Recently introduced legislation defers to states' 'direct access' laws.

Before getting physical therapy, all Medicare beneficiaries need a physician's referral or certification of a plan of care -- but that could change if Congress passes a bill now on the floor.

On May 6, the US Senate introduced legislation that would increase access to physical therapy services for Medicare beneficiaries by removing the need for a physician's referral or certification of the plan of care, announced the American Physical Therapy Association in a press release. The House introduced its version of the Senate bill on March 31.

The kicker is that the law would allow direct access to physical therapy only in states that authorize it. However, many states allow some form of direct access. Forty-eight states and the District of Columbia have eliminated the physician referral/certification of care plan requirement for patients to see physical therapists for an evaluation, while 44 states and the District of Columbia allow access to some form of physical therapy treatment without referral.

Sens. Blanche Lincoln (D-Ark), Lindsey Graham (R-S.C.), and Arlen Specter (D-Pa.) introduced the bill, entitled the Medicare Patient Access to Physical Therapists Act (S. 950), which says Medicare Part B beneficiaries who need outpatient physical therapy would have direct access to physical therapist services as permitted by state law.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility -- in many cases without expensive surgery or the side effects of prescription medications. APTA represents more than 72,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide.

“Delaying treatment puts seniors and people with disabilities at risk by impeding their ability to achieve optimal functional outcomes,” said APTA President R. Scott Ward, PT, PhD. “Removing this unnecessary and burdensome requirement will allow Medicare beneficiaries to receive high quality cost-effective physical therapy services in a timely manner.”

“As we work to move health care toward a system that improves quality and value, physical therapists are critical to increasing access to care, especially in rural America,” Lincoln said. “Our health reform efforts should enable providers to work collaboratively across care settings to deliver evidence-based health care services to the millions of Medicare beneficiaries who need them.”