South Carolina Supreme Court upholds Physical Therapy Practice Act

In Sloan v. South Carolina Board of PT Examiners, the Supreme Court held that legislation prohibiting physical therapists from working for physician practices and receiving referrals from the physician practice is constitutional. The Plaintiffs argued that there is no rational basis for prohibiting physical therapists from receiving in-house referrals from the physicians who employ them. Self-referral concerns about escalating health care costs, conflicts of interest, and excessive profits apply to all South Carolina health care providers and not just to physical therapists. In the ambit of in-house referrals, all South Carolina health care providers are similarly situated and must be treated the same under state and federal equal protection analysis.

The Supreme Court disagreed, holding that the classification is not all health care providers who receive in-house referrals, but rather just physical therapists. And since the classification treats all PTs the same, the Court upheld it as constitutional. Justice Toal dissented:

The majority concludes that it would be inappropriate to hold that the legislature must treat all health care providers and allied health professionals as similarly situated for purposes of self-referral issues. I disagree. In my view, this is precisely the type of situation in which the legislature should treat all health care providers and allied health professionals as similarly situated. Unlike the majority, I would find that the classification has no reasonable relation to the types of variations and nuances of the medical profession which would necessitate a distinction between physical therapist and all other health care professionals. Although I would agree that the separate classification of physical therapists may be appropriate in other situations, I find it difficult to envision any aspect of physical therapy which is so different from other health care services that it warrants separate classification for self-referral purposes.

I was amicus curiae for a group of patients who wanted the statute struck down. Needless to say, I'm with Justice Toal on this one!