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Problems with Insurance Companies Not Complying with SB112

First make sure your client’s insurance was new or renewed after June 8, 2011. Then make sure it is not a self-funded plan. If both of those check out then go to http://insurance.ky.gov/ and on the left hand side panel there is a button that says file a complaint. You can either file it online or print the documents out and mail them in. The PT can do it on behalf of the patient, just ensure you check the boxes that correspond. The investigation should take no more than 30 days. Make a note on your calendar to follow up with the patient after 30 days. Typically the Kentucky Department of Insurance has been contacting the patient and not the PT with the results of the investigation.

Please click here for additional information in PDF format.



Connie Hauser, PT, DPT has been appointed to Kentucky’s Health Benefit Exchange Advisory Board. Nominated by the Kentucky Physical Therapy Association, Connie will be the voice of physical therapy on the 19-member board. The Health Benefit Exchange Advisory Board will review programmatic and policy issues, and make recommendations for Kentucky’s new marketplace for health insurance mandated by the federal Affordable Care Act (ACA).

The health benefit exchange will facilitate the purchase and sale of health plans in the individual market; assist small employers in facilitating the enrollment of their employees in health plans; provide one-stop shopping by helping individuals enroll in health plans Medicaid and KCHIP; enable individuals to receive premium tax credits and premium subsidies; and qualify small businesses for tax credits.

Kentucky has only through the end of this year to demonstrate its readiness to run a health insurance exchange or the responsibility will default to the federal government, according to Gov. Steve Beshear.

KPTA has also met with state officials overseeing the Health Benefit Exchange. Your association has reviewed the potential public insurance plans and made recommendations on plans which offer the most comprehensive physical therapy coverage, which would result in the most effective outcomes for consumers.

Click here to read Governor Beshear’s full press release on the Health Benefit Exchange Advisory Board in PDF format.






The Kentucky Board of Physical Therapy has posted amendments to its’ administrative regulations. You can view the regulations online at http://pt.ky.gov or via the direct links below.

The comment period ends July 31st. A request for a hearing deadline is Monday July 23rd at 4:30.

 

 201 KAR 22:001
Definitions

201 KAR 22:040
Renewal & Reinstatement Requirements

 

201 KAR 22:045
Continued Competency

 

201 KAR 22:053
Code of Ethical Standards


KPTA Reimbursement Chair, Holly Johnson PT, DPT, and her family recently returned from their third medical mission trip to Ometepe Island, Nicaragua. Working with Global Health Outreach, a 47 member team – comprised of medical professionals and their families along with a group of local interpreters – spent a week on the island. Together, they provided over 2000 people with physical therapy, family medicine, pediatrics, obstetrics, and dentistry services, organized an eye glasses clinic, distributed shoes, and conducted Bible school for the local children.

According to Holly, many amazing accounts of service were witnessed, including a 13 year-old spina bifida patient who walked for the first time in several years with a new walker and long leg braces. This child and an adult CP patient also received new wheelchairs, and patient care was provided to a variety of pediatric, orthopedic and geriatric patients. In addition, numerous pairs of shoes and PT/medical supplies were donated by PT Pros’ patients and clinics to share with the families on the island. The medical missionary visit makes services available to approx. 40,000 residents of the island and is the only one made to Ometepe each year.




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Advertising apples as oranges? Such type of misleading advertising occurs with health care services, too. In some states the term “physical therapy” is misrepresented or inappropriately advertised to the public by individuals who are not licensed as physical therapists. This characterization is misleading to the public, illegal in some states, and an issue of public protection for patients who think they are under the care of a licensed physical therapist, but in reality are not.

“Physical therapy” is not a generic term—it describes the care provided by or under the direction of licensed physical therapists. When people seek “physical therapy” they deserve to know their care is in the hands of a licensed physical therapist. Other health care providers might share some of the same treatment techniques or rehabilitative procedures used by physical therapists, but the care should only be described or advertised as “physical therapy” or “physiotherapy” when provided by or under the direction of a licensed physical therapist.

While two health care professions may share common elements, labeling them the same thing is not right—it’s like comparing apples to oranges.


The Kentucky Physical Therapy Association is pleased to announce its’ support of Smoke-Free Kentucky. Smoke-Free Kentucky is a coalition of organizations and individuals who support making all public and work places 100% smoke-free in order to protect citizens and workers from the proven dangers of secondhand smoke. Because physical therapists and physical therapist assistants are affirmed leaders in preventative healthcare, this initiative was unanimously supported by our members who attended the 2012 Spring Conference business meeting. For more information on Smoke-Free Kentucky, please visit their official web site at http://www.tobaccofreekids.org/microsites/smokefreekentucky/partners.html.