Upcoming Webinars 

Disclaimer

The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Menu
Log in


Log in

New Jersey Physical Therapy Unprofessional Conduct

Division of Fees, Payments for Referrals

No physical therapist or physical therapist assistant shall engage directly or indirectly in the division, transferring, assigning, rebating or refunding of fees received for professional services or pay or accept fees or commissions for referrals for professional services; however, nothing in this section shall be construed to prohibit physical therapists who are members of a professional association or other business entity, properly organized pursuant to law, from making a division of fees among themselves as determined by contract to be necessary to defray joint operating costs or pay salaries, benefits, or other compensation to employees

Failure to refer patient, certain circumstances, unlawful practice

It shall be considered an unlawful practice of physical therapy if a physical therapist does not immediately refer an individual to a health care professional licensed to practice dentistry, podiatry or medicine and surgery, or other appropriate licensed health care professional, if the physical therapist has reasonable cause to believe that physical therapy is contraindicated or symptoms or conditions are present, including, but not limited to, nonmuscular and nonskeletal symptoms or conditions and conditions of the central nervous system, that require services outside the scope of a physical therapist's practice

Professional Misconduct

The following acts or practices shall be among those deemed to be violative of N.J.S.A. 45:9-37.11 et seq. and to constitute professional misconduct:

    • Accepting, or agreeing to accept, from any person, firm or corporation any fee, commission, rebate, gift or other form of remuneration for prescribing, ordering or promoting the sale of a device, appliance or other item or service; except that nothing in this section shall preclude a licensed physical therapist from accepting a product or commodity which can be used as a sample by patients, provided that the licensed physical therapist does not charge the patient for such items;
    • Charging any patient a fee for making a referral to a physician or other health care professional authorized to direct the initiation of physical therapy, for the purpose of obtaining clearance for physical therapy. Nothing in this section shall preclude a licensed physical therapist from charging a patient for a physical therapy examination and evaluation conducted prior to referral;
    • Using, or permitting the use of, his or her professional education degree, title, or license in connection with the rendition of services which are outside the scope of physical therapy practice;
    • Representing services as therapeutic, or permitting the representation of services as therapeutic, when, although the services are within the licensee's scope of practice, no therapeutic outcome is expected;
    • Rendering an intervention when, in the exercise of his or her professional judgment, the licensed physical therapist may deem such intervention to be unnecessary. When appropriate, the licensed physical therapist shall notify the referring professional in writing that the intervention is to be terminated and the reason(s) for such termination;
    • Aiding or abetting the unlicensed practice of physical therapy;
    • Falsifying or altering any patient records for the purpose of obtaining payment for services which were not rendered;
    • Authorizing the submission of any bill for professional services which were not rendered, or which were rendered only for the purpose of obtaining additional reimbursement;
    • Failure by a licensed physical therapist to assure that any bills for services rendered under his or her professional license accurately represents the services rendered and that charges submitted for services rendered by a licensed physical therapist or licensed physical therapist assistant are based solely upon the services reflected in the patient record;
    • Failure to produce a hard copy of a complete patient record upon request; or
    • Failure to refer a patient to another licensed health care professional as required by N.J.A.C. 13:39A-2.5.

Sexual Misconduct

A licensee shall not engage in sexual contact with a patient with whom he or she has a patient-therapist relationship. The patient-therapist relationship is ongoing for purposes of this section, unless:

    • Physical therapy is terminated by way of written notice to the patient and is documented in the patient record; and
    • The last physical therapy provided by that licensee was rendered more than three (3) months ago.

A licensee shall not seek or solicit sexual contact with a patient with whom he or she has a patient-therapist relationship and shall not seek or solicit sexual contact with any person in exchange for professional services.

A licensee shall not engage in any discussion of an intimate sexual nature with a patient, unless that discussion is directly related to a proper physical therapy purpose. Such discussion shall not include disclosure by the licensee of his or her own sexual relationships.

A licensee shall provide privacy and examination conditions which prevent the exposure of the unclothed body of the patient. Appropriate draping measures shall be employed to protect patient privacy.

A licensee shall not engage in sexual harassment either within or outside of the professional setting.

A licensee shall not engage in any other activity which would lead a reasonable person to believe that the activity serves the licensee's personal prurient interests or which is for the sexual arousal, or sexual gratification of the licensee or patient or which constitutes an act of sexual abuse.

Violation of any of the prohibitions or directives set forth inabove shall constitute professional misconduct.

Nothing in this section shall be construed to prevent a licensee from rendering physical therapy to a spouse, providing that the rendering of such physical therapy is consistent with accepted standards of physical therapy and that the performance of physical therapy is not utilized to exploit the patient spouse for the sexual arousal or sexual gratification of the licensee.

Citation

N.J.S.A. § 45:9-37.21

N.J.S.A. § 45:9-37.34c

N.J.A.C. § 13:39A-3.8



Powered by Wild Apricot Membership Software