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
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, S 3977 needs more co-sponsors! 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).
The Government Accounting Office determined this legislation could save $60 Million over the next 10 years, making it a possibility for inclusion in the end-of-year appropriations bill.
There is bipartisan support in both houses, but not nearly enough to capture attention in an election year. You can check the APTA Advocacy app to determine if your legislators have signed on and if not, ask for their support through the APTA Legislative Action Center.
This legislation would not have been possible without the dedication of APTA staff in conjunction with AOPA, AOTA and ASHT.
On October 29, 2024, bipartisan legislation was introduced to reverse the impending 2.8% conversion factor reduction for 2025 and increase it 4.73%, allowing a final increase of 1.9%: The Medicare Patient Access and Practice Stabilization Act of 2024 (H.R. 10073). Contact your representative today and ask them to cosponsor this crucial legislation.
CMS adopted APTA’s proposed change to PTA supervision requirements for outpatient physical therapy practices. PTAs will now be under general supervision in all practice settings in the 49 states already allowing general supervision of PTAs in all settings.
The Physical Therapist Workforce and Patient Access Act (H.R. 4829). 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.
The Expanded Telehealth Access Act (HR 3875/S.2880). This legislation would make PTs, OTs and SLPs permanent authorized providers of telehealth under the Medicare program. The full list of services CMS currently permits to be provided via telehealth can be found on CMS’ Telehealth webpage.
The Strengthening Medicare for Patients and Providers Act (H.R. 2474). 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). 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
Consider donating to the APTA PAC! Your contribution helps staff further APTA’s goals for payment, administrative burden reduction and patient access to our services. PT PAC