400+ Physical Therapists in Albany Yesterday to Advocate for Patients

New York Physical Therapy Association Calls on Legislature to Enact Legislation to Prohibit High Copays and Help Ensure Access to Physical Therapy

ALBANY , NY (05/16/2012)(readMedia)-- More than 400 physical therapists, physical therapy students, patients and consumers participated in 162 meeting with legislators in Albany yesterday as part of the New York Physical Therapy Association's (NYPTA) annual Lobby Day. The focus of this years event was insurers regressive practice of requiring subscribers to pay the higher "specialist" copay for physical therapy services. This practice can lead to foregone treatment or alternative, more invasive treatments for patients; the loss of patients and jobs for physical therapists, most of whom are small businessmen; and a more costly and less effective health care system for all New Yorkers

"The time has come to stop high copays for physical therapy," said Matthew R. Hyland, PT, PhD, MPA, president of the NYPTA. "We support A. 187A/S.4870A, which would limit the amount of the copay insurers can require to 20 percent of the cost of care or reimbursement rate, on behalf of our patients and our profession. By capping physical therapy copays, this legislation would not only protect patients from excessively high out-of-pocket health care costs but would also help reduce long-term health care costs for New York State by ensuring that patients have access to the most cost-effective musculoskeletal rehabilitation care for their needs."

The vast majority of health insurers now apply the higher "specialist" copay to physical therapy visits which results in an unfair financial burden on patients. For example, it is not uncommon for "specialist" copays to be $50 per visit which, when applied to physical therapy care that can require 10 to12 or more sessions per month, can cost a patient upwards of $500 per month in out-of-pocket costs. Further, because the amount of the higher copay exceeds the maximum amount the insurer typically allows for the visit, the insurance company pays $0 for the visit while the patient pays 100% or more of the allowable amount of the visit.

Access to physical therapy care, a cornerstone in the treatment of many musculoskeletal and neurological conditions, is an important part of the continuum of care. According to a 2010 survey of 2,099 New Yorkers conducted by the NYPTA, slightly more than half (51%) of all New Yorkers or their families have had physical therapy. Further, nearly one in four patients said they could not afford the full course of physical therapy prescribed.

"The high copay bill will allow me and others to gain their independence and return to work. Many times, physical therapy is our only means to regain our independence," said Michelle Randall from Glens Falls, NY, a full time dental assistant for 32 years. Randall suffered a stroke in October 2011 which resulted in apraxia, a disorder of the brain in which a person is unable to perform tasks or movements when asked even though the requests or command is understood. She has been undergoing physical therapy several times a week for the past six months and making steady progress. But now she finds herself forced to reduce her treatments because she can no longer afford the copays of $35 per visit on top of the other expenses -- jeopardizing her recovery and ability to regain full function and return to work.

"This issue resonates with patients and consumers across New York," continued Hyland,. "In just a little more than a week, over 5,000 individuals signed our petition urging passage of these bills and it is clear from their comments that high copays are a barrier to care and must be stopped." To access the petition and read the comments go to http://signon.org/sign/stop-high-copays-1.

The NYPTA also lobbied for two bills aimed at correcting inequities under the State Workers' Compensation program. The first, A. 7308/S. 5005, would allow duly licensed physical therapist assistants to be reimbursed for care provided under the direction of a physical therapist. The second bill would require the NYS Workers' Compensation Board to biennially review and establish a schedule of fees for physical therapists (A. 7356/S. 5090). The last time PT rates were adjusted under Workers' Comp was 1996.

"I am a licensed physical therapist, as well as a NY State Assembly member. I spent many years in practice and I welcome the NY State Physical Therapy Association to Albany again. I recognize their important rehabilitative work and wish them success in their Lobby Day efforts. I support, wholeheartedly, reduction in co-pays to physical therapists," said Assemblywoman Michelle Schimel, PT (D-16).

ABOUT THE NEW YORK PHYSICAL THERAPY ASSOCIATION:

The New York Physical Therapy Association is a professional, non-profit association representing approximately 12,000 Physical Therapists (PTs), Physical Therapist Assistants (PTAs) and PT/PTA students. The NYPTA is dedicated to serving the public's health interests, improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals in state of New York. To learn more about the New York Physical Therapy Association please visit www.nypta.org.