APTA motion aims to change prescription process

SALT LAKE CITY - Would having a physical therapist (PT) prescribe HME speed up a patient's discharge from the hospital? 

Lori Pearlmutter thinks so.

“We make the decision on what the patient needs and then we have to wait for the physician—maybe a hospitalist whose shift has ended or a doctor who gets called into surgery,” said Pearlmutter, director of therapy and cardiac rehab at Flagstaff Medical Center in Flagstaff, Ariz.

That wait time can keep patients in the hospital for up to a day longer, she said.

Pearlmutter has introduced a motion for consideration by the American Physical Therapy Association (APTA) at its House of Delegates meeting in June that, if passed, would clear the way for the APTA to support allowing PTs to prescribe HME. (Ultimately, making such a change to Medicare policy would require a bill amending the Social Security Act.)

Whether the motion passes or not, Laura Cohen says having the proposal on the floor will shine a much-needed spotlight on HME and industry issues like competitive bidding.

“Probably less than 1% of the PTs in the country even know what competitive bidding is,” said Cohen, executive director of The Clinician Task Force. “They're going to be rudely awoken July 1 when competitive bidding is introduced in their neighborhood.”

For their part, providers agree having PTs prescribe HME makes sense.

“Most of the time, we're working with the PTs, anyway,” said Scott Soderquist, president of Rehab Equipment Associates in Manchester, N.H. “This would take a layer out of the bureaucracy.”

Still, provider Doug Westerdahl would like to ensure PTs receive special training to prescribe complex rehab.

“The majority of PTs are not familiar with seating and positioning,” said Westerdahl. “Some kind of specialty credential, like the ATP, would be needed.”