Public policy is the system of laws, regulations, action plans and funding priorities adopted by federal and local governing bodies. Advocacy is the process undertaken to provide education for policy makers with the goal of shaping policy for the common good. Consistent with APTA’s 2022-2024 Strategic Plan, the Hand Academy recognizes our professional responsibility to educate policy makers to ensure equal access to our services, fair reimbursement for those services and protect our profession.
Legislation Excepting Orthoses From Reasonable Useful Lifetime Limits Introduced in the House!
New! APTA added a customizable template letter for contacting your representative to ask for co-sponsorship of HR 4315: HR 4315 Template Letter.
The Medicare Orthotics and Prosthetics Patient Centered Care Act HR 4315 was introduced in the House on June 22. If passed, this legislation will amend Title XVIII of the Social Security Act to reduce fraud, waste and abuse with respect to orthoses and prostheses by preventing drop shipment of an orthosis or prosthesis to a beneficiary who has not received fitting or adjustment of the item or training and education on its use from a qualified practitioner (including physical and occupational therapists).
This legislation also amends Section 1834(h)(1)(G)(i) by adding “custom fabricated” and custom fitted” orthoses to the list of items eligible for replacement without regard to continuous use or useful lifetime restrictions if an ordering physician determines that the provision of a replacement device or a replacement part of such a device , is necessary because of any of the following:
This legislation would not have been possible without the dedication of APTA staff in conjunction with AOPA, AOTA and ASHT.
The Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act was introduced in both houses on July 25. This legislation would change supervision of assistants from direct supervision to general supervision in all practice settings. EMPOWER Act (H.R. 4878/S. 2459)
The Physical Therapist Workforce and Patient Access Act (H.R. 4829) was introduced July 24. This would allow PTs to participate in the National Health Service student loan program. This program pays back up to $50,000 in student loans for a 2-year commitment to practice in rural or underserved areas.
6/5/23: The Expanded Telehealth Access Act (HR 3875) was reintroduced in the House. This legislation would make PTs, OTs and SLPs permanent authorized providers of telehealth under the Medicare program. APTA anticipates that a Senate companion bill will be reintroduced shortly. The full list of services CMS currently permits to be provided via telehealth can be found on CMS’ Telehealth webpage.
On May 11, 2023, the APTA-supported legislation HR 3258 was introduced in the U.S. House of Representatives with the goal to increase access to medical care and treatment for communities and individuals struggling with Long COVID and its associated conditions. The Treat Long Covid Act will fund the expansion of Long COVID clinics and empower health care providers to treat Long COVID patients in their own communities. APTA president Roger Herr, PT, MPA, was quoted in the Congressional press release: congressional press release. For consumers, patients, and other providers, APTA recently released its latest ChoosePT Public Service Announcement which you can view Long Covid PSA.
4/4/23: The Strengthening Medicare for Patients and Providers Act (H.R. 2474) was introduced in the U.S. House of Representatives. This APTA-supported bipartisan legislation would provide an annual inflationary payment update to the Medicare Fee Schedule based on the Medicare Economic Index (MEI). The MEI is a measure of inflation faced by health care providers with respect to their practice costs and general wage levels. Since the introduction of the Conversion Factor in 1992, CMS has not had the authority to adjust fees for inflation. Congress has stepped in over the past few years to reduce cuts triggered by coding changes and the statutory budget neutrality requirement affecting the PFS. Despite these actions, PTs continue to see Medicare payments decrease. We need a permanent solution to stabilize the fee schedule and take inflation into account.
The Prevent Interruptions in Physical Therapy Act (H.R 1617, S. 793) has been reintroduced in the 118th Congress. This bipartisan legislation allows a Private Practice PT to arrange for another qualified PT to treat the PT's patients during a temporary absence due to illness, vacation, continuing education, pregnancy, and other events, and still receive payment from Medicare. A limited version of this bill was included in the 21st Century Cures Act of 2016, and allows PTs in rural, medically underserved, and health professional shortage areas to use locum tenens arrangements during a temporary absence. This legislation would extend the same flexibility to private practice PTs and patients in all geographic regions.
APTA and the Private Practice Section have developed payment advocacy tools to help providers address the growing administrative burden due to utilization management practices, the use of AI algorithms for treatment eligibility decisions, denials for long Covid therapy intervention and other barriers to care access. Details are available here: State Payment Advocacy Tools
The APTA Advocacy Network (formerly PTeam) keeps APTA member advocates connected and engaged. Members participate for free and receive special legislative updates and action alerts when we need your voice. https://www.apta.org/advocacy/apta-advocacy-network
PTPAC will celebrate its 50th year in 2023! Dues cannot be used toward political donations so your contribution helps staff further APTA’s goals for payment, administrative burden reduction and patient access to our services. PT PAC