Re: State Farm Announces it may begin to enforce Archaic Physical Therapy Statute that Discriminates against Chiropractors [2 Attachments]

[Guest guest]

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@...