Meeting Public Comments

Randy Boldt [APTA Iowa]

I am a physical therapist and the CFO for our company Rock Valley Physical Therapy. We have 45 clinic locations in the state of Iowa. I appreciate the intent of this bill. Healthcare is very expensive. Physical therapy is a very small portion of the cost of health care and I appreciate how complex and expensive it is. We are opposed to this bill for the following reasons: * As providers, we are overwhelmed with administrative burden while taking care of patients. This bill would only add to the burden that is already too much. This bill requires that we start doing things that are not part of the current software that we have. We would need to make adjustments to all of our software in order to comply with this bill. A simple example is that when we have a selfpay patient, the claim does not go to the insurance. Our systems do not send these to the insurance. This would be a completely manual, on paper process and would be very difficult. There are 12 pages in this bill, most concepts are not currently part of our systems. * Physical therapists in private practice operate on small margins. We cannot afford to reduce the payment from our better paying insurance to a lower paying selfpay rate. We currently have these lower rates designed for those who don't have insurance. We simple cannot afford to lower our overall payment. I suspect we will need to increase our selfpay rates so that those with insurance do not use this and this will cause those without insurance to actually pay a higher rate. The unintended consequence is that our fees would have to increase in order to keep our better paying clients. We actually lose money on patients with Medicare and Medicaid. Therefore, we need to keep the better paying clients to stay in business. * Lastly, when we bill patients a selfpay rate, we charge them on a pervisit basis. We tell a patient without insurance it will cost $xx/visit. If this bill goes into place, we will need to work with patients in a way that they can adjudicate the payment back to their deductible or to their insurance. This will require us to communicate to patients the selfpay rates for each CPT code. We will not accurately be able to tell the patient which codes we will bill and how many we will bill prior to seeing the patient. This will make it very difficult to be accurate and transparent with a patient. The way this bill is written will make it very difficult to comply in a way that will help the patient. Although I agree with the overall idea of this bill, it is designed in a way that will not result in the desired intent. Our rates will actually go up because of this bill. We will have an increase in burden that will make it very difficult to comply like desired. Thanks for your consideration of my comments. Randy Boldt