Is the PT Compact about to experience a growth spurt? It's a very real possibility, with as many as 13 states considering or poised to consider adopting the system that allows PTs and PTAs to gain privileges to work in multiple states through a single license. If all 13 were to sign on to the system, total participation would rise to all but four states over the coming years, making the PT Compact one of the country's fastest growing multistate practice programs.

The 13 states that have introduced or are considering introduction of compact legislation are Alaska, Connecticut, Hawaii, Illinois, Maine, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Rhode Island, and Vermont. A map that tracks the states currently participating in the compact is available at the PT Compact website.

The potential bump in compact participation comes as state legislatures across the country assemble for their sessions. And that isn't the only thing happening in state houses when it comes to physical therapy: Here's a quick rundown of some of the more notable legislation that's been introduced or is being considered for introduction.

(Note: This recap is a snapshot in time — other legislation could be introduced or this legislation could be withdrawn over the coming weeks. Those interested in activities in any particular states are urged to visit APTA chapters' individual websites for details.)

Direct Access
While direct access is technically in place across the country, some states are more restrictive than others. This year, legislation to reduce current limitations has been introduced or is expected to be introduced in Georgia, Missouri, Pennsylvania, South Carolina, Texas, and Virginia.

Fair Copays and Cost-Sharing
Regulatory guardrails that limit patient copay burdens to improve access to PTs and PTAs are on the docket or expected to be in New York, Ohio, Texas, and West Virginia. In Florida, pending legislation would require insurers to apply any insured patient payments made to a provider to the insurer's cost-sharing requirements.

Administrative Burden
Legislation introduced in Maryland would reform utilization review requirements.

Payment and Business Operations
Legislators in at least four states soon may be or are currently considering changes that could have a positive impact on physical therapy payment and businesses. They include:

• Illinois: An increase in payment under Medicaid for PT, speech therapy, and occupational therapy services that would put the system on par with Medicare.
• Nebraska: Prohibition of the use of Multiple Procedure Payment Reduction by commercial insurers; establishment of payment parity for services delivered via telehealth.
• New Mexico: Tax credits for rural PTs.
• Washington: Reduced restrictions on PTs and occupational therapists in forming professional service corporations.

Scope of Practice Issues
Legislation has been or could be introduced in several states that would expand the activities included in the PT's practice scope. They include:

• Arkansas: Enable PTs to make concussion clearance determinations; include PTs among the providers empowered to issue disability placards.
• Indiana: Include PTs among the providers permitted to administer an exam (within the PT's scope of practice) to evaluate initial, renewal, or learner's commercial driver permits.
• Iowa: Allow PTs to make referrals for imaging; add PTs to the list of providers empowered to evaluate whether a hunter qualifies for use of a crossbow.
• North Dakota: Include PTs among the providers empowered to issue disability placards.
• Tennessee: Include PTs among the providers empowered to issue disability placards.
• Washington: Include dry needling in PT scope of practice.

Modernizing Practice Acts
The possibility of modernizing state physical therapy practice acts could be on the table in California and Maine.

Want to help fuel legislative wins in your state? Contact your state chapter to find out how you can get involved in advocacy.