House of Representatives Introduces Medicare Direct Access Legislation

ALEXANDRIA, VA, April 1, 2009 – Medicare beneficiaries who need physical therapist services would find it easier and more efficient to obtain treatment under legislation introduced yesterday in the US House of Representatives. The Medicare Patient Access to Physical Therapists Act (HR 1829), introduced by Representatives Earl Pomeroy (D-ND), Tim Murphy (R-PA), and Tammy Baldwin (D-WI), would allow physical therapists to evaluate and treat Medicare Part B beneficiaries who require outpatient physical therapy services, in states in which direct access is authorized, without a physician's referral or certification of the plan of care.

"Direct access under Medicare would remove unnecessary barriers to the cost-effective rehabilitation services provided by physical therapists," said APTA President R Scott Ward, PT, PhD. "Currently these health care consumers, which include seniors and people with disabilities, often have the greatest need for physical therapy services and experience unnecessary burdens to access these services. The referral/certification process can often cause delays that can impede a patient's ability to achieve his or her optimal functional outcome. In light of today's economic environment, timely access to cost-effective physical therapy services for Medicare beneficiaries is critical."

Forty-eight states and the District of Columbia have eliminated the physician referral requirement for patients to access physical therapists for an evaluation, while 44 states and DC allow access to some form of physical therapy treatment without referral. This legislation would defer to the state law on access regarding physical therapy.

"Requiring Medicare patients to get a physician referral before they can see a physical therapist puts an undue burden on residents of rural areas who often travel long distances just to see their doctor," Representative Pomeroy said. "Removing the physician referral requirement would save valuable time and money for Medicare patients in North Dakota and across the country."

Representative Murphy added, "Eliminating barriers to patient choice has been an ongoing effort of mine both in the Pennsylvania State Senate and now in Congress. The Medicare Patient Access to Physical Therapists Act eliminates the burden of unnecessary visits to physicians for patients to access physical therapy care. Delaying this care not only results in higher costs but unnecessary pain and frustration from patients. Right now, the United States Department of Defense allows licensed physical therapists to act as primary care providers for military personnel and their dependents without an initial physician referral. We should extend this option to Medicare patients, and this bill does just that."

"Health care delivery must be a collaborative and cooperative effort," said Representative Baldwin. "This legislation acknowledges the important roles of physical therapists in patient care and of individual states in influencing health care policy. As we strive to improve the quality of care, increase accessibility, and lower costs, allowing states to give Medicare patients direct access to physical therapists is one piece of the solution. I'm proud to co-sponsor HR 1829 and will work hard to see it included in our health care reform package this year."

A Senate companion bill is expected to be introduced in the next several weeks.

Physical therapists are highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility - in many cases without expensive surgery or the side effects of prescription medications. APTA represents more than 70,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide. Its purpose is to improve the health and quality of life of individuals through the advancement of physical therapist practice. In most states, patients can make an appointment directly with a physical therapist, without a physician referral. Learn more about conditions physical therapists can treat and find a physical therapist in your area at www.moveforwardpt.com.

ADVERTISEMENT