Thursday, June 26, 2008

Leveling the Playing Field

On June 23, 2008 the New Jersey General Assembly took the first step in restoring some sense and reason to the practice environment for Physical Therapists and healthcare consumers in the State of New Jersey by overwhelmingly passing Assembly Bill 2123 (A-2123).  This landmark piece of legislation seeks to establish standards of coverage and reimbursement that are commensurate with the standards of practice by which Physical Therapists in New Jersey are bound to abide.

A-2123 assures consumers that the coverage that they and their employers pay so handsome a price for will indeed provide services without arbitrary caps on payment for services rendered or visits for medically necessary services.  As we are all painfully aware, third party payment for Physical Therapy services has been in a downward death spiral.  A-2123 establishes a floor of reimbursement based on an already existing PIP fee schedule established by the State of New Jersey below which the insurers' liabilities may not fall.  It also provides for the elimination of capricious and arbitrary visit authorizations less than those proposed by the treating Physical Therapist's Plan of Care should authorization be sought.  This legislation also makes Direct Access an affordable option for consumers by eliminating all referral requirements for third party payment for Physical Therapy.  There are a host of other benefits of this legislation which are covered here.

When all else has failed there are other avenues that are available to combat the deterioration of the practice environment and the legislative arena is the one most apropos when all other avenues have failed to produce satisfactory outcomes. 

The Senate companion bill of A-2123 was introduced last week as well in the form of S-2072.  I for one am looking forward to the passage of this bill as well and the eventual enactment of this legislation by the stroke of the Governor's pen.