CHAPTER 2016-70 Senate Bill No. 450 An act relating to physical therapy; amending s. 486.021, F.S.; revising the definition of the term “practice of physical therapy”; amending s. 486.081, F.S.; providing that a licensed physical therapist who holds a specified doctoral degree may use specified letters in connection with her or his name or place of business; prohibiting a physical therapist with a specified doctoral degree from using the title “doctor” without informing the public of his or her profession as a physical therapist; amending s. 486.135, F.S.; revising the terms and specified letters prohibited from being used by certain unlicensed persons; providing a criminal penalty; amending s. 486.151, F.S.; prohibiting an unlicensed person from using specified letters; providing an effective date.

Be It Enacted by the Legislature of the State of Florida:

Section 1. Paragraph (a) of subsection (11) of section 486.021, Florida Statutes, is amended to read:

486.021 Definitions.—In this chapter, unless the context otherwise requires, the term: (11) “Practice of physical therapy” means the performance of physical therapy assessments and the treatment of any disability, injury, disease, or other health condition of human beings, or the prevention of such disability, injury, disease, or other condition of health, and rehabilitation as related thereto by the use of the physical, chemical, and other properties of air; electricity; exercise; massage; the performance of acupuncture only upon compliance with the criteria set forth by the Board of Medicine, when no penetration of the skin occurs; the use of radiant energy, including ultraviolet, visible, and infrared rays; ultrasound; water; the use of apparatus and equipment in the application of the foregoing or related thereto; the performance of tests of neuromuscular functions as an aid to the diagnosis or treatment of any human condition; or the performance of electromyography as an aid to the diagnosis of any human condition only upon compliance with the criteria set forth by the Board of Medicine.

(a) A physical therapist may implement a plan of treatment developed by the physical therapist for a patient or provided for a patient by a practitioner of record or by an advanced registered nurse practitioner licensed under s. 464.012. The physical therapist shall refer the patient to or consult with a practitioner of record if the patient’s condition is found to be outside the scope of physical therapy. If physical therapy treatment for a patient is required beyond 30 days for a condition not previously assessed by a practitioner of record, the physical therapist shall have n a practitioner of record review and sign the plan. The requirement that a physical therapist have a practitioner of record review and sign a plan of treatment 1 does not apply when a patient has been physically examined by a physician licensed in another state, the patient has been diagnosed by the physician as having a condition for which physical therapy is required, and the physical therapist is treating the condition. For purposes of this paragraph, a health care practitioner licensed under chapter 458, chapter 459, chapter 460, chapter 461, or chapter 466 and engaged in active practice is eligible to serve as a practitioner of record.

Section 2. Subsection (1) of section 486.081, Florida Statutes, is amended to read:

486.081 Physical therapist; issuance of license without examination to person passing examination of another authorized examining board; fee.—

(1) The board may cause a license to be issued through the department without examination to any applicant who presents evidence satisfactory to the board of having passed the American Registry Examination prior to 1971 or an examination in physical therapy before a similar lawfully authorized examining board of another state, the District of Columbia, a territory, or a foreign country, if the standards for licensure in physical therapy in such other state, district, territory, or foreign country are determined by the board to be as high as those of this state, as established by rules adopted pursuant to this chapter. Any person who holds a license pursuant to this section may use the words “physical therapist” or “physiotherapist,” or the letters “P.T.,” in connection with her or his name or place of business to denote her or his licensure hereunder. A person who holds a license pursuant to this section and obtains a doctoral degree in physical therapy may use the letters “D.P.T.” and “P.T.” A physical therapist who holds a degree of Doctor of Physical Therapy may not use the title “doctor” without also clearly informing the public of his or her profession as a physical therapist.

Section 3. Subsection (1) of section 486.135, Florida Statutes, is amended, subsection (2) is renumbered as subsection (3), and a new subsection (2) is added to that section, to read:

486.135 False representation of licensure, or willful misrepresentation or fraudulent representation to obtain license, unlawful.—

(1)(a) It is unlawful for any person who is not licensed under this chapter as a physical therapist, or whose license has been suspended or revoked, to use in connection with her or his name or place of business the words “physical therapist,” “physiotherapist,” “physical therapy,” “physiotherapy,” “registered physical therapist,” or “licensed physical therapist”; or the letters “P.T.; or any other words, letters, abbreviations, or insignia indicating or implying that she or he is a physical therapist or to represent herself or himself as a physical therapist in any other way, orally, in writing, in print, or by sign, directly or by implication, unless physical therapy services are provided or supplied by a physical therapist licensed in accordance with this chapter. Ch. 2016-70 LAWS OF FLORIDA Ch. 2016-70 2

CODING: Words stricken are deletions; words underlined are additions.

(b) It is unlawful for a person who is not licensed under this chapter as a physical therapist and who does not hold a doctoral degree in physical therapy to use the letters “D.P.T.” in connection with his or her name or place of business.

(c) It is unlawful for any person who is not licensed under this chapter as a physical therapist assistant, or whose license has been suspended or revoked, to use in connection with her or his name the words “physical therapist assistant,” “; or the letters “P.T.A.,” “; or any other words, letters, abbreviations, or insignia indicating or implying that she or he is a physical therapist assistant or to represent herself or himself as a physical therapist assistant in any other way, orally, in writing, in print, or by sign, directly or by implication.

(2) An unlawful act under this section is a violation of s. 486.151.

Section 4. Paragraph (d) of subsection (1) of section

486.151, Florida Statutes, is amended to read: 486.151 Prohibited acts; penalty.—

(1) It is unlawful for any person to: (d) Use the name or title “Physical Therapist” or “Physical Therapist Assistant” or any other name or title which would lead the public to believe that the person using the name or title is licensed to practice physical therapy, unless such person holds a valid license, or use the letters “D.P.T.,” unless such person holds a valid license under this chapter and a doctoral degree in physical therapy.

Section 5. This act shall take effect upon becoming a law. Approved by the Governor March 23, 2016. Filed in Office Secretary of State March 23, 2016. Ch. 2016-70

LAWS OF FLORIDA Ch. 2016-70 3
Posted on 2016-04-07

A simple pain in the neck can become much more burdensome when physician referrals, weeks of waiting and phone calls to insurance providers become involved. One South Florida medical entrepreneur is hoping to literally ease the pain and reduce barriers to care in the mold of other franchised health providers upending the traditional healthcare model.

Andy Zapata is an occupational therapist with an imposing resume and an equally lofty goal of lowering patient barriers to physical therapy and sports medicine services. As a pleasant side effect, his Miami-based, five-unit franchise, Physical Therapy Now, gives physical therapists the opportunity to break out of the traditional American medical system as well by directly treating patients, without requiring them to spend time and money seeking a physician’s referral before receiving care.

As the clinical director for a multi-unit urgent care facility in South Florida, Zapata is also a partner in five physical therapy, orthopedic, diagnostic and chiropractic centers, while also carving out time to be a medical inspector and consultant.

The company’s plans to go nationwide rely on new national direct access regulations—that took effect January 2015—allowing patients to seek treatment from a licensed physical therapist without the need for a prescription or physician’s referral. Florida was a trendsetter among states, as its direct access laws preempted the new national law.

After completing the company’s franchise disclosure document in late 2015,  Physical Therapy Now is preparing to open its first non-corporate unit a stone’s throw from its Miami headquarters.

“A lot of physical therapists still believe you need a prescription to treat a patient,” Zapata said. “I want to be able to empower physical therapists, which helps get more patients into physical therapy.”

He sees the Affordable Care Act as a huge opportunity for his business, as more insurance card-carrying people deepen the pool of potential patients. Beyond basic physical therapy services, the company also provides sports medicine and worker’s compensation services.

Thirty percent of Physical Therapy Now’s clients come from people searching for traditional therapists, but the company is focusing its marketing efforts on encouraging hospitals to refer patients to its network.

Unlike The Joint, a 280-unit chiropractic franchise that doesn’t bill any of its services to insurance providers, Physical Therapy Now accepts insurance payments, but only charges $50 per visit for people without insurance or those who would rather pay on their own. So far, a large portion of its patients are young athletes looking to stay in fighting form.

Zapata said his practice provides a turnkey operation for potential franchisees that he says is a natural fit for doctors looking to escape the daily hassles of insurance providers or of working for a large corporation.

He hopes to attract physical and occupational therapists who are savvy enough to focus on three key goals for operating each practice: clinical abilities, administrative tasks, like tracking employees and keeping medical records; and marketing. Most new therapists who become franchisees, he added, will need the most assistance with administrative and marketing tasks. The entry cost for franchisees is estimated at $100,000.

This year, the company plans to add three or four new locations, which will most likely be in or near Florida, as the company already has the protocols and infrastructure in place to expand in its home turf.

Like other medical franchises, with scale, Zapata hopes his company can make a big difference by encouraging more end users to receive treatment than under the traditional medical structure.

“A lot of end users think physical therapy is just for an initial or acute pain,” he said, “but a lot of consumers have been living with chronic pain for their whole lives—we’re now more accessible than before.”