Health occupations: physical therapists; prescription requirement for physical therapy treatment; eliminate, and make other modifications to the practice of physical therapy. Amends secs. 17801, 17820, 17822, 17824 & 17825 of 1978 PA 368 (MCL 333.17801 et seq.) & adds sec. 17825a.
Senate Bill 144 would revise Michigan’s Public Health Code provisions governing physical therapy practice. The bill broadens the definition of “health care professional” for purposes of physical therapy referrals and prescriptions to include advanced practice registered nurses and licensed professionals under several health code parts, as well as equivalent out-of-state licenses. It also clarifies the scope of physical therapy practice, including what it does and does not include, and updates terminology throughout the statute.
The bill changes when physical therapists and physical therapist assistants may treat patients without a prescription or referral. Under the bill, treatment may proceed without a prescription for up to 21 days or 10 treatments, whichever comes first, or when the patient is seeking services to prevent injury or promote fitness. It also requires physical therapists to refer or consult with an appropriate health care professional when a patient’s condition appears to be outside the scope of physical therapy, when the patient is not improving, or when there is a measurable decline, progression, or complication. The bill adds a notice requirement that patients be informed of potential financial liability when they receive physical therapy without a referral.
The bill’s impact on state law is to reduce the prescription/referral barrier for physical therapy while preserving referral and consultation safeguards. It amends several sections of the Public Health Code, including rules on who may prescribe or refer, hospital employment and privileges, referral back to other clinicians, and third-party payment requirements. It also expressly states that the act does not require new or additional insurance or workers’ compensation coverage, nor does it prevent payers from imposing medical necessity, prescription, referral, or preapproval requirements.
Overall sentiment in the available legislative record appears strongly favorable. The bill was reported favorably without amendment in committee by a 9-0 vote and then passed the Senate 36-0, indicating broad bipartisan support and little visible opposition in the recorded votes.
The main points of contention, based on the bill text rather than recorded debate, are the balance between direct access to physical therapy and continued oversight by other health professionals, and the extent to which insurers may still require referrals or preauthorization. The bill also preserves limits on physical therapists diagnosing medical conditions outside their scope, suggesting an effort to expand access without changing core professional boundaries.
SB 144 amends Michigan’s Public Health Code provisions on physical therapy practice, expanding the categories of professionals whose prescriptions or referrals can support treatment and allowing limited direct access to physical therapy without a prescription. It also adds consultation, referral-back, and patient-notice requirements, while preserving payer authority to impose coverage conditions and clarifying that the bill does not mandate new insurance or workers’ compensation benefits.
The recorded legislative sentiment is overwhelmingly positive. The bill was reported favorably without amendment in committee and passed the Senate unanimously, suggesting broad agreement that the changes modernize physical therapy practice and improve access without eliminating oversight.
The principal policy tension is between expanding direct access to physical therapy and maintaining safeguards for patient safety, scope of practice, and payer controls. Supporters appear to favor easier access and broader recognition of advanced practice registered nurses and other licensed professionals, while the statutory text reflects concern that physical therapists still refer patients out when symptoms exceed their scope and that insurers are not forced to change coverage rules.