Direct Access (DA) is the removal of a state law requirement that a physician or other practitioner refer a patient to physical therapy services for evaluation and treatment. A recent study conducted in Virginia shows a 99% patient satisfaction rate with DA, indicating that DA should be expanded.
Criminal background checks (CBCs) in nursing are becoming extremely important and in some cases, absolutely necessary. While nearly all jurisdictions ask applicants to self-report any criminal history upon application for licensure, data reflect that many nurses with criminal histories fail to self-report, according to Council of State Governments, 2012.
The Affordable Care Act (ACA) was passed in 2010 and many of its most significant sections have been implemented across the U.S. Despite its heft (the law and its accompanying rules number into thousands of pages), the ACA is notoriously free of direct changes to health professions regulation. However, the indirect effects are numerous.
Some changes are coming in 2016 and 2017 in the eligibility requirements to take the National Physical Therapy Exam (NPTE). This is not licensure eligibility. The eligibility is to sit for the NPTE only, although passing the exam is one part of the criteria for licensure eligibility. At the 2011 NPTE Summit, a discussion arose about candidates taking the exam who had no chance of passing. As a result, eligibility requirements to enhance security and public protection were reviewed. The following year a background review with benchmarking and passing statistics was undertaken. Other healthcare licensure and certification programs were compared to NPTE’s requirements so that NPTE’s eligibility requirements would not be the most or least stringent. In 2013, an eligibility panel made recommendations and Leadership Issues Forum (LIF) supported the new requirements. The 2013 Federation delegate assembly voted to enact the requirements.
Healthcare fraud is the new easy crime in America. Medicare fraud can result in a great deal of money being lost. Because physical therapy (PT) billing system is so easy – just check boxes – fraud is hurting the patients, the reputation of physical therapy, and the economy. The Institute of Medicine (IOM) reported that $765 billion per year has been lost to fraud, waste, and abuse with $75 billion of that due to fraud. This results in overutilization of services, increased costs to payers, corruption of medical decision-making, unfair competition, harm to patients, and serves to deter new students from entering the profession due to a negative public perception.
The number and types of National Physical Therapy Examination (NPTE) accommodation requests are increasing each year. Yet the bottom line may be whether candidates – especially those who receive accommodations in school and on the NPTE – can actually do the job of a competent physical therapist after receiving a university degree and passing the NPTE.
In the current healthcare environment, portability of licensed individuals has been identified by many as a critical issue. The federal government has communicated concern about the current portability barriers and several bills have been submitted to Congress in attempts to address this issue (military spouses, dual licensure system, etc.).
Physical therapist assistants (PTA) have been around for more than 40 years. Still, debate continues because of the numerous and conflicting rules, regulations, and position statements from many different boards and organizations dealing with them. From the length of their education and its cost to the means of practice to reimbursement, there are many issues to be resolved.
(Note – The 2015 Supreme Court decision against the North Carolina Board of Dental Examiners may influence the board model discussion, particularly with regards to board autonomy.) A paper published by the National Association of State Boards of Accountancy (NASBA) in fall 2010, “Establishing the semi-independent state board of accountancy,” stated that autonomous, independent boards were the most effective. In discovering the effectiveness of a board, it is important to look at the five board models as defined by the late Benjamin Shimberg, Chairman Emeritus of the Citizen Advocacy Center Board of Directors and Founder of the Council on Licensure, Enforcement and Regulation (CLEAR).
Clinical dilemmas may present themselves to students who are caught in the middle between their clinical instructor (CI) and doing “what is right.” It becomes more complicated because the student is not yet licensed. Students do not want to get into trouble with the facility or the school. CIs, who are licensees and have a Duty to Report, should serve as a role model for practice excellence, present a balance between “excellence and real life,” and work with many schools and school policies. Is the State Board obligated in some manner to students and licensees, and is its role punitive vs. remediation? That’s the question posed to attendees through hypothetical scenarios at a presentation on ethical dilemmas.
As a result of the discussions in the 2012 Leadership Issues Forum, FSBPT initiated a national survey of physical therapists practicing in the US but educated outside of the United States. The survey was developed to document the demographics of foreign-educated physical therapists and to look at the challenges and obstacles they encounter in trying to join the US workforce. The results may eventually be used to inform regulatory decisions regarding the foreign-educated physical therapist. The raw results are educational.