Hot State Issues

Direct Access in New York State allows New Yorkers access to physical therapist services without a medical referral.  Currently New Yorkers can visit a physical therapist for 10 visits or 30 days before getting a referral.

With health care costs skyrocketing, health care provider shortages occurring in parts of the state, the opioid epidemic raging and driving overdose deaths, and people of all ages suffering from a variety of musculoskeletal pain conditions, removing restrictions on direct access will improve healthcare efficiencies and is a common-sense solution to the current healthcare challenges.

Physical therapy works – data from the insurance industry shows that when people utilize physical therapy first, they were 75-90% less likely to receive a prescription for opioid pain medication. Another study found that when patients have direct access to physical therapist care, they require fewer visits to the doctor, have decreased exposure to radiation from imaging, and are less likely to require pharmacological intervention.

A growing number of states are recognizing and responding to the call for physical therapists to add imaging referral to the list of medical referrals required of a first contact provider. New York currently is considered a state where there are no known regulatory barriers to physical therapists imaging referral privileges. Physical therapists have been shown to possess the requisite knowledge and skills to make appropriate imaging referrals, which improves healthcare efficiencies.

Utilization management programs such as prior authorization, imposing visit limitations and claims denials delay access to medically necessary care, and contribute to physical therapist burnout. It is also causing facilities to hire non-clinical staff to alleviate the burden on physical therapists which takes money away from direct care.

A physical therapist assistant is a licensed clinician who works under the direction  of a licensed physical therapist. PTAs play a crucial role in the PT-PTA team and improves access to care by increasing the physical therapy workforce.  The current on-site supervision requirement in New York effectively limits access to care  particularly in rural and underserved areas where beneficiaries are 50% more likely to receive therapy from a PTA.

It's all about patient access. Telehealth provided by PTs and PTAs, when appropriate and integrated into the overall plan of care, has been shown to contribute positively to patient outcomes and increase access to care.

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