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  • DoD Moves to Include PTAs in TRICARE

    Nearly a year after being signed into law, the wheels are finally turning: a proposed rule to include physical therapist assistants (PTAs) as authorized providers under TRICARE, the health care system used throughout the military, has been issued by the US Department of Defense (DoD). APTA strenuously advocated for the change and says it's time for supporters to help push the rule over the finish line.

    The proposed rule is a fairly straightforward plan that seeks to have the TRICARE system adopt Medicare's requirements for PTAs and occupational therapy assistants (OTAs). "This rule will align TRICARE with Medicare's policy, which permits PTAs and OTAs to provide physical or occupational therapy when supervised by and billed under a licensed physical therapist or occupational therapist," DoD writes in its summary of the proposal.

    According to Kara Gainer, APTA's director of regulatory affairs, the proposal, while strongly supported by APTA, has a few issues that need to be addressed.

    "The rule references 'physical therapy assistants' when it should be 'physical therapist assistant'—that area, and a few other places in which DoD uses inconsistent language around physical therapist qualifications, are easy fixes and something that we'll be recommending," Gainer said. "Overall, however, the release of this proposed rule is a very positive step because it starts the clock ticking toward final implementation."

    The timeline for when PTAs could actually begin participating in TRICARE was an uncertainty that lingered throughout 2018—although DoD intended to have the change in place no later than 2021, nobody seemed to know just when the rulemaking process would begin. The publication of the proposed rule kicks off a series of timelines that put progress on a more trackable schedule, beginning with a 60-day deadline for public comment. According to an APTA chart on possible implementation of the rule (scroll down to view), PTAs could be participating in TRICARE as early as fall of 2019, or as late as early 2020 if all goes according to plan.

    What's next? APTA urges supporters of the change to make that support known to DoD by providing comments on the proposed rule by the February 19, 2019, deadline. In early January, APTA will offer a template letter that will make the comment process easy—be on the lookout for an announcement when that becomes available, or look for the letter on APTA's "Take Action" webpage sometime after January 1, 2019.

    Comments

    • How is this legal? Why doesn't the APTA bring a legal suit against Tricare on behalf of its members and patients we treat, who this silly rule affects?

      Posted by Robert Carpenter -> =IQ[BM on 12/21/2018 3:34 AM

    • PTAs are licensed, skilled professionals. Tricare should certainly allow them to treat and bill under a licensed PT when treating Tricare patients

      Posted by Joe Spagnolo on 12/24/2018 8:22 AM

    • As we look at the history of who is reimbursed under insurance plans, it is a wonderful time to be a PT and have PTA’s working with us for the good of our patients, finally! I am now retired, but glad this rule will be implemented. Happy New Year to all!

      Posted by Laura Coykendall on 12/26/2018 12:32 PM

    • THIS WOULD HELP THE EASE OF SCHEDULING AND SEEING PATIENTS. I GREATLY SUPPORT AS A PTA.

      Posted by CAITLIN BULLARD on 12/26/2018 12:33 PM

    • This ruling to allow PTA's to assist PT's in treating Tri-care patients is a MUST. We need to do what is necessary to stop the limitation placed on PTA's in patient care. As someone who has practiced Physical Therapy for 41 years and has seen many changes in practice-acts, there have been some good and bad practices. Most PTs I am surrounded by are in complete support of PTA's being a provider service for Tri-care service.

      Posted by Terry Trundle PTA,ATC,LAT on 12/26/2018 12:54 PM

    • Is the APTA thinking of a form letter in support of the bill for members to send to their representatives? This seems to be a very consistent and easy way to show support in mass.

      Posted by Linda Hedrick on 12/26/2018 12:57 PM

    • As a licensed PT, I completely trust my PTA's critical thinking skills, safety, and knowledge base to treat all my patient's that I see fit, regardless of insurance type. Tricare needs to extend that trust to their providers. I guess the real question is why not? What do they think is going to happen or what do they think PTAs do?

      Posted by Linda Brown on 12/26/2018 1:16 PM

    • This bill is likely good for clinic owners who want to get full reimbursement for work done by a cheaper labor resource. How is this bill good for patients? What are the honest and unbiased reasons for the energy being placed into this legislative effort?

      Posted by Shawn Patrick Riester DPT on 12/26/2018 1:40 PM

    • PTAs are trained professionals that are licensed through their state to carry out physical therapy under a licensed physical therapist. Medicare and commercial insurances allow the use of PTAs to carry out this treatment as it allows for an efficient and cost effective way for people to receive the therapy that improves their quality of life and gets them back to prior level of functioning. Tricare should feel confident in following this model as PTAs are well equipped to treat and care for their patients.

      Posted by Matthew Rudder on 12/26/2018 1:55 PM

    • Sometimes I wonder who is making the decisions about our profession. This rule should have been implemented years ago. Do we just not have a group of people that can be our voices in Washington? Look what is occurring with the MIPS and the penalties of non participation. Is this even legal?? Things for our profession are not benefiting us. Let's get together and make positive changes so we can give quality care to our patients and not be stuck being a data entry person.

      Posted by Cherisse Sansone on 12/26/2018 2:22 PM

    • Grateful that the APTA advocates for our profession. I think this will also be a great way to increase access to healthcare/physical therapy by allowing PTAs to treat Tricare patients.

      Posted by Richie on 12/26/2018 2:27 PM

    • Let's keep this simple. Our military/veterans deserve the best care available. This will allow us to improve the delivery of services. Pass the rule ASAP. Semper Fi!

      Posted by Carl Y Malmquist on 12/26/2018 2:28 PM

    • PTA's are licensed professionals and should be allowed to treat patients that have Tricare. Some PTA's are highly trained in areas their Supervising Physical Therapist may not be as well versed in; and patients with Tricare could benefit from that specialized training. This law would be advantageous to patients.

      Posted by Sherry Shrum on 12/26/2018 2:47 PM

    • PTA's provide valuable,necessary and expert care in our outpatient PT clinic setting. They perform and expedite many of the PT interventions used in our patient's Plans of Care while allowing PT's to focus on other aspects of care. Tricare should not prevent PTA's from providing care to only their patients. This makes no sense!

      Posted by Allen Breindel on 12/26/2018 3:18 PM

    • PTAs are licensed, skilled clinicians who support their patients and PT colleagues in various physical therapy settings. Often, PTAs have more one on one time available to spend with their patients. Let them see and treat our veterans!

      Posted by Nicole McManus on 12/26/2018 3:19 PM

    • Does this currently apply to all settings (outpatient, inpatient acute, IRF, SNF, home health)?

      Posted by BK on 12/26/2018 4:45 PM

    • NY should follow this as well. Our Governor has vetoed PTA's to treat Workers Comp patients because they are not "licensed professionals" We have tried to inform him that they are, but he doesn't seem to care

      Posted by Kevin Kress -> ?GQ`<I on 12/26/2018 5:28 PM

    • I support it!

      Posted by April Thompson on 12/26/2018 6:29 PM

    • Let us help, that's our job. :)

      Posted by Steven (Tony) Norton on 12/26/2018 11:19 PM

    • Why is Tricare discriminating against PTA's who are well educated, capable and licensed, Whereas in military facilities they utilizes their own PT Techs with 6 months classroom studies and 6 months hands on training. These PT Tech's can work independent of a PT, perform evaluations, and treat. Tricare need to look into there own backyard and leave the civilian sector to govern who can treat who under insurance plans.

      Posted by Fred D King II PT PhD on 12/27/2018 12:53 AM

    • Tricare patients can benefit greatly from PTA's service. PTA's have more time slots for patients have better choices in scheduling , which will improve patient's compliance in their attendance. Happy New Year!

      Posted by Noemi Licon on 12/27/2018 6:33 AM

    • I have been a Licensed Physical Therapist Assistant for 40 years and I strongly support the role of the P.T.A .to treat all patients!! Many P.T.A.'s have degrees and some several degrees along with specialty certifications. I have always appreciated the role that I have to work closely with the P.T's. I have seen the pendulum swing from the P.T. degree being a Bachelors to a Masters and now the standard is the D.P.T., while the P.T.A. seems to be still an Associates degree . I think that at least we should promote Bachelor level for the profession. I just cannot understand the barriers that exist for the L.P.T.A.!! Ugggh Starr Shank, L.P.T.A., C.L.T. W.C.C., L.M.T

      Posted by Starr L. Shank on 12/27/2018 12:06 PM

    • The passage of this law is a win for the patients we serve on a daily basis as well as the profession. The ability of a PT/PTA team to carry out a plan of care will definitely improve patient access across the country.

      Posted by David Harris PTA, MBA on 12/27/2018 12:46 PM

    • PTAs are skilled and licensed professionals. Their services have been accepted under other federal payers such as medicare. It only makes sense that Tricare follows the rest of the federal government and acknowledges the service these individuals can provide and compensates them.

      Posted by Andy Tatom PT on 12/27/2018 2:34 PM

    • I'd like to thank the folks at APTA that helped get this overdue change to the law enacted. After reading the proposed rule, it appears the proposal from DoD is good and bad. It's good in that PTA's will finally be allowed by law to treat Tricare patients, just like they can treat Medicare patients. It's bad in that the Tricare reimbursement for PTA services may be tied to the same reduced rate Medicare is proposing for PTAs (85%). Read the proposal and look for this language: "The DHA intends, in implementing instructions, to follow Medicare's requirements as found within Medicare's Benefit Policy Chapter 15.6 Part C and other issuances regarding reimbursement of services provided by PTAs."

      Posted by Joe Speckhart on 12/27/2018 6:27 PM

    • I have been a licensed PT for over 25 years & could not imagine performing my job without the support of PTA's. They are licensed professionals that are qualified to treat the patients we evaluate. Not passing this proposed rule will only serve to harm our profession and the patients we serve by encouraging the use of on-the- job trained technicians that are not educated nor qualified to perform at the same skill level as a licensed PTA.

      Posted by Dianna Parr, PT on 12/27/2018 8:09 PM

    • I have been a PTA for over 37 years, have completesd hundreds of hours of continuing education, have been active in my professional organization, mentored fellow staff new-grad PTs and have acted as a CI for PTA students. I feel myself, as many other PTAs, can bring such a wonderful perspective towards patient care, that it would be a great loss towards the goal of giving the best patient care possible to the patient with Tricare insurance if PTAs were not included as physical therapy care providers as soon as possible!

      Posted by Lisa Ferrin, PTA on 12/28/2018 12:52 AM

    • As a former PTA program director, this issue has been recognized as very frustrating for PTA grads. FINALLY showing actual progress to have PTA treatments reimbursed with TriCare patients!! PTAs are certainly capable of delivering care delegated to them by the Supervising PT. !!! I look forward to seeing full implementation of this .....

      Posted by Laura Warren, PT on 12/28/2018 11:17 AM

    • PTA's are skilled licensed professionals, period! They provide excellent patient care and can do documentation. PTA's are a valuable asset in patient care.

      Posted by Jeff Reeves on 12/28/2018 11:19 AM

    • I support this!

      Posted by Rachel Andersen on 12/31/2018 10:05 AM

    • The physical therapy profession as a whole provides a service to individuals promoting health, wellness, and a conservative approach to injury recovery. PTA's in the state of Arizona are poorly represented, supported, and promoted as a whole; Tri-care reimbursement for skilled services provided by talented and certified PTA's is well overdue; however it is positive to see the proposal moving forward.

      Posted by Denise Winters on 1/2/2019 10:11 AM

    • I find all of this interesting considering that when patients go to the VA for therapy, they only see a PT at initial eval and from second visit on, they receive their care from a LPTA. LPTA are licensed professionals whose sole purpose is to provide the best possible care to our patients. By allowing LPTAs to care for Tricare recipients, we will be giving the patients the care and attention they need and deserve rather than having to adjust a busy schedule and potentially have to shorten treatment time with another patient to accommodate the PT only rule with Tricare.

      Posted by Elizabeth Singleton on 1/8/2019 10:55 AM

    • I have been a PTA for 34 years. At 15 years I moved from Washington state to Oregon state I had to take the state board as the PT's had to take to be licensed. The PT's have 5 sections and PTA's 4 sections and both have 200 plus multiple choice questions. I have to maintain the same amount of CEU's every 2 years as the PT's do and those courses are the same courses that the PT's take. That law was changed this year and PTA's only have to get 26 CEU's I believe. From what I understand they are trying to make the PTA program a bachelors degree. I love what I do and take pride in being a PTA. This law affects the care of the patients and it definetly affects my role as a PTA. I also am concerned about the medicare law that is supposed to take affect in 2021 where PTA's are only going to be reimbursed by only 85%. What is going to happen to the PTA. I know for myself why should I go spend $20,000 plus dollars to get my bachelors if they are just taking away our ability to do our jobs. Who is going to want to higher PTA's if they are't going to get full reimbursment. With 34 years behind me there are a lot of skills I have developed which allows me to mentor the PT's. I appreciate what the APTA is doing for our profession. This bill needs to pass.

      Posted by Debra Cole, LPTA on 1/30/2019 11:49 AM

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