BE AWARE!

For all of those patients whose physicians refer to physical therapy, please

BE AWARE!!

Once a physician informs a patient that Physical Therapy is being prescribed for them, a person has a right to choose where they desire to go for Physical Therapy services. Several people have not encountered Physical Therapy in the past and may ask their physician where should I go for therapy? This is an appropriate question for the patient to ask the physician. The physician at that point can make suggestions. However, physicians are NOT to insist that a patient go to a specific practice for Physical Therapy services. This is inappropriate and violates your rights as a patient.

“Section 1877 of the Social Security Act (the Act), also referred to as the physician self-referral law (Stark II) prohibits a physician from making referrals for certain designated health care services (including physical therapy services) to an entity in which the physician (or an immediate family member of the physician) has a financial relationship (ownership or compensation interest), unless an exception applies.” (APTA website; Advocacy & Government Affairs)

In fact, when a physician or group of physicians has ownership in the providers of rehabilitation services, that information is to be disclosed to the patient or added to their prescription. Patients should BE AWARE that they have a right to go to any physical therapy clinic of their choice without feeling like their doctor would be displeased with them for their decision.

“A financial relationship can be either an ownership interest or a compensation arrangement, and can be direct or indirect.” (APTA website; Advocacy& Government Affairs)
“The law also prohibits an entity from billing for services provided as a result of the prohibited referral”. (APTA website; Advocacy & Government Affairs)

Several factors play into deciding where one may choose to go to physical therapy. Those factors include: location, cost, type of services provided, reputation, acceptance of different insurance policies, or personal preference.

Once a person has made a decision on a provider of rehabilitation services and is in compliance with the physicians orders; there should not be a problem. The therapist and the physician should have good rapport to communicate what is necessary in the overall wellbeing and progress of the patient.

The only time it is dictated where one MUST go for physical therapy services is when Worker’s Compensation is the payor source for their care. However, at that point it’s still NOT the decision of the physician on which facility to attend.

In conclusion, BE AWARE OF YOUR RIGHTS

you have a choice when Medicare or commercial insurance are the carriers.