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As much as you might hear about gridlock on Capitol Hill these days, the 117th U.S. Congress has taken action on a number of pieces of legislation relevant to physical therapy — with more in the works.

We know how hard it can be to keep up. So here's an overview of what's happening — the APTA-supported legislation that's been enacted and bills under consideration.

(Want to keep up in the future? That's easy, too: Sign up for the APTA Advocacy Network, a free member benefit that puts you on the fast-track to the latest legislative information and calls to action.)

APTA-Supported Legislation Signed Into Law

Dr. Lorna Breen Health Care Providers Protection Act
Signed into law in March, the Breen Act aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among health care professionals. The law helps promote mental and behavioral health among those working on the frontlines of the pandemic, supports suicide and burnout prevention training in health care professional training programs, and increases awareness and education about suicide and mental health among health care professionals.

Consolidated Appropriations Act of 2022
This appropriations package extends the Medicare telehealth waiver for PTs and PTAs for 151 days after the coronavirus-related public health emergency ends.

Protecting Medicare and American Farmers From Sequester Cuts Act
This was the legislation that successfully blunted payment reductions included in the 2022 Medicare Physician Fee Schedule. (Note: Those proposed cuts have returned in the proposed 2023 fee schedule rule, but bipartisan legislation has been introduced in the House that would appropriate additional funding to once again offset the cuts (see H.R. 8800 below)

APTA-Supported Legislation in Process

Supporting Medicare Providers Act of 2022 (H.R. 8800)
This very recent legislation would counteract proposed payment cuts to the Medicare Physician Fee Schedule by adding additional funding to the fee schedule's conversion factor through the end of 2023, theoretically returning that factor to its current level. The bill also contains language that acknowledges the need to address the long-term stability of the payment system.
Status: Introduced in the House

Advancing Telehealth Beyond COVID-19 Act (H.R. 4040)
This bill would extend the Medicare telehealth waivers for PTs and PTAs until Dec. 31, 2024, regardless of the status of the public health emergency. That's good news for patients and providers, of course, but it's also a boost for telehealth supporters such as APTA, because it provides even more time to collect data on the use of telehealth and give policymakers more time to craft something permanent.
Status: Passed House; awaiting Senate vote

Lymphedema Treatment Act (H.R. 3630/S. 1315)
This bill, which would expand Medicare coverage of compression treatment items for beneficiaries with lymphedema, has passed out of the House Energy and Commerce Committee and is being readied for a full House vote. The House version has 356 co-sponsors; a companion Senate bill has 73 co-sponsors. You can check on the progress of the legislation at the Lymphedema Treatment Act website.
Status: Passed out of House Energy & Commerce Committee; awaiting House vote

PREVENT Pandemics Act (S. 3799)
This sweeping legislation is intended to modernize the country’s pandemic response by increasing federal and state preparedness, improving epidemiologic data collection, accelerating research and development, and improving the medical supply chain. The bill also focuses on supporting and improving the health care provider workforce and addressing health disparities. Two additional APTA-supported pieces of legislation are folded into the PREVENT Act: the Improving Social Determinants of Health Act (H.R. 379/S. 104) and the Allied Health Workforce Diversity Act (H.R. 3320/S. 3018). The social determinants legislation would, among other things, authorize a grant program to support projects to reduce health disparities and improve health outcomes by increasing community-based capacity to address social determinants of health. The workforce diversity bill would empower the Secretary of the Department of Health and Human Services to offer grants and contracts to education programs that would in turn provide scholarships to increase the diversity of student population in health care training, including physical therapy.
Status: Passed out of Senate Health, Education, Labor, and Pensions Committee

Improving Seniors' Timely Access to Care Act (H.R. 3173/S. 3018)
This legislation would reduce administrative burden by scaling back the use of prior approval in Medicare Advantage plans. While it doesn't eliminate prior authorization, the bill would require MA plans to make regular reports to the U.S. Centers for Medicare & Medicaid Services on use of prior authorization, rates of denials, and average time for approval. The legislation also would direct HHS to establish a process for "real-time decisions" for services that are routinely approved, and mandate that MA plans engage in more consultation with stakeholders and professional organizations around approval guidelines that are evidence-based.
Status: Passed House; awaiting consideration by Senate

2023 Appropriations for Veterans Administration
This large spending bill directs the VA to do what needs to be done to improve patient access to physical therapist services in the VA health care system, including increasing pay, expanding the roles of PTs and PTAs in a range of settings including primary care, and allowing PTs to qualify for a special scholarship program.
Status: Passed House; awaiting consideration by Senate

The Medicare Patient Empowerment Act (H.R. 3322/S. 826)
This bill allows a Medicare beneficiary to enter into a direct contract with an eligible provider, including physical therapists, for any item or service covered by Medicare, otherwise known as "opting out" of Medicare. If enacted, the legislation would introduce more flexibility into opt-out provisions, including dropping the requirement for a two-year opt-out commitment and allowing providers to serve all other Medicare beneficiaries.
Status: Referred to House Energy & Commerce Committee and House Ways & Means Committee; referred to Senate Finance Committee.

Physical Therapist Workforce and Patient Access Act (H.R. 3759/S. 2676)
This bill would allow PTs to participate in the National Health Service Corps loan repayment program, an initiative that repays up to $50,000 in outstanding student loans to certain health care professionals who agree to work for at least two years in a designated Health Professional Shortage Area. The legislation was the target of the APTA Flash Action Strategy student-led advocacy initiative.
Status: Referred to House Energy & Commerce Committee; referred to Senate HELP Committee

Expanded Telehealth Access Act (H.R. 2168/S. 3193)
This bill instructs CMS to permanently adopt what is a now a temporary waiver of restrictions on Medicare payment for telehealth delivered by PTs and PTAs, occupational therapists, occupational therapy assistants, speech-language pathologists, and audiologists. The HHS Secretary also would be allowed to further expand the list of authorized telehealth providers.
Status: Referred to House Energy & Commerce Committee; referred to Senate Finance Committee

Prevent Interruptions in Physical Therapy Act (H.R. 1611/S. 2612)
This bill expands the ability of PTs to engage in what CMS is now calling "reciprocal billing and fee-for-service," otherwise known as "locum tenens," to all PTs. Currently, only PTs in rural and underserved areas are allowed to arrange for another qualified PT to treat their patients during a temporary absence due to illness, vacation, continuing education, pregnancy, and other events, and still receive payment from Medicare.
Status: Referred to House Energy & Commerce Committee; referred to Senate Finance Committee

Stabilizing Medicare Access to Rehabilitation and Therapy Act (H.R. 5536)
Also known as the SMART Act, this bill seeks to address elements of a pay differential system that cuts payment under Medicare by 15% when services are delivered by physical therapist assistants or occupational therapy assistants. Among the APTA-supported elements in the legislation: establishment of an exemption to the differential for rural and underserved areas, and adoption of less-burdensome general PTA and OTA supervision requirements for outpatient therapy under Medicare Part B. The change in supervision requirements is estimated to save CMS as much as $242 million over 10 years, according to a recent policy study co-sponsored by APTA.
Status: Referred to House Energy & Commerce Committee

Primary Health Service Enhancement Act (H.R. 5365)
This bill would expand patient access to essential physical therapist services to children and adults who receive care at rural health clinics and federally qualified health centers, also known as community health centers. The legislation elevates the status of PTs in the health centers by, among other measures, allowing them to bill independently for services billed to Medicare and Medicaid.
Status: Referred to House Energy & Commerce Committee

Optimizing Postpartum Outcomes Act (H.R. 8181)
This bill directs the HHS Secretary to develop several provisions that would significantly strengthen Medicaid's emphasis on pelvic care for individuals in the postpartum period. The legislation includes pelvic floor physical therapy among the pelvic floor services that would be covered under Medicaid and the Children's Health Insurance Program. The bill also instructs CMS to develop and issue guidance on best practices, financing options, screenings, referrals, and access, as well as terminology and diagnostic codes. Additionally, if the law passes, HHS would be required to educate and train health professionals and postpartum individuals on the importance of pelvic health and pelvic health physical therapy.
Status: Referred to House Energy & Commerce Committee

Preserving Access to Home Health Act (H.R. 8581/S.4605).  
This bipartisan legislation would provide stability for home health patients by preventing CMS' proposed 7.69% payment cut to home health services in 2023 and prevent the agency from implementing any permanent or temporary adjustment to home health prospective payment rates before 2026. This would allow more time for CMS to refine its approach to managing budget neutrality in home health.
Status: Referred to House Ways & Means Committee and House Energy & Commerce Committee; referred to Senate Finance Committee


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