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SENATE PROPOSAL OF AMENDMENT 2007-2008

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H.867

An act relating to health insurance plan coverage for athletic trainer services

     The Senate proposes to the House to amend the bill by striking out all after the enacting clause and inserting in lieu thereof the following:

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

§ 4088f.  COVERAGE FOR COVERED SERVICES PROVIDED BY
               ATHLETIC TRAINERS

(a)  To the extent a health insurance plan provides coverage for a particular type of health service or for any particular medical condition that is within the scope of practice of athletic trainers, a licensed athletic trainer who acts within the scope of practice authorized by law shall not be denied reimbursement by the health insurer for those covered services if the health insurer would reimburse another health care provider for those services.  A health insurer may require that the athletic trainer services be provided by a licensed athletic trainer 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.

(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. § 2086 is added to read:

§ 2086.   PATIENT CARE MANAGEMENT

(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 assigned.  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

(a)  26 V.S.A. § 2081a(1) (definition of assistive personnel) shall be repealed on July 1, 2009.

(b)  26 V.S.A. § 2085 (legal liability for physical therapists) shall be repealed on July 1, 2009.


Sec. 4.  EFFECTIVE DATE: APPLICABILITY

(a)  Sec. 1 of this act shall take effect on July 1, 2008 and shall apply to all health benefit plans offered, issued, or renewed on or after October 1, 2008.

(b)  Sec. 2 of this act shall take effect on July 1, 2009.



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us