Re: Question RE: CMS revisions to Medicare policy

[Guest guest]

,

It seems to say that therapy must be a therapist, assistant supervised by the

therapist; with the exception of licensure for services to be considered

therapy when billed incident to physician services. 230.5, p. 37-38 in the pdf

document in the link (http://www.cms.hhs.gov/manuals/pm_trans/R34BP.pdf).

This is one of the most cohesive, understandable, useable documents from CMS

that I have had the pleasure of reading. At least that is the way it seems

the first time through. I may require therapists to read this document.

Wade McDowell, OTR

Director of Rehabilitation Services

Activities Director

Family Health West

228 North Cherry

PO Box 130

Fruita, CO 81521

Ph:

Fax:

scout2ot@...

In a message dated 5/16/05 5:24:58 PM Mountain Daylight Time,

wittpt@... writes:

<< Hi

I read briefly the link below and still have a question.

Does it or does it not stipulate that PT provided to Medicare beneficiaries

in a physician owned PT office must be provided only by PT's and PTA's? Do

the physicians at least have the same rules for providing service to MC

beneficiaries as those of us in private practice?

Thank you in advance for the interpretation of the rules

Witt, PT

Delray Beach, FL

>>

[Guest guest]

,

It seems to say that therapy must be a therapist, assistant supervised by the

therapist; with the exception of licensure for services to be considered

therapy when billed incident to physician services. 230.5, p. 37-38 in the pdf

document in the link (http://www.cms.hhs.gov/manuals/pm_trans/R34BP.pdf).

This is one of the most cohesive, understandable, useable documents from CMS

that I have had the pleasure of reading. At least that is the way it seems

the first time through. I may require therapists to read this document.

Wade McDowell, OTR

Director of Rehabilitation Services

Activities Director

Family Health West

228 North Cherry

PO Box 130

Fruita, CO 81521

Ph:

Fax:

scout2ot@...

In a message dated 5/16/05 5:24:58 PM Mountain Daylight Time,

wittpt@... writes:

<< Hi

I read briefly the link below and still have a question.

Does it or does it not stipulate that PT provided to Medicare beneficiaries

in a physician owned PT office must be provided only by PT's and PTA's? Do

the physicians at least have the same rules for providing service to MC

beneficiaries as those of us in private practice?

Thank you in advance for the interpretation of the rules

Witt, PT

Delray Beach, FL

>>

[Guest guest]

In a message dated 5/16/2005 7:44:49 P.M. Mountain Standard Time,

wittpt@... writes:

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

,

It would seem that way. My optimistic side says most physicians would not

go there as a reflection at least on themselves.

I have been researching the billing type of question as I have a new grad OT

we call her an OTG (no OT license in CO, just trademark) that we were not

able to bill for until she was officially a " graduate " . Lots of CMS searching

and that was the most restrictive of the standards for Medicare I could find,

when no licensure. She has done all coursework. Done all internships.

Taken the exam. Graduated. Can't get NBCOT results until into June or maybe

July when official transcripts are available plus processing delay. For OT,

sort of like SLP, the National Boards meet most state requirements for testing.

That is actually a benefit of the trademark in CO for OT -- they still

couldn't call themselves OTR, Occupational Therapist, regardless of who they

work

for until they have NBCOT paperwork.

Wade

Wade McDowell, OTR

Director of Rehabilitation Services

Activities Director

Family Health West

228 N. Cherry, PO Box 130

Fruita, CO 81521

W:

Fax:

scout2ot@...

[Guest guest]

In a message dated 5/16/2005 7:44:49 P.M. Mountain Standard Time,

wittpt@... writes:

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

,

It would seem that way. My optimistic side says most physicians would not

go there as a reflection at least on themselves.

I have been researching the billing type of question as I have a new grad OT

we call her an OTG (no OT license in CO, just trademark) that we were not

able to bill for until she was officially a " graduate " . Lots of CMS searching

and that was the most restrictive of the standards for Medicare I could find,

when no licensure. She has done all coursework. Done all internships.

Taken the exam. Graduated. Can't get NBCOT results until into June or maybe

July when official transcripts are available plus processing delay. For OT,

sort of like SLP, the National Boards meet most state requirements for testing.

That is actually a benefit of the trademark in CO for OT -- they still

couldn't call themselves OTR, Occupational Therapist, regardless of who they

work

for until they have NBCOT paperwork.

Wade

Wade McDowell, OTR

Director of Rehabilitation Services

Activities Director

Family Health West

228 N. Cherry, PO Box 130

Fruita, CO 81521

W:

Fax:

scout2ot@...

[Guest guest]

It looks like physicians can not use anyone other than PTs and PTAs to bill

for PT, and furthermore, PTA services can not be billed unless directly

supervised by the PT in the physician office environment--effective June 6.

Pierre H. Rougny, PT MTC

Director of Rehab

Sebasticook Valley Hospital

21 Leighton St.

Pittsfield, ME 04967

(207)487-9293

CMS revisions to Medicare policy

Hi everyone,

From the PT Bulletin on Friday:

" Revisions to the Medicare manual

<http://www.cms.hhs.gov/manuals/pm_trans/R34BP.pdf> for therapy services

released May 6 are being hailed by APTA as a significant advance in helping

physical therapists and physical therapist assistants provide care for

Medicare beneficiaries. In addition to implementing provisions of the

November 15 regulations clarifying personnel standards for " incident to "

services and supervision requirements in private practice settings, the new

manual provisions omit the requirement for a physician visit prior to

certification and give physical therapists up to 30 days to obtain

certification of the plan of care.

" These clarifications are the result of literally years of discussion and

collaboration between APTA and the Centers for Medicare and Medicaid

Services, " said Dave Mason, APTA vice president of government affairs. " They

will significantly enhance the ability of physical therapists and physical

therapist assistants to provide the care their Medicare patients need

without needless obstacles and administrative expense. We deeply appreciate

the dedication of CMS officials in getting these changes approved, and we

will continue to work with the agency and Medicare carriers to ensure that

these changes are implemented and applied effectively. "

APTA has prepared a summary

<http://www.apta.org/documents/Public/GovtAffairs/ManualrevisionsummaryFINAL

_0505.pdf> of the new manual provisions "

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

ptclinic@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

It looks like physicians can not use anyone other than PTs and PTAs to bill

for PT, and furthermore, PTA services can not be billed unless directly

supervised by the PT in the physician office environment--effective June 6.

Pierre H. Rougny, PT MTC

Director of Rehab

Sebasticook Valley Hospital

21 Leighton St.

Pittsfield, ME 04967

(207)487-9293

CMS revisions to Medicare policy

Hi everyone,

From the PT Bulletin on Friday:

" Revisions to the Medicare manual

<http://www.cms.hhs.gov/manuals/pm_trans/R34BP.pdf> for therapy services

released May 6 are being hailed by APTA as a significant advance in helping

physical therapists and physical therapist assistants provide care for

Medicare beneficiaries. In addition to implementing provisions of the

November 15 regulations clarifying personnel standards for " incident to "

services and supervision requirements in private practice settings, the new

manual provisions omit the requirement for a physician visit prior to

certification and give physical therapists up to 30 days to obtain

certification of the plan of care.

" These clarifications are the result of literally years of discussion and

collaboration between APTA and the Centers for Medicare and Medicaid

Services, " said Dave Mason, APTA vice president of government affairs. " They

will significantly enhance the ability of physical therapists and physical

therapist assistants to provide the care their Medicare patients need

without needless obstacles and administrative expense. We deeply appreciate

the dedication of CMS officials in getting these changes approved, and we

will continue to work with the agency and Medicare carriers to ensure that

these changes are implemented and applied effectively. "

APTA has prepared a summary

<http://www.apta.org/documents/Public/GovtAffairs/ManualrevisionsummaryFINAL

_0505.pdf> of the new manual provisions "

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

ptclinic@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

[Guest guest]

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

[Guest guest]

-

That's the way that I read the document. It's sort of a half-step up from

having " the girl in the white coat " doing ultrasound and moist heat...and

calling that " physical therapy " -- and billing it as professional services

incident to a physician visit.

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

RE: Question RE: CMS revisions to Medicare policy

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

-

That's the way that I read the document. It's sort of a half-step up from

having " the girl in the white coat " doing ultrasound and moist heat...and

calling that " physical therapy " -- and billing it as professional services

incident to a physician visit.

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

RE: Question RE: CMS revisions to Medicare policy

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Dick

You and I have the exact same thought pattern on this one! Is it even worth

pondering why a licensure requirement was omitted?? Either, I am stupid for

not understanding why or the powers that be at CMS is!

Witt, PT

Delray Beach, FL

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

[Guest guest]

And what state in the USA allows physical therapy to be practiced without a

license, Medicare or no?

Lucy Buckley PT

Chatham, MA

RE: Question RE: CMS revisions to Medicare policy

>

>

> Wade

>

> Thank you for the help!

>

> Please excuse my next question if I sound like a fool

>

> Do I then understand that a MD can still hire a PT graduate who has not

> passed his state licensure exam and bill MC for services provided to MC

> beneficiaries?

>

>

>

>

>

>

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State Association with a

> professional workshop or course - call us at 313 884-8920 to arrange

> PTManager encourages participation in your professional association. Join

> and participate now!

>

[Guest guest]

And what state in the USA allows physical therapy to be practiced without a

license, Medicare or no?

Lucy Buckley PT

Chatham, MA

RE: Question RE: CMS revisions to Medicare policy

>

>

> Wade

>

> Thank you for the help!

>

> Please excuse my next question if I sound like a fool

>

> Do I then understand that a MD can still hire a PT graduate who has not

> passed his state licensure exam and bill MC for services provided to MC

> beneficiaries?

>

>

>

>

>

>

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State Association with a

> professional workshop or course - call us at 313 884-8920 to arrange

> PTManager encourages participation in your professional association. Join

> and participate now!

>

[Guest guest]

-

Thanks for the note.

I guess that I have to keep reminding myself that the AMA is the single

strongest PAC in the nation. Also, Docs have worked for decades on the

assumption that any unlicensed person's work becomes " professional " if the

Doc assented to it.

Medicare's policy is that " If it isn't a real PT (or PTA supervised by a PT)

then it isn't PT. " -- So they've sort of created this half-way step in

which a Doc has to use a person with some educational requirements, if not

the license. It's just that when strong centralized governmental solutions

are sought, the window opens for what economists call " unintended secondary

consequences. "

I'm glad that I'm not the Doc's legal consultant. Imagine having to explain

in court why you're using a person who did not get licensed? Of course,

this is not without precedent. There are other venues, such as the

military, where a State license is not required. They have great quality,

and I think that most services actually want a therapist to be licensed in

some state of residence, just to avoid this kind of issue.

Have a great week!

Dick Hillyer

Cape Coral, FL

(About 150 miles due West, !)

RE: Question RE: CMS revisions to Medicare policy

Dick

You and I have the exact same thought pattern on this one! Is it even worth

pondering why a licensure requirement was omitted?? Either, I am stupid for

not understanding why or the powers that be at CMS is!

Witt, PT

Delray Beach, FL

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

[Guest guest]

-

Thanks for the note.

I guess that I have to keep reminding myself that the AMA is the single

strongest PAC in the nation. Also, Docs have worked for decades on the

assumption that any unlicensed person's work becomes " professional " if the

Doc assented to it.

Medicare's policy is that " If it isn't a real PT (or PTA supervised by a PT)

then it isn't PT. " -- So they've sort of created this half-way step in

which a Doc has to use a person with some educational requirements, if not

the license. It's just that when strong centralized governmental solutions

are sought, the window opens for what economists call " unintended secondary

consequences. "

I'm glad that I'm not the Doc's legal consultant. Imagine having to explain

in court why you're using a person who did not get licensed? Of course,

this is not without precedent. There are other venues, such as the

military, where a State license is not required. They have great quality,

and I think that most services actually want a therapist to be licensed in

some state of residence, just to avoid this kind of issue.

Have a great week!

Dick Hillyer

Cape Coral, FL

(About 150 miles due West, !)

RE: Question RE: CMS revisions to Medicare policy

Dick

You and I have the exact same thought pattern on this one! Is it even worth

pondering why a licensure requirement was omitted?? Either, I am stupid for

not understanding why or the powers that be at CMS is!

Witt, PT

Delray Beach, FL

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

[Guest guest]

-

Thanks for the note.

I guess that I have to keep reminding myself that the AMA is the single

strongest PAC in the nation. Also, Docs have worked for decades on the

assumption that any unlicensed person's work becomes " professional " if the

Doc assented to it.

Medicare's policy is that " If it isn't a real PT (or PTA supervised by a PT)

then it isn't PT. " -- So they've sort of created this half-way step in

which a Doc has to use a person with some educational requirements, if not

the license. It's just that when strong centralized governmental solutions

are sought, the window opens for what economists call " unintended secondary

consequences. "

I'm glad that I'm not the Doc's legal consultant. Imagine having to explain

in court why you're using a person who did not get licensed? Of course,

this is not without precedent. There are other venues, such as the

military, where a State license is not required. They have great quality,

and I think that most services actually want a therapist to be licensed in

some state of residence, just to avoid this kind of issue.

Have a great week!

Dick Hillyer

Cape Coral, FL

(About 150 miles due West, !)

RE: Question RE: CMS revisions to Medicare policy

Dick

You and I have the exact same thought pattern on this one! Is it even worth

pondering why a licensure requirement was omitted?? Either, I am stupid for

not understanding why or the powers that be at CMS is!

Witt, PT

Delray Beach, FL

I'm trying to consider the number of therapists who will choose not to get

licensed. But... hm-m-m... it could include a new graduate... or someone

who has taken and failed the exam five times. In Florida, where you and I

live and work, failing five times is the functional equivalent of a

professional death sentence, so the unsuccessful candidate could

theoretically now go to work for an orthopod for... $65K? instead of work

for us for ... $46K?

Things that make me go, " hm-m-m...?

Have a good evening,

Dick Hillyer, PT

Cape Coral, FL

[Guest guest]

If the procedures are called PHYSICAL THERAPY AND there the state practice

act protecting the title (definition of PT) then they can only use licensed

providers, if they call it something else or the legal backing is not in

place then anyone can use the 97000 codes baring eval and reeval

Ron Barbato P.T.

Corporate Director , Rehabilitation

Ephraim McDowell Health

Voice (859 )239-1515

Fax (859 )936-7249

rbarbato@...

" PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that

is privileged, confidential and/or exempt from disclosure under applicable

law. If you are not the intended recipient, then please do not read it and

be aware that any disclosure, copying, distribution, or use of the

information contained herein (including any reliance thereon) is STRICTLY

PROHIBITED. If you received this transmission in error, please immediately

advise me, by reply e-mail, and delete this message and any attachments

without retaining a copy in any form. Thank you. "

RE: Question RE: CMS revisions to Medicare policy

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

If the procedures are called PHYSICAL THERAPY AND there the state practice

act protecting the title (definition of PT) then they can only use licensed

providers, if they call it something else or the legal backing is not in

place then anyone can use the 97000 codes baring eval and reeval

Ron Barbato P.T.

Corporate Director , Rehabilitation

Ephraim McDowell Health

Voice (859 )239-1515

Fax (859 )936-7249

rbarbato@...

" PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that

is privileged, confidential and/or exempt from disclosure under applicable

law. If you are not the intended recipient, then please do not read it and

be aware that any disclosure, copying, distribution, or use of the

information contained herein (including any reliance thereon) is STRICTLY

PROHIBITED. If you received this transmission in error, please immediately

advise me, by reply e-mail, and delete this message and any attachments

without retaining a copy in any form. Thank you. "

RE: Question RE: CMS revisions to Medicare policy

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

If the procedures are called PHYSICAL THERAPY AND there the state practice

act protecting the title (definition of PT) then they can only use licensed

providers, if they call it something else or the legal backing is not in

place then anyone can use the 97000 codes baring eval and reeval

Ron Barbato P.T.

Corporate Director , Rehabilitation

Ephraim McDowell Health

Voice (859 )239-1515

Fax (859 )936-7249

rbarbato@...

" PRIVILEGED AND CONFIDENTIAL: This transmission may contain information that

is privileged, confidential and/or exempt from disclosure under applicable

law. If you are not the intended recipient, then please do not read it and

be aware that any disclosure, copying, distribution, or use of the

information contained herein (including any reliance thereon) is STRICTLY

PROHIBITED. If you received this transmission in error, please immediately

advise me, by reply e-mail, and delete this message and any attachments

without retaining a copy in any form. Thank you. "

RE: Question RE: CMS revisions to Medicare policy

Wade

Thank you for the help!

Please excuse my next question if I sound like a fool

Do I then understand that a MD can still hire a PT graduate who has not

passed his state licensure exam and bill MC for services provided to MC

beneficiaries?

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

[Guest guest]

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

[Guest guest]

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

[Guest guest]

Please keep in mind that many of the points being made regarding this topic

constitute legal arguments or regulatory interpretations. As such, they can

only truly be answered by the courts, or regulatory agency responsible for

enforcement. While it may be tempting for us to form our own conclusions

about this issue, it really is a mistake to do so.

That having been said, here are some personal opinions on these questions:

1. PTs without licenses can work in Physicians offices.

If you don't have a license, you are not a PT.

2. The MDs can bill 3rd party payors (including medicare) for this.

You are making a broad assumption that has not been tested yet under

Medicare, but courts might dispute this conclusion.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

Again, you are making a broad assumption subject to individual state

statutes & regulations.

4. The PT state board cannot regulate one who has no license.

Not true, unless statutorily prohibited. The unlicensed practice of

any profession is genrerally punishable by the respective Board of the

profession, if not as a criminal offense.

5. A change in the PT practice act prohibiting such practice arrangements

has no value in that type of practice.

Again, you are making an assumption about State law.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Confidentiality Note: This electronic mail is a communication from M & I

Consulting that may be privileged, confidential or otherwise protected from

disclosure. This information contained herein, is intended to be for the

addressee only. The authorized recipient of this information is prohibited

from disclosing this information to any other party and is required to

destroy the information after its stated need has been fulfilled.

If you are not the addressee, any disclosure, copy, distribution or action

taken in reliance on the contents of this electronic mail is strictly

prohibited. If you have received this electronic mail in error, please

notify the sender immediately.

Re: Question RE: CMS revisions to Medicare policy

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Please keep in mind that many of the points being made regarding this topic

constitute legal arguments or regulatory interpretations. As such, they can

only truly be answered by the courts, or regulatory agency responsible for

enforcement. While it may be tempting for us to form our own conclusions

about this issue, it really is a mistake to do so.

That having been said, here are some personal opinions on these questions:

1. PTs without licenses can work in Physicians offices.

If you don't have a license, you are not a PT.

2. The MDs can bill 3rd party payors (including medicare) for this.

You are making a broad assumption that has not been tested yet under

Medicare, but courts might dispute this conclusion.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

Again, you are making a broad assumption subject to individual state

statutes & regulations.

4. The PT state board cannot regulate one who has no license.

Not true, unless statutorily prohibited. The unlicensed practice of

any profession is genrerally punishable by the respective Board of the

profession, if not as a criminal offense.

5. A change in the PT practice act prohibiting such practice arrangements

has no value in that type of practice.

Again, you are making an assumption about State law.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Confidentiality Note: This electronic mail is a communication from M & I

Consulting that may be privileged, confidential or otherwise protected from

disclosure. This information contained herein, is intended to be for the

addressee only. The authorized recipient of this information is prohibited

from disclosing this information to any other party and is required to

destroy the information after its stated need has been fulfilled.

If you are not the addressee, any disclosure, copy, distribution or action

taken in reliance on the contents of this electronic mail is strictly

prohibited. If you have received this electronic mail in error, please

notify the sender immediately.

Re: Question RE: CMS revisions to Medicare policy

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Please keep in mind that many of the points being made regarding this topic

constitute legal arguments or regulatory interpretations. As such, they can

only truly be answered by the courts, or regulatory agency responsible for

enforcement. While it may be tempting for us to form our own conclusions

about this issue, it really is a mistake to do so.

That having been said, here are some personal opinions on these questions:

1. PTs without licenses can work in Physicians offices.

If you don't have a license, you are not a PT.

2. The MDs can bill 3rd party payors (including medicare) for this.

You are making a broad assumption that has not been tested yet under

Medicare, but courts might dispute this conclusion.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

Again, you are making a broad assumption subject to individual state

statutes & regulations.

4. The PT state board cannot regulate one who has no license.

Not true, unless statutorily prohibited. The unlicensed practice of

any profession is genrerally punishable by the respective Board of the

profession, if not as a criminal offense.

5. A change in the PT practice act prohibiting such practice arrangements

has no value in that type of practice.

Again, you are making an assumption about State law.

Ken Mailly, PT

Mailly & Inglett Consulting, LLC

Tel. 973 692-0033

Fax 973 633-9557

68 Seneca Trail

Wayne, NJ, 07470

www.NJPTAid.biz

Bridging the Gap!

Confidentiality Note: This electronic mail is a communication from M & I

Consulting that may be privileged, confidential or otherwise protected from

disclosure. This information contained herein, is intended to be for the

addressee only. The authorized recipient of this information is prohibited

from disclosing this information to any other party and is required to

destroy the information after its stated need has been fulfilled.

If you are not the addressee, any disclosure, copy, distribution or action

taken in reliance on the contents of this electronic mail is strictly

prohibited. If you have received this electronic mail in error, please

notify the sender immediately.

Re: Question RE: CMS revisions to Medicare policy

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!

[Guest guest]

Ken, , , et. al. --

AHAH! The State of Arkansas comes to my feeble little mind.

So... a Doc who bills anyone for pt-type services " incident to " a physician

visit may be legal for the time being... but after June 1, it'll have to be

performed by a person who meets CMS definition of a therapist, short of

licensure. That will include evaluations, Plans of Care, short and

long-term goals, certs & re-certs, daily progress notes, discharge

summaries, and the entire package we associate with " PT " .

Hm-m-m... as we've seen in the Arkansas chiropractic case, some State board

may consider these acts to meet their definition of " Physical Therapy " and

pursue someone.

Mightn't a Doc calim that if it's under his/her license, any and all PT is

legal?

Interesting. But it's still better than having the " tech " or " aide " do the

work, isn't it?

Dick Hillyer, PT

Cape Coral, FL

Re: Question RE: CMS revisions to Medicare policy

Follow my logic please:

[First, an apology to anyone offended by thinking they were referred

to as crooks in a now deleted post, this is not the case. I have

nothing but respect for the persons who use this board and have the

courage to post opinions that might be offensive to some. A full

retraction to anyone named Ken and everyone who reads this list-serve

as I do not believe any of you to be crooks. Thank you.]

Now, back to topic.

And correct any factual or logical flaw in this, please, and this

loophole may become problematic.

1. PTs without licenses can work in Physicians offices.

2. The MDs can bill 3rd party payors (including medicare) for this.

3. The PT has no license (or willingly forfeits the license), works

in the MD office, and the MD can continue to bill for it.

4. The PT state board cannot regulate one who has no license.

5. A change in the PT practice act prohibiting such practice

arrangements has no value in that type of practice.

Thanks.

Simonetti, PT

Looking to start your own Practice?

Visit www.InHomeRehab.com.

Bring PTManager to your organization or State Association with a

professional workshop or course - call us at 313 884-8920 to arrange

PTManager encourages participation in your professional association. Join

and participate now!