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| Published
by the APTA/Colorado Chapter September 16, 2003 |
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DORA Warns
Small PT Clinic |
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| The
agency that regulates the practice of physical therapy and licenses
physical therapists in Colorado has cited a little known, and even less
understood statute in its threat to shut down a small physical therapy
clinic in rural Colorado and to discipline the two physical therapists
that are employed there.
The Department of Regulatory Agencies
(DORA) issued a cease-and-desist order to the clinic’s owners and their
employed therapists in response to a complaint filed by a competitor. The
order requires the clinic to reorganize by December 31, 2003 or face
disciplinary and other action against the clinic and its physical
therapists. |
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| Issue is Longstanding One | ||
| The issue of corporate practice
and ownership has long been a contentious issue in the state’s Physical
Therapy Practice Act. For more than 30 years, Section 12-41-124, C.R.S.,
has required that physical therapy services can only be provided by and
through individuals who are licensed as physical therapists in the state
of Colorado, according to Greg Smith, APTA Colorado Chapter’s legal
counsel. In other words, Smith explained further, if Colorado PTs desire
to organize (or be employed by) an entity providing physical therapy
services, such as a corporation, limited liability company or limited
liability partnership, the Practice Act requires that such entity be
organized as a professional entity. This
professional entity must be entirely owned by one or more licensed
physical therapists and must include certain mandatory provisions in its
organizational documents, including that the entity is organized solely to
provide physical therapy services. There is no specific exemption
from this rule for hospitals, home health agencies, rehabilitation
agencies, nursing homes or schools. Only a very few "provider
networks" (mostly larger hospitals) that meet the requirements of the
Insurance Commissioner are exempt from this requirement.
Read the PT Practice Act at: |
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| The Colorado Chapter has
consistently brought this language forward to the General Assembly as
needing clarification or change in order to bring dozens of entities into
compliance with the law. During the 2001 Sunset Review, the policy arm of
DORA responsible for writing the sunset report, wrote, "The
current statute was modeled after the corporate practice section of the
Medical Practice Act and has little relevance for the actual practice of
physical therapy. Section 12-41-124, C.R.S., requires that the corporation
be organized solely for the purposes of practicing physical therapy and
that all shareholders of the corporation be licensed to practice physical
therapy. However, the physical therapy profession has never been one where
its licensees all practice independently. Licensees may be employees of
hospitals, other health care agencies, or practice in a clinic with
occupational therapists and speech pathologists. This section is at total
variance with the reality of practice." DORA went on to
recommend that licensed professionals be allowed to obtain the advantages
associated with corporate practice, while maintaining professional control
over professional decisions. Even with the urging of the Colorado Chapter,
the necessary changes were never thoroughly discussed by lawmakers and
this section of the law remained virtually untouched. |
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| The Chapter estimates that half
of Colorado physical therapists are employed directly through various
entities that do not meet the corporate ownership requirements, despite
the contrary provisions of the Practice Act. This subjects them to
potential disciplinary action by the Colorado licensing agency. |
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| What Next? | ||
| Since issuance of the
"cease and desist" order, DORA has convened an internal task
force to address the problem posed by the strict "corporate
practice" rules in the PT Practice Act and in similar laws for other
health professionals such as optometrists, chiropractors and dentists. The
Chapter’s Governmental Affairs Committee will monitor all developments
and lobby for needed improvements in the PT Practice Act during the next
session of the Legislature which begins in early January. Due to the
uncertainty of any legislative action that would solve all related
problems, Smith advises all organizations that provide physical therapy
services to retain a legal expert to review their organizational documents
for compliance with the Practice Act. Some organizations may be able to
restructure themselves so as to comply even with today’s strict rules,
while others will have to await a potential legislative solution.
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Another membership benefit
brought to you by the APTA/Colorado Chapter |
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| Download printable version of this e-Bulletin in PDF | ||
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| American
Physical Therapy Association / Colorado Chapter 7853 East Arapahoe Court, Suite 2100 Centennial, Colorado 80112-1361 U.S.A. www.aptaco.org Copyright 2003, APTA/Colorado Chapter. |
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