNews #34: Apr 16, 2018: State Legislative Updates, HHS & ACA, Geriatric Referrals, & Research Corner with John LaRue

It’s Monday, April 16th! We hope you got your taxes done… It’s a heavy week for legislative updates. The direct access bill in Illinois moves out of committee, California Physical Therapy Association opposes the new athletic training bill while advancing an animal PT bill, and, at the federal level, Health & Human Services advances legislation to weaken the Affordable Care Act. As the silver tsunami starts to build, referrals to PT are dropping for the geriatric population. Last, we introduce you to our new research segment with John LaRue–this month, the new knee pain & mobility deficits clinical practice guideline revision.

Illinois Heads for Direct Access:
A bill that would grant Illinois PTs the ability to diagnose and provide Direct Access passed out of committee last week, with the understanding that there would be an amendment attached before advancing to the floor. It has been placed on the Illinois House calendar for debate.

Updates on Colorado’s Sunset Bill:


The bill has moved out of the Senate committee on health and is on to the committee on finance. The bill contains language that writes dry needling into the practice act, as well as language on PT diagnosis.

California’s legislative session has opened with 2 pieces of contentious legislation.
Athletic trainers in the state are attempting to gain licensure through assembly bill 3110. According to the California Physical Therapy Association, “The bill would grant Athletic Trainers licensure and the ability to treat injuries, illnesses and impairments in any setting with very little oversight. CPTA expressed opposition to the bill due its overly broad scope of practice and suggested that the concerns raised by proponents of the bill could be addressed through title protection.” The CPTA is urging physical therapists to contact their legislators in opposition to this bill.

Red rover, red rover, send PT right over!
A bill that would dictate the administration of animal PT has advanced to the California State Legislature. The bill would require a certificate in animal rehab and a referral from a veterinarian, but would allow off-site treatment, under “indirect supervision”. Believe it or not, this rekindles an incredibly contentious topic in California, with Veternarians warning that it potentially undermines the Veternary Practice Act. Who knew? We’ll keep you posted as the bill advances.

At the federal level, Health & Human Services has advanced rules to weaken the Affordable Care Act. Most concerning is the rule allowing states to provide alternatives to “benchmark plans”, which require a certain level of coverage. Under the new rules, states could offer alternatives, which would not be required to cover essential health benefits such as physical therapy. The APTA has opposed the new rules. Feel free to check out the CMS fact sheet on the rule changes – available at Talusmedia.org.

The silver tsunami is coming… but will that mean more PT?
While recent research has overwhelmingly shown the cost effectiveness of PT treatment, other data shows a troubling trend – reduced referral rates from Primary Care Physicians. A recent article in the Journal of General Internal Medicine shows a 50% drop in referral to PT for Musculoskeletal conditions from 2003 to 2014, even as an aging population develops more of these conditions. Even more troubling? Specialist referral rates went up, which can prove to be a less cost effective option.

John’s Research Corner:

For this week in John’s Research Corner, Talus Media Correspondent John LaRue discusses one of the most recent Clinical Practice Guidelines from the Journal of Orthopedic and Sports Physical Therapy (JOSPT) on “Meniscal and Articular Cartilage Lesions” for the 2018 Revision. The Clinical Practice Guidelines represent an accessory or resource to a clinician’s professional judgment and clinical expertise in a certain patient population, to help assist them towards a positive outcome for the patient. For these specific clinical guidelines, the articles outlines the evidence-based research behind early progressive knee motion, progressive weight-bearing loading through the injured joint, the most valid and reliable outcome measures, and interventions that lead not only to success in the early phases of rehab, but for the return-to-sport phase, as well. To check out these Clinical Practice Guidelines, visit https://www.jospt.org/doi/abs/10.2519/jospt.2018.0301.

Talus Media News is a subsidiary of Talus Media: PT Views & PT News. You can find all interviews mentioned in this newscast on our sister channel, Talus Media Talks. Check us out on Twitter & Facebook @TalusMedia.