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Introduced by Committee on Government Operations


Subject:  Professions and occupations; insurance; coverage; athletic trainers

Statement of purpose:  This bill proposes to require health insurance plans to cover services that are within the scope of practice of athletic trainers and would otherwise be covered if provided by another type of health care provider.


It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  8 V.S.A. § 4088f is added to read:



(a)  A health insurance plan that provides coverage for services which are within the scope of practice of an athletic trainer licensed under chapter 83 of Title 26 if those services are provided by another health care provider shall provide coverage for those services if provided by an athletic trainer licensed under chapter 83 of Title 26.  A health insurer may require that the athletic trainer services be provided by a licensed athletic trainer under contract with the insurer or upon referral from a health care provider under contract with the insurer.  Services provided by athletic trainers may be subject to reasonable deductibles, co-payment and co-insurance amounts, fee or benefit limits, practice parameters, and utilization review consistent with applicable rules adopted by the department of banking, insurance, securities, and health care administration; provided that the amounts, limits, and review shall not function to direct treatment in a manner unfairly discriminative against athletic trainer care, and collectively shall be no more restrictive than those applicable under the same policy for care or services provided by other health care providers but allowing for the management of the benefit consistent with variations in practice patterns and treatment modalities among different types of health care providers.  Nothing in this section shall be construed as impeding or preventing either the provision or coverage of health care services by licensed athletic trainers within the lawful scope of athletic trainer practice in hospital facilities on a staff or employee basis.

(b)  As used in this section, "health insurance plan" means an individual or group health insurance policy, a hospital or medical service corporation or health maintenance organization subscriber contract, or another health benefit plan offered, issued, or renewed for a person in this state by a health insurer, as defined in subdivision 9402(7) of Title 18.  The term shall not include benefit plans providing coverage for specific disease or other limited benefit coverage.

Sec. 2.  26 V.S.A. § 2085 is amended to read:

§ 2085. Legal Liability Patient Care Management

(a) Physical therapists are professionally and legally responsible for patient care given by assistive personnel under their supervision. A physical therapist may delegate to assistive personnel and supervise selected acts, tasks or procedures which fall within the scope of physical therapy practice, provided such acts, tasks or procedures do not exceed the assistive personnel's education or training.

(b)  The director of professional regulation shall identify by rule the physical therapy services that may only be performed by, and are the sole responsibility of, the supervising physical therapist.

(c)  Assistive personnel, other than physical therapist assistants, shall perform patient care activities under on-site supervision of a licensed physical therapist.  For purposes of this section, "on-site supervision" means the supervising physical therapist must be:

(1)  continuously on-site and present in the department or facility where the assistive personnel are performing services;

(2)  immediately available to assist the person being supervised in the services being performed; and

(3)  maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated to assistive personnel.

(d)  With respect to supervision of a physical therapist assistant, the supervising physical therapist shall make regular visits at reasonable frequency to the place where the service is provided for the purpose of observing the physical therapist assistant treat the patient.

(a)  A physical therapist shall be professionally responsible and legally liable for all aspects of the physical therapy care of each of his or her patients.  The director of the office of professional regulation shall identify by rule physical therapy services that only a physical therapist may perform.  At a minimum, a physical therapist shall provide:

(1)  the initial examination and documentation for each of his or her patients;

(2)  periodic reexamination and documentation of each of his or her patients;

(3)  the documented discharge of the patient, including the response to therapeutic intervention at the time of discharge.

(b)  A physical therapist shall ensure the qualifications of all physical therapist assistants and physical therapy aides under his or her direction or supervision.

(c)  For each of his or her patients on each date of treatment, a physical therapist shall provide all of the therapeutic intervention that requires the expertise of a physical therapist and shall determine the use of physical therapist assistants or physical therapy aides who provide for the delivery of care that is safe, effective, and efficient, provided the assigned acts, tasks, or procedures do not exceed the person’s education or training, and provided:

(1)  A physical therapist assistant shall work under a physical therapist’s supervision.  A physical therapist assistant may document care pursuant to the existing treatment plan from the supervising physical therapist.

(2)  A physical therapist may use physical therapy aides for designated routine tasks.  A physical therapy aide shall work under the on-site supervision of a physical therapist who is continuously on site and present at the facility, who is immediately available to assist the person being supervised in the services being performed, and who maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated.  This supervision by the physical therapist may extend to off-site supervision of the aide only when the physical therapy aide is accompanying and working directly with a physical therapist assistant with a specific patient or when performing nonpatient-related tasks.

(d)  A physical therapist’s responsibility for patient care management shall include accurate documentation of and billing for the services provided.

(e)  A physical therapist shall be responsible for communicating the status of a patient’s progress and other relevant information to the patient’s referring health care professional unless the patient declines to authorize release of the patient’s physical therapy records.

Sec. 3.  REPEAL

26 V.S.A. § 2081a(1) (definition of assistive personnel) shall be repealed on July 1, 2008.


Sec. 1 of this act shall apply to all health benefit plans offered, issued, or renewed on or after October 1, 2008.

Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont