Physical Therapy CO-Pay Issues:  Lead.  There is an ever increasing co-pay burden on the PT patient often making care unaffordable.  Many insurance companies consider a PT visit/treatment the same as a physician specialist.  Examples were provided; including Federal BC/BS has $75 co-pay if services are provided by hospital outpatient department.  As an aside to the PT issue, PEIA will now have a $500 co-pay (subject to deductibles and co-insurance) for procedures that are often referred to physical therapists for post-operative care.  These include spine procedures, knee and hip replacements, and shoulder surgery.  Committee members felt we need to be proactive.  Similar legislation completed in KY.  Need to define the scope of problem with our members and possibly other providers (OT, SLP, chiropractors). 
Payment for Physical Therapist Assistant Services:  Lead.  In another attempt to cut reimbursement to physical therapists, insurance companies are excluding the interventions provided by PTA’s from reimbursement. 

Scope of PT Practice: Monitor all legislation introduced.  Protect the profession of physical therapy.

Chiropractic Practice Act Revision: Monitor  any legislation introduced relating to the scope of practice of chiropractors.

Health Care Reform: This may include insurance exchanges, medical homes legislation which we will monitor.  WVPTA would likely support legislation that involves the WV Physical Activity Plan, and Obesity Prevention Plan.

Assignment of Benefits: Monitor.  A bill to change the requirement that insurance payments be made directly to the patient and to allow payment to the provider of care.  The bill from the WV Hospital Association will likely be narrow in scope (pertaining to emergency treatment by hospitals).   The insurance lobby opposes any assignment of benefits changes as it allows out of network and out of the negotiated rates which would increase the cost of health care insurance.  PT’s are looking to receive direct payment for the care provided to patients.  Currently the patients are paid by the insurance company and often do not pay physical therapist bills.  Strategy is monitor for opportunities to include PT services.

Rental Network PPO Market (aka Silent PPO):  WVPTA should support WV State Medical Association in any effort to regulate the Rental Network PPO.  The WVSMA has a position statement which coincides with the needs of physical therapists.

Lead: The WVPTA will bear full responsibility for decision making, strategy development and lead the lobbying effort.
Support: We will participate with others and follow their lead, suggest strategies, participate in possible coalitions to support legislation.
Monitor: Watch the issue, report to full Exec. Board, report to membership and watch, but with no major action.
Oppose: WVPTA will work to defeat legislation