Clearing the Air…An Open Letter to the New York Times Editors

The following article was posted to the Physical Therapy Business Alliance website and we wanted to share…

Since the release of Medicare 2012 payments to providers, authors/journalists have shared multiple perspectives in their interpretation of the data. Because the payments to providers are based on NPI numbers, physical therapists in private practice are included in the database.

open_LetterJeff Hathaway, President of Physical Therapy Business Alliance, has a response to Julie Creswell’s and Robert Gebeloff’s interpretation of the data. Below is the letter Hathaway shared with The New York Times.

RE: “One Therapist, $4 Million in 2012 Medicare Billing” article published 4/27/14

The Physical Therapy Business Alliance (PTBA) representing 700 private practice locations and a founding member of the Alliance For Physical Therapy Quality and Innovation (representing over 2,000 locations) strongly objects to the tone and implications of the article “One Therapist, $4 Million in 2012 Medicare Billing” that was published on Sunday 4/27/14.

As pointed out by numerous medical organizations including the American Medical Association, the raw data released by the Center for Medicare and Medicaid Services requires in depth analysis as to precisely what the numbers represent and as the article noted, may in fact be the result of multiple providers as opposed to one individual.

The purpose of this letter however is not to discuss a case in which no background has been provided, but more importantly, to express a strong objection to such blatantly irresponsible broad-brush statements such as, “procedures they never perform – something that is often easier to do in physical therapy than in fields like oncology and cardiology, ” and, “unscrupulous practitioners bill Medicare for unnecessary treatment.”  Such inflammatory, sensational, and unsubstantiated statements reflect not just poor journalism, but do a disservice to the thousands of physical therapists and the patients they serve.

Physical Therapy accounts for less than 2% of all Medicare payments – hardly a large slice of the pie and not nearly the “Medicare gold mine” that the author opined. That is not a misprint – “less than 2%”. For perspective it is important to note that 1% of doctors accounted for 14% of Medicare billings, an amount totaling $77 billion, which is 15 times greater than the complete rehab industry.

Fraud should never be tolerated, but the author of the article uses poorly analyzed data to suggest the Medicare program is on the verge of collapse as a result of payments to physical therapy. Contrary to the author’s opinion, we would suggest that the fact that physical therapy only represents a miniscule part of the payment total is actually a strong case for a complete revamping of the Medicare payment system owing to the growth of an aging population, and the substantial medical evidence that non-surgical management by a physical therapist of many conditions is far more cost effective than surgery and expensive lab tests.

Additionally, if we are really interested in improving quality of life, the allocation for physical therapy services should increase, not decrease.

The reality is that if the Medicare data were examined appropriately and the current research applied by our existing healthcare system by the vast majority of physical therapists who practice ethically, the articles written would be questioning why physical therapists are not more prominent in the daily lives of citizens across this country.


Jeffrey W. Hathaway, DPT


Physical Therapy Business Alliance

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