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  • Required Rehabilitation Benefits Under Threat: Time to Make PT Voices Heard

    The US Department of Health and Human Services (HHS) is pushing for changes that would allow states to dramatically alter the way essential health benefits (EHBs) are managed, opening up the possibility for consumer confusion, market disruption, and reductions in patient access to services including rehabilitation.

    APTA says it's time to push back.

    Now available on the APTA website: a template letter that makes it easy for physical therapists and physical therapist assistants to let HHS and the US Centers for Medicare and Medicaid Services (CMS) know how the EHB proposal will harm both patients and physical therapy practices. The letter allows sender to personalize contents to reflect their individual circumstances and practice settings, but ensures that the overarching message is consistent—that the proposed changes "are likely to have a detrimental impact on not only my practice, but also patients' ability to access medically necessary care."

    The HHS proposal would allow states to alter the minimum requirements for health insurance policies offered through a state's insurance exchange. Although states still would be required to only accept plans that included all 10 EHBs—rehabilitation among them—they could mix and match elements from other states when establishing the baseline for allowable plans, potentially shrinking coverage. Adding to the uncertainty, states would be permitted to reconfigure their so-called "benchmark plans" every year.

    Additionally, the proposal would lower the bar for benchmark plans overall, stipulating that they need be only slightly better than the skimpiest allowable employer-sponsored or self-insured group plan. More details are available in a PT in Motion News story on the proposal, as well as a notice from HHS.

    For more information on the effort to oppose the EHB proposal, contact APTA staff at advocacy@apta.org. Deadline for comments is November 27.