Jonty Felsher, Michelle Handyside and Scott Uelsmann attended the MPTA (Missouri Physical Therapy Association) Lobby Day in Jefferson City. This year’s focus was on a Fair Co-pay Bill which would lower patients’ co-payments for outpatient Physical Therapy. See how you can be an advocate for all Private Practice Physical Therapy Outpatient Clinics in Missouri below.
Health Insurance Companies set up financial contracts with all healthcare providers in order to establish operating and reimbursement standards. These contracts are solely based on the bargaining power of the healthcare provider and the needs of the insurance company. These contracts have no relation to the quality of service provided by the hospital or clinic.
Over the last 20 years, large hospital systems have been given more favorable contracts than private practice clinics, especially in the field of physical therapy. Based purely on the size of the organization, insurance companies would be more willing to listen to the needs of the healthcare provider. More often than not, the needs of large hospital systems were taken into consideration because of the number of providers and services the system provided.
Conversely, the needs of private practice clinics and their owners are rarely taken into consideration when contracting reimbursement rates and patient co-pays. Without the benefit of having hundreds of providers and a multitude of services, private practice clinic owners are unable to negotiate for the basic needs just to maintain operations. Requests for reviews and appeals to the insurance companies routinely fall on deaf ears. Health Insurance companies are impeding Fair Trade Competition by deliberately paying large hospital systems more than private practice clinics for the same services.
Thus, we are taking our fight to the state legislature. We are fighting for fair pay and fair patient co pay amounts. The insurance industry routinely discriminates against small businesses by paying hospitals as much as 100% more than they reimburse for the same services we provide. We’re asking that you please contact your state senator and representative and respectfully request their support by co-sponsoring the bills that are listed below. If you do not know your state representative or senator you may look them up at www.house.mo.gov and www.senate.mo.gov in the “Legislature Look-up” but a 4 digit zip code extension is needed. Your 4 digit zip code extension can be found at zip4.usps.com/zip4.
After finding out your specific State Senator and Representative, please email, send a letter in the mail, or call to ask for their support on the following bills that are active in the 2012 Missouri Legislative Session (January thru Mid May):
Senate Bills:
Senate Bill 644, sponsored by Senator Kurt Schaefer: Requires health carriers to reimburse a physical therapist in the same amounts as paid to a licensed physical therapist for rendering the same services regardless of the setting or venue. (Equal Pay for Equal Services Bill)
Senate Bill 687, sponsored by Senator Eric Schmitt: Limits the copayment, coinsurance, or deductible imposed by a health insurer for physical therapy services by a licensed physical therapist to that for services provided by a primary care physician or osteopath. (Fair Co Pay Bill)
House Bills:
House Bill 1355, sponsored by Rep. Donna Lichtenegger: Requires health carriers to reimburse a physical therapist in the same amounts as paid to a licensed physical therapist for rendering the same services regardless of the setting or venue. (Equal Pay for Equal Services Bill)
House Bill 1134, sponsored by Rep. Dwight Scharnhorst: Limits the copayment, coinsurance, or deductible imposed by a health insurer for physical therapy services by a licensed physical therapist to that for services provided by a primary care physician or osteopath. (Fair Co Pay Bill)
Thank you for being an advocate for all Private Practice Physical Therapy Outpatient Clinics in Missouri.