HB232 Alabama 2024 Session

Summary

Primary Sponsor

Leigh HulseyRepresentative

Republican

Session

Regular Session 2024

Title

Scope of practice of physical therapists

Summary

HB232 expands Alabama physical therapists' scope to include initial screenings and certain non-referral services, with new education, liability, and practice rules.

What This Bill Does

The bill allows licensed physical therapists and compact privilege holders to perform initial screenings without a referral for non-work-related injuries or conditions, and to provide some physical therapy services without a prescription under specific limits. It creates a concept of a physical therapy referrer and sets minimum education requirements, annual continuing education, and a minimum professional liability insurance level. It also imposes visit and time limits (11 visits or 30 days without a referral) before a referral is required, requires a plan of care to be provided within 15 days, and restricts certain activities (like ordering imaging or prescribing medications). It expands direct access in cash-pay scenarios and exempts certain settings (home health, nursing homes, wellness/conditioning, and developmentally disabled children under a plan of care). The bill includes liability protections for referrers, other safety provisions, and advertising restrictions, with an effective date of June 1, 2024.

Who It Affects

• Licensed physical therapists and compact privilege holders: gain authority to conduct initial screenings without referral for non-work injuries, must meet new educational and insurance requirements, may supervise up to four assistants, must provide a plan of care within 15 days, and face advertising and scope restrictions.
• Patients and health care providers: patients may access certain PT services directly without referral in defined cases (cash-pay direct access), but non-work-related treatment without referral is time-limited and requires a plan of care; referrers (physicians, dentists, chiropractors, PAs, and NPs in collaborative agreements) have defined roles and liability protections.
• Health insurers and health plans: the act clarifies coverage expectations but does not require health benefit plans to cover these additional PT services.

Key Provisions

• Defines physical therapy referrer and related terms; allows initial screenings by PTs without referral for non-work injuries under minimum educational requirements.
• Permits non-referral services in specific cases: child with developmental disability under plan of care, home health, nursing home, wellness/conditioning for injury prevention or fitness, and previously diagnosed conditions with a plan of care within 90 days of diagnosis.
• Requires a plan of care for PT services to be provided to the referrer within 15 days of initiating treatment; health care providers who rendered the diagnosis must be informed.
• Imposes limits on non-referral treatment: if no beneficial response within 30 days or 11 visits, the patient must be referred to an appropriate health care provider; some exemptions apply (e.g., developmental disability, home health, nursing home, etc.).
• Prohibits certain activities by PTs: practicing medicine/osteopathy/dentistry/chiropractic medicine, ordering or interpreting imaging or diagnostic tests, certain procedures, prescribing medications, admitting/discharging from facilities, and specific post-concussion or post-surgical restrictions without referral.
• Requires ongoing regulatory controls: two hours of annual continuing education on professional standard of care; minimum liability insurance of $100,000 per occurrence and $300,000 aggregate for PTs treating without a referral; board may increase but not decrease coverage.
• Prohibits promoting oneself as a doctor unless followed by appropriate credentialing terms (Doctor of Physical Therapy, DPT, or PT) in advertising.
• Limits on supervision: a physical therapist cannot supervise more than four physical therapy assistants at one time; athletic trainer scope remains restricted per other acts.
• Establishes civil liability protections for physical therapy referrers for services performed without a referral; clarifies scopes and enforcements under the Alabama Physical Therapy Practice Act.
• Effective date: the act becomes effective June 1, 2024.

AI-generated summary using openai/gpt-5-nano on Feb 22, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Occupational Licensing Boards