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A dozen organizations including APTA have joined together to press Congress to take action on the 15% payment cuts rolled out this year for services delivered by PTAs and occupational therapy assistants under Medicare. In a letter to congressional leaders, the groups write that "there could not be a worse time than now" to carry out the payment differential, and they urge support for a bill that would mitigate some of the most damaging parts of the differential system.

The letter, signed by groups including the American Occupational Therapy Association, the Brain Injury Association of America, United Cerebral Palsy, and the National Association for Rehabilitation Providers and Agencies, calls for lawmakers to include the Stabilizing Medicare Access to Rehabilitation and Therapy Act, or SMART Act (H.R. 5536), as part of any upcoming must-pass continuing resolution or omnibus package to keep the federal government operating.

The SMART Act, sponsored by Rep. Bobby Rush, D-Ill., and Jason Smith, R-Mo., continues to be the focus of APTA grassroots efforts, with the association calling on members and supporters to contact legislators to support the bipartisan bill. (Visit the APTA Patient Action Center to send a message to your legislators, and sign up for the APTA Advocacy Network, a free service that sends you special legislative updates and action alerts.)

As of the publication date of this article, the U.S. House of Representatives passed a continuing resolution without the SMART Act included, but it only funds the government through March 11. That means even if the House-approved resolution passes in the Senate, a new one will need to be hammered out in the coming weeks. Additionally, lawmakers could pass omnibus legislation that would address multiple issues. Either action could include the SMART Act provisions.

The SMART Act doesn’t completely eliminate the differential system, which the U.S. Centers for Medicare & Medicaid Services argues is required by law, but it does delay implementation for a year and blunt some of its effects. Among provisions of the SMART Act supported by APTA, in addition to the one year delay: 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 .

"Given staffing shortages and recruitment difficulties facing rehabilitation therapy providers as a result of the pandemic, there could not be a worse time than now to cut payments for services provided by occupational therapy assistants and physical therapist assistants," the letter states. "These professionals are a crucial part of the therapy workforce and ensuring that beneficiaries have access to therapy services."


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