§ 40.54. Disclosure of financial or ownership interest—statement of policy.
(a) Definitions. The following words and terms, when used in this section, have the following meanings, unless the context clearly indicates otherwise:
(1) Appliances or devices—Gas, oxygen, therapy equipment, therapeutic equipment, instruments, syringes and their component parts or accessories, hearing aids, eyeglasses, contact lenses, prosthetic devices, orthotics, crutches and cervical collars.
(2) Disclose to the patient—The physical therapist makes known to the patient at the time a referral is made that the physical therapist has a financial or ownership interest in the facility or entity to which the patient is referred. The physical therapist shall also inform the patient of the patient’s freedom to choose an alternate provider.
(3) Facility or entity—Another practitioner of the healing arts, licensed health care practitioner, partnership, association, group practice, business corporation and professional corporation not on the premises of the physical therapist.
(4) Financial interest of the physical therapist or ownership by the physical therapist in the facility or entity—A financial or ownership interest to any extent or degree including interest held by the physical therapist, the therapist’s spouse or minor children. The term does not include employment by a hospital if the remuneration paid to the physical therapist is not contingent upon the therapist’s referral of patients to hospital-related services.
(5) Health-related services—Radiologic services, physical therapy, occupational therapy, counseling, laboratory services and nursing home care.
(6) Pharmaceutical—A drug or pharmacy.
(7) Practitioner of the healing arts—A physical therapist.
(8) Referral—The act of prescribing, ordering, directing, redirecting or recommending to a patient a specific facility or entity which provides a health-related service, test, pharmaceutical, appliance or device, by means of prescription, recomended course of treatment, or direction concerning diagnostic or therapeutic treatment of services.
(9) Test—Laboratory work, radiologic tests, nuclear medicine scanning and other laboratory services.
(b) Use of patient disclosure forms.
(1) It is the physical therapist’s responsibility to disclose to the patient a financial or ownership interest when making a referral covered by the act of May 26, 1988 (P. L. 403, No. 66) (35 P. S. § § 449.21—449.23). The Board believes that meaningful disclosure shall be given to each patient at the time a referral is made. The disclosure may be made orally or in writing. In either event, it is recommended that the disclosure be memorialized, dated and signed at the time of referral by the physical therapist and the patient, and that the physical therapist maintain written evidence of the disclosure. If the physical therapist delegates the disclosure to another person in the therapist’s office, the disclosure shall be memorialized, dated and signed by the person making the disclosure and the patient.
(2) The memorialization of the disclosure shall be substantially in the following form:
I ACKNOWLEDGE THAT I HAVE BEEN ADVISED BY MY PHYSICAL THERAPIST THAT HE HAS A FINANCIAL OR OWNERSHIP INTEREST IN THE FACILITY OR ENTITY TO WHICH HE HAS REFERRED ME, AND THAT HE HAS ADVISED ME THAT I AM FREE TO CHOOSE ANOTHER FACILITY OR ENTITY TO PROVIDE THE SERVICE, DRUG, DEVICE OR EQUIPMENT.
(3) Written evidence shall constitute presumptive evidence that the physical therapist made the required disclosure in an enforcement proceeding before the Board. The disclosure to the patient is not the act of the patient signing the form, but is the act of the physical therapist disclosing to the patient the therapist’s financial or ownership interest and advising the patient of the patient’s freedom of choice.
(c) Guidelines for disclosure. If the patient is a minor, unconscious, of unsound mind, or otherwise incompetent to understand freedom of choice in the selection of a facility or entity, disclosure shall be made to the guardian, spouse or closest adult next of kin. A physical therapist may not disclose his interest unless the patient is competent to understand his freedom of choice. A physical therapist will not be disciplined for failure to disclose if an emergency prevents consulting the patient or the patient’s next of kin.
(d) Posting notice of disclosure requirement. It is recommended that compliance with the disclosure requirement include the prominent posting of a printed notice, at least 8 1/2" x 11" in the physical therapist’s waiting room in all office locations, substantially in the following form:
TREATMENT IN THIS OFFICE MAY INCLUDE A RECOMMENDATION FOR FURTHER DIAGNOSTIC TESTING, FOR VARIOUS FORMS OF THERAPY OR TREATMENT, OR FOR DRUGS OR DEVICES. PENNSYLVANIA LAW REQUIRES YOUR PHYSICAL THERAPIST TO DISCLOSE TO YOU ANY FINANCIAL INTEREST HE HAS IN TREATMENT FACILITIES, TESTING LABORATORIES, MEDICAL EQUIPMENT SUPPLIES, PHARMACEUTICAL COMPANIES AND PHARMACIES TO WHICH HE REFERS YOU. HE MUST ALSO ADVISE YOU THAT YOU ARE FREE TO CHOOSE ANOTHER FACILITY OR ENTITY TO PROVIDE THE SERVICE, DRUG, DEVICE OR EQUIPMENT. (ACT 66-1988)
Source The provisions of this § 40.54 adopted May 4, 1990, effective May 5, 1990, 20 Pa.B. 2437; renumbered August 13, 1992, effective August 14, 1992, 22 Pa.B. 4299. Immediately preceding text appears at serial pages (148370) to (148372).
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