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APTA's advocacy for the profession never stops. The always-moving nature of the association's work is all about scanning the current environment and looking ahead, which means there usually isn't much time to savor the wins.

But sometimes, looking back is a good way to appreciate where we're headed.

With a new set of public policy priorities created for the 118th Congress serving as an advocacy road map, APTA continues not only to be at the table for important payment and policy discussions in Washington, but to have an influential role in how those discussions play out. Following is a quick list of just some of the gains APTA has helped to secure for the profession. Think of it as a way to prep for our upcoming live webinar on the latest regulatory, legislative, and payment news, set for June 22 at 2 p.m. ET.


APTA-Backed Legislation Now in Congress

Several promising bills have been introduced in the U.S. House of Representatives or the Senate (or both), most of which incorporate APTA's input. And there may be more to come, so stay tuned.

Strengthening Medicare for Patients and Providers Act (H.R. 2474). Ties the conversion factor used to calculate payment under the Medicare Physician Fee Schedule to the Medicare Economic Index. This seemingly technical change could have a big impact: Because the economic index accounts for inflation, it could pave the way for providers, including PTs,to gain ground in a system that has reduced payment year over year through coding changes and the U.S. Centers for Medicare & Medicaid Services' budget neutrality requirements.

Expanded Telehealth Access Act (H.R. 3875). Makes telehealth permanent for PTs and PTAs under Medicare, and allows the Secretary of Health and Human Services to further expand the list of authorized telehealth providers.

Prevent Interruptions in Physical Therapy Act (H.R. 1617/S.793). Expands the ability of PTs to bring in another licensed PT to treat Medicare patients during temporary absences. That ability, known as locum tenens, is currently limited to PTs in rural or underserved areas of the country.

Optimizing Postpartum Outcomes Act (H.R. 2480). Directs the HHS Secretary to develop several provisions that would significantly strengthen Medicaid's emphasis on pelvic care for mothers in the postpartum period, and includes pelvic floor physical therapy among the services that would be covered under Medicaid and the Children's Health Insurance Program.

SHARE Act (H.R. 1310). Addresses issues related to required FBI background checks to participate in interstate licensure compacts, such as the PT and PTA compact system used by many states. The legislation would help to ease difficulties some states are experiencing in obtaining the background checks.

Pro tip: You can join advocacy efforts toward the legislation listed above by visiting the APTA Patient Action Center — it only takes a few minutes to make your voice heard.

CMS, Commercial Payer, and Education Wins

Capitol Hill isn't the only place APTA is moving the needle. Thanks to the association's strong relationship-building efforts and engaged members, we're also impacting decisions made by CMS, commercial payers, and the U.S. Department of Education.

A CMS Reversal on Telehealth
After initially saying only PTs and PTAs in private practices would be allow to continue to provide services via telehealth after the end of the public health emergency, CMS ultimately extended the waivers to PTs and PTAs in all settings. The turnaround was largely the result of a strong advocacy effort by APTA, the American Speech-Language-Hearing Association, and the American Occupational Therapy Association.

Prior Authorization Reform in Medicare Advantage
In its final rule, CMS responded to advocacy from APTA and other groups by putting up better guardrails around the use of burdensome prior authorization in Medicare Advantage. The new rule limits the application of prior authorization, provides assurances that a prior authorization approval remains valid as long as medically necessary, and makes accommodations for patients in transition from one MA plan to another.

Aetna Suspends Prior Authorization in Five States
Providers in Delaware, New Jersey, New York, Pennsylvania, and West Virginia who participate in Aetna are no longer required to obtain precertification for physical medicine services.

Expanded Access to Power Seat Equipment Under Medicare
In a national coverage determination issued in May, CMS adopted provisions recommended by APTA and other groups that expanded its plans to extend coverage for power seat elevation equipment on Group 3 wheelchairs. In the end, CMS went beyond what APTA advocated, allowing durable medical equipment contractors under Medicare to provide elevation device coverage for beneficiaries outside of those groups. That discretion is even extended to include Group 5 wheelchairs, for more specialized populations.

A New Grant Program to Support PTs and PTAs Who Will Work With Children Who Have Disabilities
APTA's ongoing relationship with the U.S. Department of Education made it possible for DOE to launch a grants program available to historically Black colleges and universities, American Indian tribally controlled colleges and universities, and minority-serving institutions to enhance education around working with children with disabilities. Additional grants, available to all higher education institutions, are targeted at increasing the number of service-related personnel in the workforce, and to prepare personnel for leadership roles.

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