Legislative Update: HB188 - January 27, 2023 Windham Independent
Legislative Update - HB188
The Finance committee met twice this week, with full day public hearings on Tuesday and Thursday, while the Finance II committee met for public hearings/executive session on Wednesday. I am told that three days in Concord counts as a light work week for Finance - time will tell. All our meetings are available on the House of Representatives YouTube channel.
As the primary sponsor of two bills (HB188 and HB516), I would like to introduce them to you, starting with HB188 - Relative to the duration of physical therapy.
This is the proposed bill language:
1 Physical Therapy Practice Act; Referral to Health Care Professional. Amend RSA 328-A:9, II to read as follows:
II. A physical therapist shall refer a patient or client to appropriate health care practitioners when:
(a) The physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice; or
(b) Physical therapy is contraindicated[; or
(c) There is no documented improvement within 25 calendar days of the initiation of treatment].
This is as simple as it gets in terms of legislation - it removes paragraph (c) from the current language, period, eliminating the existing mandate to stop treating a patient after 25 days unless a physician approves continuing the treatment.
We are dealing with a primary physician shortage in many parts of the state, and asking a patient and a physical therapist that agree on a course of treatment to stop after a few weeks unless a doctor approves further treatment will leave some patients unable to get the care they need - doctor visits come with a cost (especially for uninsured people) and can be hard to schedule in a timely manner. Patients who know they cannot (or afford to) see a doctor may be discouraged from even talking to a therapist in regards to conditions that require longer term therapy, so the current paragraph (c) is limiting access to physical therapy.
20 other states (including MA and VT) allow patients to see PTs with no physician referral and time limits, with no reports of harm to the patients that I could find. Physical therapists already refer patients to physicians when the consult is needed to provide care. Insurance companies already have rules on how long patients can receive PT before a physician visit is required. Any concerns that PT's may still offer unnecessary treatment without physician supervision can be addressed through the Physical Therapy Governing Board, who handles their professional licensing.
Healthcare is a complex topic, but removing an RSA paragraph that offers no benefits but has a downside should benefit the residents of New Hampshire by improving our ability to access necessary services.
I am always happy to talk to any Windham resident - you can reach me with concerns or questions about any legislative matters at 603 267 4142 (call or text), email me at dpm@leg.state.nh.us or send me a letter at 12 Clarke Farm Rd., Windham, NH 03087.
Daniel Popovici-Muller
Windham Representative