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Federal Affairs Liaison Report
(Posted: 04/17/2019)

The 2019 APTA Federal Affairs Forum was held March 31-April 2, 2019.  The meeting targeted legislation supporting APTA’s public policy priorities, identified by Advocacy at APTA and supported by the House of Delegates.

More Movement, Better Health

Legislators, consumers, and payers acknowledge the cost of health care is rising while the outcomes are not improving.  Payment continues to target treatment in lieu of prevention.  Physical therapists are positioned to be primary contributors to the advancement of wellness and prevention of the chronic conditions caused by harmful lifestyle choices.  To that end, APTA has set the following public policy goals:

  • Enact policies that empower people to live healthy and independent lives.
  • Eliminate barriers to health care services
  • Support efforts to increase efficiencies in health care service delivery, including reducing provider administrative burden and increasing cost transparency for consumers.
  • Prioritize research and clinical innovation to increase access to appropriate value-based health care services.

 Population Health Priorities 

  • Guaranteed access to essential health benefits for all Americans.
  • Support for programs targeting increase physical activity and exercise for all ages.
  • Support funding for prevention and wellness services in public and commercial insurance plans.
  • Support funding for public health initiatives to increase health literacy.
  • Advance policies to educate primary care services providers about nonpharmacological interventions for pain management.

 Patient Choice and Access

  • Include physical therapists as primary care providers.
  • Expand direct access to physical therapy services
  • Expand coverage and payment for rehabilitation services including those delivered via digital health and telehealth platforms.
  • Reduce co-payments for physical therapy services.
  • Enact legislation to allow physical therapists to opt out of Medicare and privately contract with Medicare beneficiaries.

 Research and Innovation

  • Increase funding for rehabilitation research across federal agencies.
  • Ensure parity for the physical therapy profession regarding the use, certification, and interoperability of electronic health records.
  • Support the use of the Physical Therapy Outcomes Registry in both public and commercial payment programs to drive the delivery of quality, effective, and efficient rehabilitation services.

 Legislation: 116th Congress, first session

 As this is a new Congress, previous legislation expired and requires reintroduction.  APTA representatives advocated for:

  • Reconsideration of the eligibility of physical therapists to provide telehealth services
  • Recognition and inclusion for physical therapists as musculoskeletal pain experts
  • Recognition, inclusion and paid providers of services in community health centers. 

In addition, APTA representatives served as educators to the legislators and their aides regarding  delays in care due to prior authorization requirements.  Over 80% of Medicaid, Medicaid fee-for-service programs, Medicare Advantage, and Commercial payers require prior authorization for physical therapy services.  In addition, 72% of nearly 16,000 respondents to a web-based survey reported an average delay of 3 days prior to accessing services due to pending authorization requests. The high cost of co-payments was also identified as a barrier to care.

One bill was introduced during our time on the Hill:  S 970 Physical Therapist Workforce and Patient Access Act of 2019 Introduced by Senator Jon Tester 4/1/19, includes physical therapists in the National Health Service Corps Loan Repayment program.  This program provides student loan forgiveness for physical therapists who serve in areas identified as rural and underserved after graduation. 

I was one of 4 delegates from Iowa, one of whom was a physical therapy student from the University of Iowa program.  We had a face-to-face meeting with Senator Chuck Grassley, Chair of the powerful Senate Finance Committee and with Representative Dave Loebsack and met with the health care legislative aids for Representative Steve King,

Cindy Axne and Senator Joanie Earnst.  Our comments were well received but without  commitments to introduce or support legislation addressing these issues. 

I appreciate the opportunity to represent the Academy and urge continued participation in the annual Federal Advocacy Forum by representatives of the Academy.

Marsha Lawrence PT DPT CHT
Federal Affairs Liaison
Academy of Hand and Upper Extremity Rehabilitation


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Past Events

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Sep 12, 2019: PT Pub Night - Albuquerque

Join your fellow PTs, PTAs, and PT/PTA students in Albuquerque on Thursday, September 12, at 5:30 PM for PUTPubNight.

If you can't make the event or wish to check in early, you can do so at We'll donate $1 for each online check-in to Global PT DOS.

Link to Facebook PT Pub Night event.

Site Leader: Jen Kiger

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Jan 23, 2019 – Jan 26, 2019: APTA Combined Sections Meeting

Washington, DC (preconference course January 22)

Click here for more information.