PTA Legislative Issues

Governor Hochul Signs WCB PTA Bill

APTA New York is happy to report that the WCB PTA Bill (S9462-A/A 1204-A) was signed into law by Governor Hochul.

This new law will allow occupational therapy assistants and physical therapist assistants to provide care to workers’ compensation patients under the direction and supervision of an authorized provider. 

This change will take effect on October 27^th, and we will be on the lookout for any updates from the Workers Compensation Board.

Governor Hochul Signs PTA Licensure Bill

We are pleased to announce that the PTA licensure bill introduced by APTA New York was passed by the New York State Senate and Assembly and signed by Governor Kathy Hochul!  Physical Therapist Assistants (PTAs) are now formally licensed professionals in New York State.  This bill will take effect eighteen months after the Governor’s signing, which was August 17, 2022.

NYPTA Public Policy Priorities

1. Direct Access. NYPTA will pursue removal of current direct access limitations within New York State. This change will remove barriers which restrict New Yorkers from accessing physical therapist services in a timely manner. Introduced legislation will reflect the training and expertise of the physical therapist and their ability to refer patients for medical management when appropriate.
   
   
2. Patient Access/High-Copay Legislation. NYPTA will continue to pursue legislation and other initiatives to increase accessibility for patients for physical therapist services. These efforts will focus on affordable co-payments in line with office visit copayments, and will also include eliminating arrangements for disproportionately tiered copayments based on the type of facility in which physical therapy services are provided. 
    
3. Licensure of the Physical Therapist Assistant. NYPTA will continue to pursue advancement of the statutory recognition of the PTA from “certified” to “licensed”. This change will accurately reflect the academic training and passage of a national licensure exam currently required to achieve certification. (COMPLETED)
   
   
4. Practice Act Advancement: NYPTA will continue to determine opportunities and barriers related to an updated Physical Therapist Practice Act. This work will guide chapter leadership in crafting a contemporary practice act consistent with current and future physical therapist education and practice.
   
   
5. Workers Compensation. NYPTA will advocate for the coverage of services provided by the physical therapist assistant under the supervision of the physical therapist. (COMPLETED)
   
   
6. Combating the Opioid Epidemic: NYPTA will support policy initiatives which curb the use of opioids for pain management and will also support evidence-based therapies including physical therapy for the treatment of pain. 
   
   
7. Protecting Patients’ Rights to Provider Choice. NYPTA will pursue opportunities to prevent any provider from limiting a patient’s ability to seek care from the provider of their choice. This may include enhanced transparency of physician ownership in ancillary services and restrictions on conditioning a referral for physical therapy on where the services will be performed.
   
   
8. State Budget. NYPTA in conjunction with the lobbyist will monitor the budget process and oppose budget proposals that have a negative impact on the physical therapy profession.
   
   
9. NYPTA will continue to oppose the legislation, in its most recent form, that would unduly expand the scope of practice of Athletic Trainers. NYPTA will monitor the legislative activities of other professions and will respond accordingly. NYPTA will also continue to oppose the corporate practice of the profession and legislation which would negatively impact the physical therapy scope of practice.
   
   
10. NYPTA will collaborate with APTA and other professional organizations in investigating the viability of pursuing PT Compact Licensure in New York State.
    
    
11. NYPTA will identify and address statutory and regulatory barriers to physical therapists’ ability to order diagnostic imaging in New York State. 

PTA Payment Differential

The PTA payment differential started in 2022 along with a special claims designation.  In the post-cap payment system (Centers for Medicare and Medicaid Services), outpatient therapy services performed by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) will be reimbursed at 85% of the Medicare physician fee schedule - a change opposed by APTA.

As of June 2022, the bill to address the PTA differential, known as the Stabilizing Medicare Access to Rehabilitation and Therapy Act (H.R. 5536) - SMART Act for short - remains in effect and the APTA continues to collaborate with a host of other professional and patient advocacy groups to fight for this passage.

Mandatory Continuing Education

The law is described in detail on the New York State Department of Education web site†. A few key elements are the following:

• 36 hours of continuing education are required over each registration period (3 years)
• The law became effective on September 1, 2009; CEUs taken before September 1, 2009 CANNOT be used to meet the requirement. For those that have renewal dates from January 1, 2010 to October 1, 2012, there will be a proration schedule of 1/2 credit hour per month. Refer to chart† on NYSED web site. Licensees whose registration is due to be renewed on or after October 1, 2012, must complete 1.0 hour of continuing education for each month of the Registration Period.
• New graduate physical therapists and physical therapist assistants will NOT have to meet this requirement during their first 3 year license/certification timeframe.

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Two Bill Extensions of NYS Practice Act Affecting PTAs Become Law With Sunset Clauses Continuing (see expiration repeal dates below)

Two physical therapist assistant extender bills were signed into law:

Chapter 258

• Extends the provisions of Chapter 534 of the Laws of 1993 relating to physical therapist assistants to provide services in home care settings for an additional four years until June 30, 2026. These services are allowed when the supervising physical therapist establishes a program of care for a patient, has an initial joint visit with the patient and the PTA, periodically evaluates and treats such patient and provides a final evaluation to determine if the treatment plan should be terminated.

Chapter 252

• Extends the provisions of Chapter 20 of the Laws of 1998 relating to physical therapist assistant services in elementary and secondary schools for an additional 5 years until June 30, 2025. This law allows physical therapist assistants to provide therapy services in public and private primary and secondary schools for preschoolers.

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Legislative and Practice Links (NYS Education Department)

• NYS Education Department Home Page†
• Practice Guidelines†
• Article 136 - New York State Practice Act†
• Test Your Knowledge of Law and Practice† (worth 2 continuing education credits with 100% correct answers)
• Continuing Education:Questions & Answers for PTs and PTAs†

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Limited Permit Rules Regarding Graduating PTAs

Limited permits may be issued to physical therapist assistants; the fee is $50. Limited permits for physical therapist assistants are valid for 6 months. An online application for a limited permit (Form 5) must be filed with or after submitting an Application for Licensure (Online Form 1 and $103 fee). A limited permit cannot be issued until all required documents are received, including Form 2 from the college acknowledging that the student has completed all academic and clinical components of the program and is a student in good standing. Only upon documented approval of the limited permit (issuance of limited permit number by New York State), is the graduating PTA able to begin employment as a PTA. The limited permit issued is good for 6 months only. A PTA graduate may apply for and receive confirmation of a second limited permit which is also for 6 months only, but this second limited permit is only approved if the graduate has already taken and failed the National Physical Therapy Examination for PTAs or has already applied to take the NPTE. Therefore a graduating PTA student may only work for up to a total of one year on limited permits. The issuance of a second 6-month term limited permit is NOT automatic. Do not let first permit expire if planning to request a second limited permit.

IMPORTANT NOTICE: Only Physical Therapist graduates have a 90 day exemption immediately following graduation, assuming they have abided by several rules. This exemption does NOT apply to physical therapist assistant graduates.

The Department may issue limited permits to an applicant for licensure which authorize the practice of physical therapy under the on-site supervision of a New York State licensed and currently registered physical therapist. On-site supervision means that the supervising physical therapist is in the same facility and readily available to the permittee.

An applicant receiving a limited permit is restricted to employment in a public hospital, an incorporated hospital or clinic, a licensed proprietary hospital, a licensed nursing home, a public health agency, a recognized public or non-public school setting, the office of a licensed physical therapist, or in the civil service of New York State or a political subdivision in New York State.

If you change supervisors and/or settings, or you have to add or remove a supervisor or setting, after a permit is issued, you must obtain an amended permit using the Limited Permit Change Form. After changes are processed you will receive an amended permit. A fee is not required for an amended permit issued as a result of a change in supervisor or setting. You must also submit a Form 5CS - Certification of Supervisor for Limited Permit for each new supervisor you are adding (see Upload Additional Documentation above).

It is important for all PTA graduates working under a limited permit to remember that until they obtain their official certification, they must sign documents/charts with their signature followed by ", PTA-limited permittee".

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Information from Office of the Professions

See the following link for News & Current Issues

See the following link for Practice Alerts

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Medicaid Requirement: Graduation from a CAPTE Accredited Program, No Equivalency

Centers for Medicaid and Medicare (CMS) has reported, "CMS would expect providers to be graduates of physical therapy programs accredited by CAPTE (Commission on Accreditation in Physical Therapy Education), and if applicable, licensed by the State. Equivalency rulings are not valid for physical therapist qualifications." This interpretation means most foreign educated physical therapists licensed in New York State are unable to provide treatment and be reimbursed by Medicaid. Note, there are only two foreign programs accredited by CAPTE, one in Scotland and one in Canada.

Due to a posting on the State Education Department's Medicaid web site, many think that because an equivalency is used for licensure, this same equivalency is applied for Medicaid. This is not the case. There is no equivalency for Medicaid reimbursement eligibility for those who graduated from a non-CAPTE accredited education program. The New York Physical Therapy Association is challenging this ruling as it will limit who can provide care, especially to those populations in need (ie. children in school settings).