End Unfair Practice of "Specialty Copays"
The New York Physical Therapy Association (NYPTA) is calling on the state legislature to end the unfair practice of so-called "specialty"copays, which are costing patients in dollars and foregone treatment and physical therapists in lost patients and jobs, leaving New York State with a more costly and less effective health care system.
Managed care companies continue to restrict access to physical therapy services by imposing "specialty" copayments of $40 or more per visit, when the insurance benefit that the patient pays for is the same or only a few dollars above that amount.
Managed care health insurers have designated physical therapists as specialists for copayment purposes, allowing health plans to charge patients more per visit while maintaining reimbursement levels to physical therapists, thus shifting more of the cost burden onto the backs of consumers.
These specialty copayments add up for New Yorkers, since physical therapy frequently requires multiple visits over an extended period of time as the practice of physical therapy works in conjunction with the healing process.
THE PATIENT PERSPECTIVE:
It begins with a shooting pain down my right leg. Over the next several days and weeks, the pain gets worse and tingling begins. Soon the pain becomes so excruciating I can’t get out of bed so I finally make an appointment with my doctor. She tells me I have two choices: I can see a orthopaedic surgeon or neurosurgeon to discuss surgery or, I can go to a physical therapist (PT) and avoid surgery. [read more]
THE PHYSICAL THERAPIST PERSPECTIVE: One of the most rewarding things about being a physical therapist is when patients’ express their gratitude for helping them return to their normal activities -- pain free -- after they have had a serious issue that caused them pain and limited their ability to move. Every day we see patients who have low back pain or radiating leg pain that is referred from the spine. Every day we carry out treatments that aim to reduce pain, restore movement and teach patients how to treat themselves at home and work. [read more]
NYPTA Advisory panel on Legislation (APOL)
The purpose of APOL is to:
- monitor and react to all legislative activities that would affect the practice of physical therapy
- disseminate legislative information to districts via liaisons for input
- develop legislation that reflects the changes in scope and need of the practice of physical therapy and, in accordance with the membership needs
- develop guidelines for members to react to legislation in an appropriate, professional and informed manner
- and identify methods of recruiting support for our legislative interests.
If you are interested in becoming a active in the legislative arena, send an email to Mike Mattia, APOL chair at email@example.com.
To contact a member of APOL, visit the legislative section of the NYPTA website.