April 2024
APTA CT Advocacy Hall of Famers Vic Vaughan and Joan-Alice Taylor, together with Halle Anderson, SPT, a Stonington native attending Duke University, joined over 140 members from around the country for APTA’s Capitol Hill Day. The team met with over half the Connecticut delegation offices. The Economic Value of Physical Therapy report, recently published by APTA, was highlighted in each visit. Click here to see the presentation of the other issues discussed.
August 2023
Administrative Burden Win:
UnitedHealthcare Walks Back Plan of Care Change
After steering toward a change that threatened to significantly increase the administrative burden faced by PTs, commercial insurer UnitedHealthcare has reversed course on the most problematic elements of its expanded policies. Read more
State of the Profession: 2 Reports
May 2023
APTA Capitol Hill Day
APTA Capitol Hill Day: Mark your calendars for July 24-25, 2023. The event will take place at the Omni Shoreham in Washington, DC. All APTA members are invited to attend.
https://www.apta.org/your-career/courses-and-events/calendar-of-events/2023/07/24/capitol-hill-day
Be Aware: We hired a vendor to schedule Capitol Hill meetings. Please do not book Capitol Hill meetings on your own. Multiple meeting requests may damage our relationship with the office, cause confusion, and is ill advised.
Heads Up: Pre-event webinar on Wednesday, July 19 at 8:00 p.m. ET for all attendees.
Regulatory Update
FY 2024 IRF Proposed Rule: The Inpatient Rehabilitation Facility (IRF) proposed rule has only major payment updates; 3.7%payment increase. There is an inflationary update using updated data.
FY 2024 SNF Proposed Rule: The Skilled Nursing Facility (SNF) rule also contains an inflationary update and includes a proposed estimated $1.2 billion increase in payments to SNFs. We were expecting minimum staffing requirements in the rule but they are not currently.
Telehealth Guidance Forthcoming: We’re working with CMS to gain clarity on what the upcoming end of the public health emergency means for billing telehealth under Medicare.
Congressional Update
Take Action: Strengthening Medicare for Patients and Providers Act (H.R. 2474) introduced. This bipartisan bill would allow for an annual inflationary update to the Medicare Physician Fee Schedule. This would help stabilize the Fee Schedule and is a great first step for true reform. Take action on this bill by visiting the Legislative and Patient Action Centers.
Fraud Elimination Bill Introduced: A bill we are endorsing and monitoring is on electromyography and cutting down fraud and abuse with mobile labs. The bill is called the Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act (H.R. 2639).
Pelvic Health Bill: The Optimizing Postpartum Outcomes Act (H.R. 2480) would help raise awareness on the importance of pelvic health physical therapy for postpartum mothers.
April 2023
2023-2024 APTA Public Policy Priorities
The Big Idea: APTA establishes its public policy priorities every two years in conjunction with the new Congress. This document provides a ‘big picture’ of the role of PT in the health care system and how PT can improve outcomes, reduce costs, and ultimately transform society. Additionally, this document provides background about PTs and PTAs, and how PT impacts their communities.
How?: The document is developed by the APTA Public Policy and Advocacy Committee and approved by the APTA Board of Directors.
But: This document is not an exhaustive list of all policies and bills APTA is advocating for. The document is meant to highlight major areas of our legislative efforts.
– We have confirmation from Key Contacts that most have sent it to their representatives at this time
Regulatory Update
The Big Idea: Federal regulators issue rules throughout the year and the public has a comment period where they can comment on the proposed rule before it becomes a final rule. These rules can impact scope of practice, payment, etc. and APTA members are encouraged to submit comments in tandem with comments sent by APTA as a whole.
State of Play: CMS proposed several regulations addressing prior authorization policies. The most significant of these three proposed rules seeks to give patients, in-network providers, and insurers streamlined access to claims and counter data, lab results, prior auth requests, and cost-sharing information. The rule aims to reduce wait times and improve transparency.
Taking Action: Check out comment opportunities and learn more about regulatory advocacy on the Regulatory Action Center. There is a comment form, which is more open-ended and a template form which is pre-filled out and faster for advocates. Prior authorization comments close on March 13.
Why This Matters: Your comments are important and, by law, must be read by regulators. Your comments show your diverse perspectives, experience, expertise, ‘horror stories’, and is complementary to comments submitted by APTA.
Your Personal Story Matters: Check out “How to Draft a Personalized Letter” for best practices to make your letter the best it can be. Questions? Reach out at advocacy@apta.org
Congressional Update
The Big Idea: At the beginning of a new Congress, which is every two years, any bills that weren’t passed must be reintroduced.
Heads Up: March will hopefully be a busy month as we expect various bills to be reintroduced. This includes telehealth, pelvic health, National Health Services Corps combined with community health centers, and more. When these bills are reintroduced, advocates can expect action alert opportunities to connect with Congress.
Coming Up: The Public Health Emergency is set to end on May 11 though waivers will continue through the end of 2023.
Continue Your Civic Education: Curious about Congress? Learn how a bill becomes a law.
– There are no current bills introduced at the time of this writing. These should be pressed forward around mid-March. As per the regulatory update, there is a narrow focus this year on a few bills. Some are a carry-over from last year which will be re-introduced, some are new, and other will be attempted to be rolled in with other bills.
November 2022
APTA-Supported Legislation Signed Into Law
Dr. Lorna Breen Health Care Providers Protection Act
Signed into law in March, the Breen Act aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among health care professionals. The law helps promote mental and behavioral health among those working on the frontlines of the pandemic, supports suicide and burnout prevention training in health care professional training programs, and increases awareness and education about suicide and mental health among health care professionals.
Consolidated Appropriations Act of 2022
This appropriations package extends the Medicare telehealth waiver for PTs and PTAs for 151 days after the coronavirus-related public health emergency ends.
Protecting Medicare and American Farmers From Sequester Cuts Act
This was the legislation that successfully blunted payment reductions included in the 2022 Medicare Physician Fee Schedule. (Note: Those proposed cuts have returned in the proposed 2023 fee schedule rule, but bipartisan legislation has been introduced in the House that would appropriate additional funding to once again offset the cuts (see H.R. 8800 below)
APTA-Supported Legislation in Process
Supporting Medicare Providers Act of 2022 (H.R. 8800)
This very recent legislation would counteract proposed payment cuts to the Medicare Physician Fee Schedule by adding additional funding to the fee schedule’s conversion factor through the end of 2023, theoretically returning that factor to its current level. The bill also contains language that acknowledges the need to address the long-term stability of the payment system.
Status: Introduced in the House
Advancing Telehealth Beyond COVID-19 Act (H.R. 4040)
This bill would extend the Medicare telehealth waivers for PTs and PTAs until Dec. 31, 2024, regardless of the status of the public health emergency. That’s good news for patients and providers, of course, but it’s also a boost for telehealth supporters such as APTA, because it provides even more time to collect data on the use of telehealth and give policymakers more time to craft something permanent.
Status: Passed House; awaiting Senate vote
Lymphedema Treatment Act (H.R. 3630/S. 1315)
This bill, which would expand Medicare coverage of compression treatment items for beneficiaries with lymphedema, has passed out of the House Energy and Commerce Committee and is being readied for a full House vote. The House version has 356 co-sponsors; a companion Senate bill has 73 co-sponsors. You can check on the progress ofthe legislation at the Lymphedema Treatment Act website.
Status: Passed out of House Energy & Commerce Committee; awaiting House vote.
PREVENT Pandemics Act(S. 3799)
This sweeping legislation is intended to modernize the country’s pandemic response by increasing federal and state preparedness, improving epidemiologic data collection, accelerating research and development, and improving the medical supply chain. The bill also focuses on supporting and improving the health care provider workforce and addressing health disparities. Two additional APTA-supported pieces of legislation are folded into the PREVENT Act: the Improving Social Determinants of Health Act (H.R. 379/S. 104) and the Allied Health Workforce Diversity Act (H.R.3320/S. 3018). The social determinants legislation would, among other things, authorize a grant program to support projects to reduce health disparities and improve health outcomes by increasing community-based capacity to address social determinants of health. The workforce diversity bill would empower the Secretary of the Department of Health and Human Services to offer grants and contracts to education programs that would in turn provide scholarships to increase the diversity of student population in health care training, including physical therapy.
Status: Passed out of Senate Health, Education, Labor, and Pensions Committee
Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018)
This legislation would reduce administrative burden by scaling back the use of prior approval in Medicare Advantage plans. While it doesn’t eliminate prior authorization, the bill would require MA plans to make regular reports to the U.S. Centers for Medicare &Medicaid Services on use of prior authorization, rates of denials, and average time for approval. The legislation also would direct HHS to establish a process for “real-time decisions” for services that are routinely approved, and mandate that MA plans engage in more consultation with stakeholders and professional organizations around approval guidelines that are evidence-based.
Status: Passed House; awaiting consideration by Senate
2023 Appropriations for Veterans Administration
This large spending bill directs the VA to do what needs to be done to improve patient access to physical therapist services in the VA health care system, including increasing pay, expanding the roles of PTs and PTAs in a range of settings including primary care, and allowing PTs to qualify fora special scholarship program.
Status: Passed House; awaiting consideration by Senate
The Medicare Patient Empowerment Act (H.R. 3322/S.826)
This bill allows a Medicare beneficiary to enter into a direct contract with an eligible provider, including physical therapists, for any item or service covered by Medicare, otherwise known as “opting out” of Medicare. If enacted, the legislation would introduce more flexibility into opt-out provisions, including dropping the requirement for a two-year opt-out commitment and allowing providers to serve all other Medicare beneficiaries.
Status: Referred to House Energy & Commerce Committee and House Ways & Means Committee; referred to Senate Finance Committee.
Physical Therapist Workforce and Patient Access Act(H.R. 3759/S. 2676)
This bill would allow PTs to participate in the National Health Service Corps loan repayment program, an initiative that re pays up to $50,000 in outstanding student loans to certain health care professionals who agree to work for at least two years in a designated Health Professional Shortage Area. The legislation was the target of the APTA Flash Action Strategy student-led advocacy initiative.
Status: Referred to House Energy & Commerce Committee; referred to Senate HELP Committee
Expanded Telehealth Access Act (H.R. 2168/S. 3193)
This bill instructs CMS to permanently adopt what is a now a temporary waiver of restrictions on Medicare payment for telehealth delivered by PTs and PTAs, occupational therapists, occupational therapy assistants, speech-language pathologists, and audiologists. The HHS Secretary also would be allowed to further expand the list of authorized telehealth providers.
Status: Referred to House Energy & Commerce Committee; referred to Senate Finance Committee
Prevent Interruptions in Physical Therapy Act (H.R. 1611/S. 2612)
This bill expands the ability of PTs to engage in what CMS is now calling “reciprocal billing and fee-for-service,” otherwise known as “locum tenens,” to all PTs. Currently, only PTs in rural and underserved areas are allowed to arrange for another qualified PT to treat their patients during a temporary absence due to illness, vacation, continuing education, pregnancy, and other events, and still receive payment from Medicare.
Status: Referred to House Energy & Commerce Committee; referred to Senate Finance Committee
Stabilizing Medicare Access to Rehabilitation and Therapy Act (H.R. 5536)
Also known as the SMART Act, this bill seeks to address elements of a pay differential system that cuts payment under Medicare by 15% when services are delivered by physical therapist assistants or occupational therapy assistants. Among the APTA-supported elements in the legislation: establishment of an exemption to the differential for rural and underserved areas, and adoption of less-burdensome general PTA and OTA supervision requirements for outpatient therapy under Medicare Part B. The change in supervision requirements is estimated to save CMS as much as $242 million over 10 years, according to a recent policy study co-sponsored by APTA.
Status: Referred to House Energy & Commerce Committee
Primary Health Service Enhancement Act (H.R. 5365)
This bill would expand patient access to essential physical therapist services to children and adults who receive care at rural health clinics and federally qualified health centers, also known as community health centers. The legislation elevates the status of PTs in the health centers by, among other measures, allowing them to bill independently for services billed to Medicare and Medicaid.
Status: Referred to House Energy & Commerce Committee
Optimizing Postpartum Outcomes Act (H.R. 8181)
This bill directs the HHS Secretary to develop several provisions that would significantly strengthen Medicaid’s emphasis on pelvic care for individuals in the postpartum period. The legislation includes pelvic floor physical therapy among the pelvic floor services that would be covered under Medicaid and the Children’s Health Insurance Program. The bill also instructs CMS to develop and issue guidance on best practices, financing options, screenings, referrals, and access, as well as terminology and diagnostic codes. Additionally, if the law passes, HHS would be required to educate and train health professionals and postpartum individuals on the importance of pelvic health and pelvic health physical therapy.
Status: Referred to House Energy & Commerce Committee
Preserving Access to Home Health Act (H.R. 8581/S.4605).
This bipartisan legislation would provide stability for home health patients by preventing CMS’ proposed 7.69% payment cut to home health services in 2023 and prevent the agency from implementing any permanent or temporary adjustment to home health prospective payment rates before 2026. This would allow more time for CMS to refine its approach to managing budget neutrality in home health.
Status: Referred to House Ways & Means Committee and House Energy & Commerce Committee; referred to Senate Finance Committee
CMS Update:
APTA submitted comments to the Centers for Medicare and Medicaid Services in response to its request for information from the public on various aspects of the Medicare Advantage program. The RFI is seeking stakeholder feedback on how to strengthen MA plans in ways that align with the Vision for Medicare and CMS Strategic Pillars. APTA primarily spoke to how CMS can reduce significant barriers to care faced by both patients and providers. First, we advocated for more plan transparency, asking that CMS provide oversight of MA advertising to ensure that the benefits MA plans market are provided unimpeded to enrollees. We also described how onerous prior authorization procedures are delaying patient care and creating more administrative burden. Consequently, APTA recommended extensive prior authorization oversight and standardized utilization management processes to ease provider workloads and improve patient experiences. Our letter also requested that CMS consider APTA a valuable partner when figuring out how to create effective VBMs that utilize specialty providers. Finally, APTA voiced provider frustrations with MAOs and detailed several reforms that will be necessary to allow MA plans to properly serve a growing number of enrollees over the next decade.
On Aug. 8, 2022, APTA nominated Dr. Matt Janes, a member of APTA’s Post-Acute Care Workgroup, to serve on CMS’ Health Equity Technical Expert Panel (TEP). To evaluate whether or not a health equity-focused structural composite measure should be included within the Home Health and Hospice Quality Reporting Programs (QRPs), CMS is seeking individuals with differing perspectives and areas of expertise to serve as health equity experts on a TEP. The objective of the TEP is to consider a health equity structural composite measure that includes organizational activities to address access to and quality of hospice and home health care for underserved populations. APTA believes that Dr. Janes will make an outstanding addition to the ten-member panel and awaits the panel’s input on the health equity quality measure.
On September 6, 2022, APTA submitted comments on the 2023 Medicare Physician Fee Schedule proposed rule. APTA commented on numerous proposals including the reduction in the conversion factor, telehealth and remote therapeutic monitoring, supervision of PTAs, underutilized physical therapy services and the quality payment program. APTA’s efforts to encourage members to draft their own, unique comment letter was successful with 40 letters written using the form, with potentially many more submitted directly to regulations.gov.
June 2022
Support of H.R. 5365: Expand Care at Community Health Centers
The American Physical Therapy Association (APTA) is supporting Congress to pass the Primary Health Services Enhancement Act (H.R. 5365). This bipartisan legislation would expand patient access to essential physical therapy services to children and adults who receive care at rural health clinics and federally qualified health centers, also known as community health centers (CHCs).
CHCs provide primary health services to more than 30 million people in over 12,000 rural and urban communities across America, including nearly 3 million Medicare beneficiaries and one in five Medicaid beneficiaries. Presently, CHCs cover a range of necessary health services, including access to physicians, advanced practice nurses, dentists, and other services. However, community health centers are restricted in how physical therapy services are provided and reimbursed. H.R. 5365 would address this problem by allowing physical therapists to provide care to patients in CHCs and bill Medicare and Medicaid directly. In such a rural state our Connecticut residents would benefit from this access to needed services.
This link better explains the current limitations on the provision of Physical therapy in CRCs but also identifies why physical therapy is a true clinical support of the other necessary health services.
Position Paper: Primary Health Services Enhancement Act | APTA
The link also offers you a letter for asking your representative to cosponsor H.R. 5365: Primary Health Services Enhancement Act.
Complete act can be found on Congress.gov H.R.5365 – 117th Congress (2021-2022): Primary Health Services Enhancement Act | Congress.gov | Library of Congress
Text of H.R. 5365: Primary Health Services Enhancement Act (Introduced version) – GovTrack.us
School-Based Therapy
Rep. Jahana Hayes (D-CT) and Rep. Brian Fitzpatrick (R-PA) introduced bipartisan resolution designating and celebrating the week of April 25 through April 29, 2022, as “National Specialized Instructional Support Personnel Appreciation Week.” Schools are home to more than one million specialized instructional support personnel across the United States, including physical therapists, nurses, speech-language pathologists, audiologists, and more. This resolution builds on the Save Education Jobs Act, an APTA-endorsed bill introduced by Rep Hayes to help mitigate the impacts of students’ learning loss as a result of the COVID-19 pandemic and support specialized instructional support personnel, including physical therapists.
Supervision of PTAs in Outpatient Settings:
On April 23, 2022, Rep. Bobby Rush (D-IL) led a bipartisan letter to the U.S. House Appropriations Committee requesting that the committee include report language in the upcoming annual appropriations bill clarifying Congressional intent surrounding supervision requirements for PTAs and OTAs. The report language directs CMS not to limit access or alter reimbursement for outpatient therapy services by imposing supervision requirements for assistants in outpatient settings that are more stringent than what is required by state law. Rep. Rush was joined by Rep. Jason Smith (R-MO), along with Representatives Budd (R-NC), Carter (D-LA), Cohen (D-TN), Horsfield (D-NV), McBath (D-GA), McEachin (D-VA), McKinley (R-WV), Panetta (D-CA), and Wild (D-PA).
Pelvic Health:
Rep. Jamie Herrera Beutler (R-WA) and Rep. Lisa Blunt Rochester (D-DE) plan to introduce the Optimizing Postpartum Outcomes Act in the near future. This bipartisan legislation instructs the Centers for Medicare and Medicaid Services (CMS) to issue guidance on coverage under Medicaid and CHIP (Children s Health Insurance Program) for pelvic floor services, including pelvic floor physical therapy, performed during the postpartum or neonatal period. The legislation also requires Government Accountability Office (GAO) to conduct a study on pelvic floor programs that address gaps in coverage for covered pelvic health services, including pelvic floor physical therapy, for postpartum individuals and other services postpartum women received during their pregnancies. Additionally, the bill instructs the HHS Secretary to carry out a program to educate and train health professionals on the benefits of pelvic floor physical therapy and to educate postpartum women on the importance of pelvic floor examinations and physical therapy, what pelvic floor examinations and physical therapy are, and how to obtain an examination for pelvic physical therapy. APTA Government Affairs and representatives from APTA Academy of Pelvic Health worked with Rep. Herrera Beutler’s office in the drafting of the legislation.
May 2022
WORKFORCE DIVERSITY: On March 10, 2022, Senators Patty Murray (D-WA) and Richard Burr, (R-NC) unveiled a new legislative package known a known as the PREVENT Pandemics Act (S. 3799). This sweeping bill aims to modernize the country’s pandemic response, to include increasing federal and state preparedness, improving epidemiologic data collection, accelerating research and development, and improving the medical supply chain. The legislation also focuses on supporting and improving the health provider workforce and addressing health disparities. The PREVENT Pandemics includes language from the APTA’s supported ALLIED WORKFORCE DIVERSITY ACT (S. 1679), sponsored by senators Bob Casey (D-PA) and Lisa Murkowski (R-AK). The legislation was passed by the Senate Health, Labor, and Pensions Committee (HELP) on March 15, 2022, and will next be considered by the full Senate.
SISP: On March 24, 2022, U.S. Representatives Marie Newman (IL-03), Brian Fitzpatrick (PA-01) and Susan Wild (PA-07) introduced the Growing, Recruiting, and Obtaining Workers in Specialized Instructional Support Personnel Services (GROW SISPS) Act (H.R. 7219) as part of an effort to ensure students receive the individualized support they need to succeed in the classroom. The new bill will create a grant program at the Department of Education to increase partnerships between school districts and colleges to train and certify various Specialized Instruction Support Personnel programs (SISPs) to better serve rural and lower-income school districts. In school districts across the nation, Specialized Instructional Support Personnel, or SISPs, work with teachers, school support staff, parents, community members, and other education stakeholders to help students remove learning barriers. They include physical therapists and assistant that work with students with disabilities and provide crucial services to students to address students’ needs in school.
LONG COVID: On April 6, 2022, the Targeting Resources for Equitable Access to Treatment for Long COVID (TREAT Long COVID) Act was introduced in the U.S House by Reps. Ayanna Pressley (MA-07), Don Beyer (VA-08) and Lisa Blunt Rochester (D-DE), and in the Senate by Senators Tim Kaine (D-VA), Tammy Duckworh (D-IL) and Edward Markey (D-MA). The legislation aims to increase access to medical care and treatment for communities and individuals struggling with Long COVID. The TREAT Long COVID Act would expand treatment for Long COVID nationwide by authorizing the Department of Health and Human Services to award grants up to $2,000,000 to health care providers, including community health centers; grant funding for the creation and expansion of multidisciplinary Long COVID clinics to address the physical and mental health needs of patients; prioritize funding for health providers that plan to engage medically underserved populations and populations disproportionately impacted by COVID-19; and ensure that treatment is not denied based on insurance coverage, date or method of diagnosis, or previous hospitalization.
PTAs: On April 6, 2022, Rep. Bobby Rush (D-IL) sent a “Dear Colleague” to his House colleagues requesting their support and signature on a letter to the House Appropriations Committee on the current PTA/OTA direct supervision requirement under Medicare. Specifically, the letter requests that report language be added to the FY 2023 Congressional appropriations legislation that would require the Centers for Medicare and Medicaid Services (CMS) to change the current ‘direct supervision’ regulatory requirement of PTAs and OTAs to instead defer to the supervision requirements found in states’ physical therapy licensure law.
March 2022
Consolidate Appropriations Act of 2022
On Wednesday night (3/9/2022) the U.S House passed the Consolidated Appropriations Act of 2022 the $1.5 trillion omnibus spending package to fund the federal government through September 2022. On March 10, 2022 the U.S. Senate passed the House legislation before tonight’s midnight deadline to prevent a government shutdown.
For physical therapy the spending package includes language specifically providing a 151-day (5 month) blanket extension of the current Medicare telehealth waivers for Physical Therapy, OT, SLP and Audiology after the date the Public Health Emergency (PHE) is declared over. The specific inclusion of physical therapy in the package was critical and sets the stage for a permanent or longer extension of the current telehealth waiver. APTA is grateful to our champions in Congress on this issue.
The legislation also extends for 151 days after the end of the PHE the removal of the geographic requirements for originating sites, allowing for telehealth services to continue to be provided to Medicare beneficiaries in the home and all areas of the country. The legislation also requires that the Medicare Payment Advisory Commission (MedPAC) provide a report to Congress no later than June 15, 2023, examining Medicare telehealth utilization, expenditures, payment policy, and impacts on beneficiary access to care and quality. It requires the Secretary of HHS to make publicly available on a quarterly basis data on Medicare claims for telehealth services. It also requires the HHS Office of Inspector General (OIG) to provide a report to Congress no later than June 15, 2023, on program integrity risks associated with Medicare telehealth services.
At this time there are indications that the Biden Administration could end the PHE in July, likely driven by the upcoming midterm elections and declining infection rates of COVID. Should the PHE end in July, the 5-month extension of the current telehealth waivers for therapy provided by the legislation would kick-in and last until mid-December of 2022. In December Congress would need to extend the blanket telehealth waiver for therapy into 2023 and do so via a year-end Medicare package or other end-of-year must-pass legislation. Either way, the language in the spending package ensures that there will not be a “telehealth cliff” for therapy after the PHE ends and provides Congress more time work on a more permanent telehealth solution.
SMART Act (PTA Differential)
On the downside, the House-passed Consolidated Appropriations Act did not include language from the SMART Act, APTA-supported legislation aimed at mitigating the impact of the PTA/OTA differential. Rep. Bobby Rush (D-IL), sponsor of the bill, led a bipartisan effort with his colleagues on the House Energy & Commerce Committee aimed at House leadership to have the SMART Act be included in the package; you can read more about that effort HERE. APTA met yesterday with the office of House Majority Leader Steny Hoyer to discuss possible future legislative vehicles this year for the SMART Act.
last chance to show their support for H.R. 5536, the Stabilizing Medicare Access to Rehabilitation and Therapy Act, or SMART. We all need to think about how this impending reduction will affect how we practice and how we run our businesses. If implemented this may also affect how other payers may consider payment reduction. The 15% cut piles on top of other reductions to the Medicare fee schedule and is simply not sustainable in ensuring access to therapy services. There could be nothing easier as APTA has already had all of the info completed with just a sign on letter to be completed
Workforce Diversity and Social Determinant of Health
On Wednesday, March 9, Chairwoman Patty Murray (D-WA) of the Senate Health, Education, Labor, and Pensions Committee (HELP) and Ranking Member Richard Burr (R- NC) released the PREVENT Pandemics Act, bipartisan legislation focused on strengthening the nation’s public health and medical preparedness and response systems in the wake of the COVID-19 pandemic.
**Of note – language from our Allied Health Workforce Diversity bill (Senate Bill 1679) is included in the PREVENT Pandemics Act legislative package. Our senate sponsors (Senators Casey and Murkowski who also sit on the HELP Cmte) were able to get the Workforce Diversity bill language included the PREVENT Pandemics legislative package.
The PREVENT Pandemics Act also includes language from the APTA-endorsed Improving Social Determinants of Health Act (S.104) which requires the Centers for Disease Control and Prevention (CDC) to establish a program to improve health outcomes and reduce health inequities by coordinating activities across the CDC. As part of the program, the CDC must award grants to eligible organizations to build capacity to address social determinants of health. The Senate HELP Committee has scheduled a mark-up on the PREVENT Pandemics Act for this Tuesday, March 15.
October 2021
The APTA is actively advocating for several issues in the House and Senate.
3.5% Medicare Pay Cut Proposed
In July, Centers for Medicare & Medicaid Services (CMS) released its proposed 2022 Medicare Physician Fee Schedule rule. The proposed rule would cut physical therapy payment by an estimated 3.5%. This is on top of the 3.3% cut in 2021. Additionally, CMS is set to implement a 15% cut in 2022 for services provided by a physical therapist assistant. Additionally a 2% cut will go into effect when Medicare sequestration returns in 2022. The APTA has garnered support for a Dear Colleague letter (the Bera-Buschon letter) which asks the House leadership to act to halt these proposed cuts and to give time to develop a long-term reform to the Medicare Fee Schedule.
Policy Solution for PTA Differential Pay Cut
As above, a 15% cut for services provided by a PTA is set to begin in 2022. This bipartisan legislation was proposed on Friday October 8, 2021 by Rep. Bobby Rush (D-IL) and Rep. Jason Smith (R-MO). The legislation has three primary policy goals:
There will be opportunities coming for a grassroots effort to encourage support for this bill.
Expanded Telehealth Access Act of 2021 (H.R. 2168)
Currently physical therapists and physical therapist assistants may provide telehealth services under Medicare during the declared public health emergency. At this time, PTs and PTAs have not been granted the permanent ability to furnish services through telehealth. This bill adds PTs, PTAs as well as occupational therapists, occupational therapy assistants, audiologists and speech language pathologists as authorized providers of telehealth under Medicare.
Physical Therapist Workforce and Patient Access Act (H.R. 3759/S. 2676)
This bill adds physical therapists to the National Health Service Corps Repayment Program, allowing PTs the ability to apply for tuition reimbursement when choosing to work in underserved areas.
The Allied Health Workforce Diversity Act (H.R. 3320/S.1679)
This bill would provide grants for accredited higher education programs to recruit qualified individuals from underrepresented backgrounds in the fields of PT, OT, SLP, respiratory therapy, and audiology.
Please see the APTA Advocacy App where you can see if your representatives have signed on to the letter or any of these bills. Please consider calling or emailing your representatives about these issues.
To learn more about these issues, please see the APTA Patient Action Center at https://www.apta.org/advocacy/take-action/patient-action-center or reach out to our Federal Affairs Liaison, Maryclaire Capetta, at Maryclaire.capetta@uconn.edu.
We are looking for people who are interested in federal issues affecting physical therapist practice to serve as Key Contacts for our CT legislators. Please reach out to Maryclaire if you are interested in serving in this role.
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