AB 1000 – Bad for Consumers and Creating Fraud in the System – Deserves to be Vetoed

by Kenneth Winer, DC

Assembly Bill 1000, authored by Assemblymembers Bob Wieckowski and Brian Maienschein, currently awaits action by Governor Brown after its passage on Thursday. The bill would specify that patients may directly access physical therapy treatment without a referral for the lesser of a period of 45 days or 12 visits.

Don’t be mistaken. AB 1000 is bad policy for California consumers, and will create fraud in the system. The bill allows physical therapists to illegally bill insurance companies for diagnostic codes despite the fact that physical therapists are not legally allowed to diagnose in California.

The bill is very misleading to consumers. If the bill were to become law, patients will assume that “direct access” to a physical therapist will be a “covered benefit” under their health care plan — but then they will get the bill in the mail for their 12 visits.

Beyond that, AB 1000 creates additional barriers for patients in the system by limiting their access to qualified providers when seeking to get a diagnosis after they have been treated for up to 12 visits or 45 days.  This provision could lead to more serious unnecessary illnesses that could have been treated appropriately had the patient seen the appropriate providers and been properly diagnosed before the 12 physical therapist visits.

Beginning next year, millions of Californians who currently are uninsured will be covered under the new Affordable Care Act.  We know that in order for expanded coverage to succeed, patients must have convenient, timely access to healthcare services and primary care providers who can diagnose, treat and manage patients’ health needs. Yet AB 1000 limits certain providers’ scope of practice at the very time when the state is seeking to expand the scope of practice for providers to ensure proper access to the health care that consumers have been promised.

AB 1000 deserves to be vetoed.