California Direct Access / CMA

April 9, 2011

California Medical Association shows it true hypocrisy

Direct Hiring, Physical Therapist Issue Head CMA List - Capitol Desk -

California

Healthline<http://ptmanagerblog.com/direct-hiring-physical-therapist-issue-head-\

c>

Posted by <http://posterous.com/people/1l1oCkDWEWjv> Kovacek, PT, DPT,

MSA <http://posterous.com/people/1l1oCkDWEWjv> to

PTManager<http://ptmanagerblog.com>

Direct Hiring, Physical Therapist Issue Head CMA List

by Gorn

During the California Medical Association's 37th Annual Legislative

Leadership Conference this week in Sacramento, the organization outlined

some of the legislation it would fight for this year -- and legislation it

would fight against.

" Sometimes it feels like Groundhog Day around here, " CMA legislative analyst

Jodi Hicks said. " Every year, it seems, we have this discussion about a plan

to have some kind of direct hiring of physicians, and what that should look

like. "

Last year, three different bills were proposed on the issue. Two new bills

have been proposed this year to allow direct hiring of physicians by

hospitals, in an effort to increase the number of primary care physicians

working in rural and underserved areas in California.

AB

1360<http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_1351-1400/ab_1360_bill_2011\

0218_introduced.pdf>

by

Assembly member Sandré Swanson (D-Alameda) allows all health care districts

in the state to directly hire doctors, and AB

824<http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_0801-0850/ab_824_bill_201103\

31_amended_asm_v98.pdf>by

Assembly member Wesley Chesbro (D-Santa ) authorizes some rural

hospitals to hire physicians. The CMA has generally opposed bills that would

dilute the ban on corporate medicine, though it did support a limited, pilot

program in the past. The CMA opposes both bills in their current form. The

problem, Hicks said, is that allowing hospitals to have so much influence on

doctors could compromise patient care.

" In the past, we've supported bills that required the medical staff to have

a vote, and that makes a big difference in terms of patient protection, "

Hicks said. " Also, we wanted to make sure we're not displacing physicians

who already exist in the community, and that hospitals can't hire new

doctors to get rid of physicians that they just don't like. "

AB 1360 is scheduled to be heard in committee Apr. 12, and AB 824 is slated

for an Apr. 26 hearing.

The other major point of opposition, Hicks said, is the physical therapists'

effort to become solely independent contractors.

" Physical therapy has become an issue yet again, " Hicks said. " There's a

medical corporations code, and the intent was how to structure a medical

corporation and the code lists who can be part of a medical corporation.

What was never put on the list was physical therapists. "

Hicks said adding physical therapists to the list would be basically

cleaning up an administrative lapse. Some therapists disagree, and say that

patients should get direct access to physical therapy without being referred

by a physician.

Earlier this week, AB

783<http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_0751-0800/ab_783_bill_201102\

17_introduced.pdf>by

Assembly member Hayashi (D-Castro Valley), a bill the CMA says

would

correct the codification of physical therapists, was passed 9-0 out of the

Assembly Committee on Business, Professions and Consumer Protection.

Back to Capitol Desk<http://www.californiahealthline.org/capitol-desk.aspx>

Reader Comments:

- 3

- 04/08/2011

- DeFoe

I would like to clarify that physical therapists are not attempting to

" become solely independent contractors.” AB 783 would legalize the

employment of physical therapists by medical, podiatric and chiropractic

corporations, allowing them to control the point of access to physical

therapist services and engage in referral-for-profit care. It should also be

noted that AB 783 applies only to professional corporations. Physical

therapists can and will continue to legally be employed by hospitals,

nursing and rehabilitation facilities, nonprofit corporations and a variety

of other business arrangements in which there is no financial incentive for

referral. Physical therapists who wish to continue practicing in physicians’

offices may do so, but as self-employed therapists. If physicians truly care

about continuity of care, patient convenience, or job loss, they should have

no objection to physical therapists maintaining their independence as

self-employed professionals in their offices.

- 2