Physical Therapists Practice Voted Out of House Legislation to update the practice act for physical therapists was introduced by Representative Bill Reineke (R- Tiffin) and Representative Theresa Gavarone (R – Bowling Green) at the beginning of the 132nd Ohio General Assembly. House Bill 131 was assigned to the House Health and Aging committee. Representative Gavarone, joint sponsor of this legislation, serves as the Health and Aging committee vice-Chairwoman. As introduced, House Bill 131 would have done two important things for the practice of Physical Therapy: clarify that “physical therapy” includes determining a diagnosis in order to treat a person’s physical impairments, functional limitations, and physical disabilities; determining a prognosis; and determining a plan of therapeutic intervention, and add that physical therapy includes ordering tests such as diagnostic imaging and studies that are performed and interpreted by other licensed health care professionals. After hours of conference calls, meetings, and stakeholder discussions there has been an agreement reached. The Ohio State Medical Association, who came out as an opponent to the as-introduced bill, has agreed to take their positon to neutral by only moving the diagnosis portion of the bill forward at this time. The agreed to language reads: "Physical therapy diagnosis" means a judgment that is made after examining the neuromusculoskeletal system or evaluating or studying its symptoms and that utilizes the techniques and science of physical therapy to establish a plan of therapeutic intervention. "Physical therapy diagnosis" does not include a medical diagnosis. Sub. HB 131 was voted favorably out of the House Health Committee on Wednesday, March 21st. Although uncommon, the committee accepted the substitute version and voted on the legislation in the same day. The final vote count was 15 yes, 0 no. On April 11th Sub. HB 131 went on to pass out of the House of Representatives unanimously with a vote of 95- 0. The speeches and vote can be found by going to: http://www.ohiochannel.org/video/ohio-house-of-representatives-4- 11-2018 Sub. HB 131 will be referred to a Senate committee in the coming weeks! Substitute Licenses for Licensed Medical Professionals Representative Jay Edwards (R- Nelsonville) introduced House Bill 491 which is intended to help cut down the burden of dual licensing for certain licensed related service personnel and their ability to work in a school based setting as a short and long-term substitute. Currently, the Ohio Department of Education requires that school based PTs must obtain a Pupil Services License to practice in a school setting, in addition to the board license issued by the State. Many school districts across the State are seeing a shortage in many specified disciplines and it is becoming difficult to find short and long-term substitutes that need to have the additional professional licensure to provide the service to students. This legislation would apply for short and long-term substitute purposes only. The proposed legislation would apply to the following licensed professionals: 1. School Speech-Language Pathologist 2. School Nurse 3. School Audiologist 4. Occupational Therapist 5. Physical Therapist 6. Occupational Therapy Assistant 7. Physical Therapy Assistant 8. School Social Worker House Bill 491 was reported out of House Education and Career Readiness Committee on March 21st with an amendment that requires substitute nurses to hold bachelor's degrees. Licensure Board Considers Rule Revisions The OTPTAT Board has filed a series of rule modifications. Most rules were up for 5-year review, which is required of all state agencies. The OPTA had the opportunity to review the proposed changes and did not identify anything problematic. A public hearing is scheduled on these rule amendments for June 5, 2018 at 2:00pm. Rules filed as a 5-year review, when no changes are proposed, are not subject to a public hearing. Detailed information on all of the rules can be found here: http://www.registerofohio.state.oh.us/jsps/publicdisplayrules/processPublicDisplayRules.jsp?agencyNumberString=4755 &actionType=all&doWhat=GETBYFILINGAGENCY&Submit=Search The Board provided the following summary of the rules up for review: 4755-1-01, -02, -03: These rules govern notice given for various board activities under the occupational therapy section, including meetings, rule-making, and investigations. Rule amendments are proposed to simplify the language, streamline internal business practices, and refer to applicable Ohio Revised Code section instead of repeating language located elsewhere. 4755-3-11: This rule provides detail on what is needed to obtain a temporary license to practice as an occupational therapist or occupational therapist assistant in Ohio. No changes are proposed. 4755-24-03, -04, -05, -06, -07, -08. -09: These rules lay out the maximum amount of fees that can be charged for various activities under the physical therapy section. There are no plans to change the fee amounts that are currently in place. One change in 4755-24-05 eliminates the need for a notarized statement, which lines the rule up with current practice and places less burden on the licensee. 4755-48-01, -02: These rules detail processes for investigations, inspections, and discipline for the athletic trainer’s section. A slight change is being made to reflect current practice that a license holder in a disciplinary situation must pay for any health examinations required by the board. Price Transparency Representative and practicing physician Steve Huffman (R – Tipp City), has introduced House Bill 416 to address healthcare price transparency as well. HB 416 provides that beginning June 1, 2018 a healthcare provider must, on the request of a patient or the patient's representative, provide to that individual a reasonable, good faith estimate of the cost for each scheduled service. Under the bill "scheduled service" means a health care service or procedure that a patient or the patient's representative has scheduled at least seven days before the service or procedure is to occur. The estimate may be given in writing, electronically, or verbally and must include the following: • If the patient is insured, the estimate shall specify the amount the healthcare provider expects to receive as payment from the patient's health plan issuer for each scheduled service. • The estimate shall specify the amount that the patient or party responsible for the patient's care will be required to pay to the healthcare provider for each scheduled service. • The estimate shall include a disclaimer that the information provided is only an estimate based on facts available at the time the estimate was prepared and that other required health care items, services, or procedures could change the estimate. • If applicable and known to the healthcare provider at the time the estimate is given, the estimate shall include a notification that the provider is out-of-network for the patient. The estimate required must be based on information available at the time the estimate is provided and need not take into account any information that subsequently arises, such as unexpected additional services or procedures. The legislation also provides that the patient is responsible for payment of the healthcare service or procedure even if they do not receive a cost estimate. These requirements would not apply in either of the following circumstances: 1. The patient is insured and the health plan issuer fails to supply the necessary information to the health care provider within 48 hours of the provider's request to the issuer for that information. In that case, the health care provider may notify the patient or the patient's representative of the health plan issuer's failure. 2. The scheduled service the patient is to receive requires preauthorization from the patient's health plan issuer. In that case, section 3726.03 of the Revised Code applies. House Bill 416 has had three hearings in the House Insurance committee. Providing remarks in support of the bill were the Ohio Hospital Association and the Ohio State Medical Association. Opposing the measure was the Ohio Association of Health Plans. House Bill 289 – Would Require Review of All Boards and Commissions Legislation has been introduced by Representatives Ron Hood (R – Ashville) and Rob McColley (R – Napoleon) that would require the Ohio General Assembly to review and evaluate all boards and commissions every five years. Without the legislature passing legislation to continue the operation of each licensing board, boards would automatically expire. During the review process “each board shall have the burden of demonstrating to the standing committee a public need for its continued existence.” The legislative committee reviewing the board will look to provide for the “least restrictive regulation” for each profession to protect consumers from present, significant, and substantiated harms that threaten public health and safety. The legislative service commission (LSC) would also be charged with evaluating for the “least restrictive regulation”. Under HB 289; "Least restrictive regulation" means the public policy of relying on one of the following, listed from the least to the most restrictive, as a means of consumer protection: market competition; third-party or consumer-created ratings and reviews; private certification; specific private civil cause of action to remedy consumer harm; actions under Chapter 1345. of the Revised Code; regulation