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APTA, the American Occupational Therapy Association, the National Association for the Support of Long-Term Care, and the National Association of Rehabilitation Providers have collaborated to bring a unified message to Congress about the PTA payment differential included in the proposed 2022 Medicare Physician Fee Schedule. That message, in the form of a sign-on letter to legislative leaders, calls on Congress to step in soon to counter the effects of a system that puts patient access to needed care at serious risk.

Not Now, Not This Way

The Aug. 2 letter from APTA, AOTA, NARA, and NASL characterizes the proposed PTA differential system as rushed and flawed, and asks Congress to require at least a one-year delay in implementation to allow for needed fixes.

"The rehabilitation therapy sector is still recovering from the devastating impact of COVID-19 on patients and staff as we continue to provide services during the public health emergency,” the letter states. "To protect access to care, we request that Congress take action to mitigate the impact of these cuts."

APTA and its coalition partners argue that the system as currently designed unfairly impacts providers in rural and underserved areas of the country, threatening patient access to care that's already hard to find. While the differential system itself is baked into a 2018 federal law, the organizations believe much more can be done to soften the impact of the change.

Specifically, the letter requests that Congress require a delay of at least one year before the differential is imposed (coding requirements are already in place, but changes to payment aren't supposed to be rolled out until 2022). The organizations hope that the delay will give CMS and stakeholders time to develop mitigation strategies — namely, an exemption to the differential in rural and underserved areas.

The letter also calls for Congress to direct CMS to loosen its requirements that PTAs working for private practices must receive direct supervision; instead allowing for general supervision as is the case in all other settings.

"The pending Medicare payment differential for therapy services furnished by an assistant compounds other recent significant payment reductions to therapy services under the fee schedule," the letter states, referring to the proposed conversion factor reductions. "These multiple cuts are being implemented at the same time practices and facilities are trying to recover from the effects of the pandemic, and — along with the current 50% MPPR reduction policy and anticipated return of the 2% Medicare sequestration — are simply not sustainable for therapy services."

Part of a Larger Strategy

The letter is just one of the more recent and visible elements of what APTA Vice President of Government Affairs Justin Elliott describes as a multifaceted advocacy effort to take on two important issues — the differential and a proposed PT payment cut — on two important fronts.

"We are in full swing with our grassroots push to get members, patients, and other stakeholders to contact CMS to directly address the many problems in the proposed physician fee schedule, and we make that as easy to do as possible," Elliott said. "But we also realize that Congress most likely has a crucial role to play in these two major issues, so it's imperative that we educate lawmakers now on the need for the changes we describe. The next few months will be critical."

In July, the association joined more than 100 other professional and health care organizations in a letter to Congress requesting action to address the proposed Medicare payment cut to physical therapy and some three dozen other professions.

What You Can Do (Takes Two Minutes)

APTA offers easy ways to make your voice heard.

Send Your Comments to CMS About the PTA Differential Using the APTA Template

Ask Congress To Fight the Cuts

Learn more: Visit the APTA Medicare Payment Differential advocacy page.

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