Chapter 225

2008 -- H 7870 SUBSTITUTE A AS AMENDED

Enacted 07/05/08

A N A C T

RELATING BUSINESSES AND PROFESSIONS - PHYSICAL THERAPISTS

Introduced By: Representative Peter F. Kilmartin

Date Introduced: February 26, 2008

It is enacted by the General Assembly as follows:

     SECTION 1. Section 5-40-13 of the General Laws in Chapter 5-40 entitled "Physical

Therapists" is hereby amended to read as follows:

5-40-13. Grounds for discipline of licensees. -- (a) The board has power to deny,

revoke, or suspend any license issued by the department or applied for in accordance with this

chapter, or to discipline a person licensed under this chapter upon proof that said person has

engaged in unprofessional conduct including, but not limited to:

      (1) Fraud or deceit in procuring or attempting to procure a license or in the practice of

physical therapy;

      (2) Is habitually intemperate or is addicted to the use of habit forming drugs;

      (3) Is mentally and/or professionally incompetent;

      (4) Has repeatedly violated any of the provisions of this chapter;

      (5) Providing services to a person who is making a claim as a result of a personal injury,

who charges or collects from the person any amount in excess of the reimbursement to the

physical therapist by the insurer as a condition of providing or continuing to provide services or

treatment;

      (6) Conviction, including a plea of nolo contendere, of one or more of the offenses listed

in section 23-17-37;

      (7) Abandonment of a patient;

      (8) Promotion by a physical therapist or physical therapist assistant of the sale of drugs,

devices, appliances, or goods or services provided for a patient in a manner as to exploit the

patient for the financial gain of the physical therapist or physical therapist assistant;

      (9) Making or filing false reports or records in the practice of physical therapy;

      (10) Repeated failure to file or record, or impede or obstruct a filing or recording, or

inducing another person to fail to file or record physical therapy reports;

      (11) Failure to furnish patient records upon proper request;

      (12) Practice as a physical therapist assistant without supervision by a physical therapist

licensed in the state of Rhode Island;

      (13) Incompetent or negligent misconduct in the practice of physical therapy;

      (14) Revocation, suspension, surrender, or limitation of privilege based on quality of

care provided or disciplinary action against a license to practice as a physical therapist or physical

therapist assistant in another state, jurisdiction, or country;

      (15) Failure to furnish the board, administrator, investigator, or representatives

information legally requested by the board;

      (16) Violation of this chapter or any of the rules and regulations or departure from or

failure to conform to the current standards of acceptable and prevailing practice and code of

ethics of physical therapy.

      (b) Whenever a patient seeks or receives treatment from a physical therapist without

referral from a doctor of medicine, osteopathy, dentistry, podiatry, chiropractic, physician

assistant, or certified registered nurse practitioner, the physical therapist shall:

      (1) Disclose to the patient, in writing, the scope and limitations of the practice of

physical therapy and obtain their consent in writing; and

      (2) Refer the patient to a doctor of medicine, osteopathy, dentistry, podiatry, or

chiropractic within ninety (90) days after the date treatment commenced; provided, that a physical

therapist is not required to make this a referral after treatment is concluded;

      (3) No physical therapist who has less than one year clinical experience as a physical

therapist shall commence treatment on a patient without a referral from a doctor of medicine,

osteopathy, dentistry, podiatry, chiropractic, physician assistant, or certified registered nurse

practitioner.

(c) For purposes of this chapter and notwithstanding any other provisions of this chapter

or any rules or regulations adopted by the board, any person licensed or registered under this

chapter who is a bona fide employee or independent contractor of a physician or a physician

group entitled to wages and compensation pursuant to such employment or contract, or is a co-

owner of a physical therapy practice with a physician group, shall not be deemed to be engaged in

conduct unbecoming a person licensed or registered under this chapter, or to be engaged in

conduct detrimental to the best interest of the public, or to be in violation of any other provision

of this chapter by virtue of any of the above relationships, and shall not be subject to licensure

denial, suspension, revocation, or any other disciplinary action or penalty under this chapter:

(1) solely by virtue of such employment or contract; or

(2) solely by virtue of the provision of physical therapy services pursuant to a referral

from the employing or contracting physician or physician group.

Any such interest referenced in this paragraph shall be in accordance with federal and

state law, specifically, including, but not limited to, chapter 5-48.1.

SECTION 2. Section 5-37-22 of the General Laws in Chapter 5-37 entitled “Physical

Therapists” is hereby amended to read as follows:

5-37-22. Disclosures. -- (a) (1) Any physician who is not a participant in a medical

insurance plan shall post a notice, in a conspicuous place in his or her medical offices where it

can be read by his or her patients, which reads, in substance, as follows:

      "To my patients:

      I do not participate in a medical insurance plan. You should know that you shall be

responsible for the payment of my medical fees."

      (2) Any physician who fails to post this notice shall not be entitled to charge his or her

patients any amount for medical fees in excess of that allowed had the physician participated in a

medical insurance plan.

      (b) Every physician shall disclose to patients eligible for Medicare, in advance of

treatment, whether the physician accepts assignment under Medicare reimbursement as payment

in full for medical services and/or treatment in the physician's office. This disclosure shall be

given by posting in each physician's office, in a conspicuous place, a summary of the physician's

Medicare reimbursement policy. Any physician who fails to make the disclosure as required in

this section shall not be allowed to charge the patient in excess of the Medicare assignment

amount for the medical procedure performed.

      (c) When a patient requests, in writing, that his or her medical records be transferred to

another physician or medical practice group, the original physician or medical practice group

shall promptly honor the request. The physician or medical practice group shall be reimbursed for

reasonable expenses (as defined by the director pursuant to section 23-1-48) incurred in

connection with copying the medical records.

      (d) Every physician or medical practice group shall, upon written request of any patient

(or his or her authorized representative as defined in section 5-37.3-3(1)) who has received health

care services from the physician or medical practice group, at the option of the physician or

medical practice group either permit the patient (or his or her authorized representative) to

examine and copy the patient's confidential health care information, or provide the patient (or his

or her authorized representative) a summary of that information. If the physician or medical

practice group decides to provide a summary and the patient is not satisfied with a summary, then

the patient may request, and the physician or medical practice group shall provide, a copy of the

entire record. At the time of the examination, copying or provision of summary information, the

physician or medical practice group shall be reimbursed for reasonable expenses (as defined by

the director pursuant to section 23-1-48) in connection with copying this information. If, in the

professional judgment of the treating physician, it would be injurious to the mental or physical

health of the patient to disclose certain confidential health care information to the patient, the

physician or medical practice group shall not be required to disclose or provide a summary of that

information to the patient, but shall upon written request of the patient (or his or her authorized

representative) disclose that information to another physician or medical practice group

designated by the patient.

      (e) Every physician who has ownership interest in health facilities or laboratories,

including any health care facility licensed pursuant to chapter 17 of title 23, any residential

care/assisted living facility licensed pursuant to chapter 17.4 of title 23, any adult day care

program licensed or certified by the director of the department of elderly affairs, or any

equipment not on the physician's premises, shall, in writing, make full patient disclosure of his or

her ownership interest in the facility or therapy prior to utilization. The written notice shall state

that the patient has free choice either to use the physician's proprietary facility or therapy or to

seek the needed medical services elsewhere.

(f) Every physician who makes a referral of a patient to receive physical therapy services

shall provide the notice required by this section if the services are provided by employees or

independent contractors of the physician or if the entity is one in which the physician has an

ownership interest. Any such interest referenced in this paragraph shall be in accordance with

federal and state law, specifically including, but not limited to, Rhode Island general laws chapter

5-48.1.

(f) (g) Unless otherwise expressly stated in writing by the medical practice group, all

medical records shall be the property of the medical practice group with which a physician is

associated when that physician created all such medical records. A medical practice group shall

provide patients with access to patients' medical records in the same manner as is required of

individual physicians under this chapter. To the extent a medical practice group fails to provide

access to patients in accordance with the requirements of this chapter, the individual officers of

the medical practice group (or in the absence of officers, the shareholders or owners of the

medical practice group), in their capacities as licensees of the board, shall be subject to the

disciplinary powers of the board.

     SECTION 3. This act shall take effect upon passage.

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LC02207/SUB A

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