Re: State Farm Announces it may begin to enforce Arch aic Physical Therapy Statute that Discriminates against Chiropractors

[Guest guest]

comment on the PIP mills that appear to be a part of the problem here: I employ three part time LMT's to deliver 1/2 hour problem focused massage sessions to selected Injury patients. Two of the three work other times at what appears to be PIP mills where every patient gets an hour session every time,as well as consults with several professionals. I can understand State Farm's dismay at repeatedly receiving huge billings on every patient.

Can OBCE peer review or some other disciplinary venue address this? : R Johansen D.C. PC,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818----- Re: State Farm Announces it may begin to enforce Archaic Physical Therapy Statute that Discriminates against Chiropractors

We should ask Vern to jump on this.Oh I forgot-he has been terminated.... :-( Bruce Chaser, D.C. wrote:

Hey Docs:

Sorry to distract you this Monday evening.

Apparently a representative from State Farm notified the OBCE Executive Director today that it intends to start relying upon an old Physical Therapy Statute to begin issuing Personal Injury Protection (PIP) coverage denials for any Physical Therapy Treatment that is referred by a licensed chiropractic physician. The statute in question is not even found in the PIP or insurance statutes. The statute is in the Physical Therapy statutes.

The statute in question is ORS 688.132 and states: "688.132 Duty to refer person; exceptions; when personal injury protection benefits available. (1) A licensed physical therapist shall immediately refer a person to a medical doctor, osteopathic physician, chiropractic physician, podiatric physician and surgeon, naturopathic physican, dentist, phsyician assistant or nurse practitioner if: (a) Signs or symptoms are present that require treatment or diagnosis by such providers or for which physical therapy is contraindicated or for which treatment is outside the knowledge of the physical therapist or scope of practic of physical therapy; . . . . . . . . . . (2) Notwithstanding any provision of ORS 742.518 to 742.542 (the PIP statutes), personal injury protection benefits are not required to be paid for physical therapy treatment of a person covered by the applicable insurance policy unless the person is referred to the physical therapist by a licensed physician, podiatric physician and surgeon, naturopathic physician, dentist, physician's assistant or nurse practitioner."

Aparently, physical therapists, according to the insurance company, can be required by law to refer a patient to a chiropractic physician, but chiropractors are prohibited from referring PIP motor vehicle injury patients to physical therapists. Now that statutory interpretation seems convoluted to me, but that is apparently going to be State Farm's position. What's "physician?" I would think the same logic applied to medical doctors would mean that medical doctors are not "physicians" referenced as those who can refer to physical therapists. This apparent new position of State Farm is absolute BUNK, but that doesn't mean it's not going to be State Farm's position, and if they're successful I would imagine every other insurer will follow suit.

Attached are the documents from the Insurance Division as well as Dave McTeague's letter back in 1997 to the Insurance Division requesting those documents. To Dave's credit, he indicates he's been trying to get people concerned about this possible issue for 13 years and nobody seemed overly concerned. Obviously, if State Farm takes this position, we cannot let it stand, it is outrageous, and is certainly not something our law firm will ever tolerate without a fight. If any of your patients have physical therapy bills denied by State Farm because you referred the patient to the physical therapist, please give any of our attorneys a call at 1-800-289-3443.

I will pass more information on as I get it. If it turns out to be true, in addition to the courtroom, I would imagine that your State Association might be able to get involved in terms of authorizing a legislative effort to simply have the statute amended.

Just relax. We're just making you aware of a potential issue as soon we were made aware of it.

G.

Gatti, Gatti, Maier, Sayer, Thayer, & Associates

1781 Liberty St. SE

Salem, OR 97302

1-(800) 289-3443

msmith@...

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[Guest guest]

Ron,

Not without a complaint filed, for the most part. IMHO.

Minga Guerrero DC

Re: State Farm Announces it may begin to enforce Arch aic Physical Therapy Statute that Discriminates against Chiropractors

comment on the PIP mills that appear to be a part of the problem here: I employ three part time LMT's to deliver 1/2 hour problem focused massage sessions to selected Injury patients. Two of the three work other times at what appears to be PIP mills where every patient gets an hour session every time,as well as consults with several professionals. I can understand State Farm's dismay at repeatedly receiving huge billings on every patient.

Can OBCE peer review or some other disciplinary venue address this?

:

R Johansen D.C. PC,DABCO

Chiropractic Life Center

12762 SE Stark Street

Portland Oregon 97233

Voice 5032557746,Fax 5032550818

----- Re: State Farm Announces it may begin to enforce Archaic Physical Therapy Statute that Discriminates against Chiropractors

We should ask Vern to jump on this.

Oh I forgot-he has been terminated.... :-(

Bruce Chaser, D.C.

wrote:

Hey Docs:

Sorry to distract you this Monday evening.

Apparently a representative from State Farm notified the OBCE Executive Director today that it intends to start relying upon an old Physical Therapy Statute to begin issuing Personal Injury Protection (PIP) coverage denials for any Physical Therapy Treatment that is referred by a licensed chiropractic physician. The statute in question is not even found in the PIP or insurance statutes. The statute is in the Physical Therapy statutes.

The statute in question is ORS 688.132 and states: "688.132 Duty to refer person; exceptions; when personal injury protection benefits available. (1) A licensed physical therapist shall immediately refer a person to a medical doctor, osteopathic physician, chiropractic physician, podiatric physician and surgeon, naturopathic physican, dentist, phsyician assistant or nurse practitioner if: (a) Signs or symptoms are present that require treatment or diagnosis by such providers or for which physical therapy is contraindicated or for which treatment is outside the knowledge of the physical therapist or scope of practic of physical therapy; . . . . . . . . . . (2) Notwithstanding any provision of ORS 742.518 to 742.542 (the PIP statutes), personal injury protection benefits are not required to be paid for physical therapy treatment of a person covered by the applicable insurance policy unless the person is referred to the physical therapist by a licensed physician, podiatric physician and surgeon, naturopathic physician, dentist, physician's assistant or nurse practitioner."

Aparently, physical therapists, according to the insurance company, can be required by law to refer a patient to a chiropractic physician, but chiropractors are prohibited from referring PIP motor vehicle injury patients to physical therapists. Now that statutory interpretation seems convoluted to me, but that is apparently going to be State Farm's position. What's "physician?" I would think the same logic applied to medical doctors would mean that medical doctors are not "physicians" referenced as those who can refer to physical therapists. This apparent new position of State Farm is absolute BUNK, but that doesn't mean it's not going to be State Farm's position, and if they're successful I would imagine every other insurer will follow suit.

Attached are the documents from the Insurance Division as well as Dave McTeague's letter back in 1997 to the Insurance Division requesting those documents. To Dave's credit, he indicates he's been trying to get people concerned about this possible issue for 13 years and nobody seemed overly concerned. Obviously, if State Farm takes this position, we cannot let it stand, it is outrageous, and is certainly not something our law firm will ever tolerate without a fight. If any of your patients have physical therapy bills denied by State Farm because you referred the patient to the physical therapist, please give any of our attorneys a call at 1-800-289-3443.

I will pass more information on as I get it. If it turns out to be true, in addition to the courtroom, I would imagine that your State Association might be able to get involved in terms of authorizing a legislative effort to simply have the statute amended.

Just relax. We're just making you aware of a potential issue as soon we were made aware of it.

G.

Gatti, Gatti, Maier, Sayer, Thayer, & Associates

1781 Liberty St. SE

Salem, OR 97302

1-(800) 289-3443

msmith@...

____________________________________________________________

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