Direct Access Legislation Passes in Alabama

Originally posted on: 2012-04-27

After trying for over two decades, the Alabama Chapter of the APTA was successful in passing direct access legislation through the Alabama legislature. The Alabama Senate unanimously approved the bill on Tuesday, April 24 and moving Alabama towards being the 47th state with direct access; pending Governor Bentley’s signature. The direct access bill was introduced in February into the Alabama House and Senate Health Committees as HB 163 and SB 223, respectively. HB 163 was introduced into the House Health Committee by sponsor Representative Ed Henry and as SB 223 into the Senate Health Committee by sponsor Senator Bill Hotzclaw. A hearing was held on HB 163 on March 7 and on SB 223 on March 14. On March 21, HB 163 received a favorable vote (8 to 6) and passed out of the House Health Committee. Also on March 21, SB 223 received a tie vote (3 to 3) in the Senate Health Committee and therefore did not get out of committee at that time. Along the way, the Alabama Medical Association introduced a counter-bill that, instead of removing the referral requirement for PT, extended referral privileges to include Physician Assistants, Nurse Practitioners, and Chiropractors.  On April 12, the Alabama Chapter of the APTA and the Alabama Medical, Chiropractic and Dental Associations reached agreement on compromised language (more detail provided below). HB 163 was substituted with the compromised bill and passed out of the House on Tuesday, April 17. The bill was approved unanimously in the Senate Health Committee on the following day (April 18).

The compromised language was taken from the Louisiana Physical Therapy Practice Act that has been in place since 2003. Chapter leaders vetted the language with APTA National Staff, Current LA Chapter President, Beth Ward PT, DPT; Past-President of the LA Chapter, Greg LeBlanc, PT, DPT, OCS; and APTA Board of Directors Member and LA Chapter member, Sharon Dunn, PhD, PT, OCS. After carefully considering input from all these sources, the Chapter leadership decided that the compromise would be a significant step forward towards achieving unrestricted direct access and would be in the best interest of Alabama citizens and the PTs/PTAs providing services to them.

The entire bill can be viewed on the Alabama Legislature Website clicking HERE. Several additional points should be made concerning passage of the bill:
There is no insurance mandate associate with the new legislation. As such, PT practitioners are still obligated to abide by payment regulations for insurance companies of those patient/clients for whom they are seeking 3rd party payment.
The Rules and Regulations (i.e., parts of the Alabama PT Administrative Code) that elaborate on the Alabama PT Practice Act will need to be written and processed by the Alabama Board of Physical Therapy for practitioners to fully understand how the law can be applied.
A great deal of discussion, exploration and education will need to take place for us to fully realize the possibilities available to Alabama PT practitioners and their patients/clients.

A variety of activities have been underway to promote the bill including holding regional courses throughout the state to enlist supporters, a post card campaign to educate legislators about the bill, an updated website about the bill at, and a “targeted” Legislative Day  scheduled for March 20 where constituents of key members of the House and Senate Health Committees were invited to come to Montgomery for face-to-face meetings. Special thanks are in order for a large number of Chapter leaders including members of the Board of Directors, the Government Affairs Committee, and the PIAA Task Force. Additionally, all PT/PTA licensees and PT/PTA students should be commended for launching an unprecedented grassroots effort to pass this legislation. Finally, the Chapter is particularly grateful to APTA National for unrelenting support to achieve this victory.