A potential win for patient access to care is once again in the works: Bipartisan legislation introduced in the U.S. House and Senate proposes to expand 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.
The legislation, known in both the House and Senate as the Prevent Interruptions in Physical Therapy Act (H.R 1617, S. 793) seeks to expand engagement in what the U.S. Centers for Medcare & Medicaid Services calls "reciprocal billing and fee-for-service" to all PTs. The bill was introduced in the House by Reps. Gus Bilirakis, R-Fla., and Paul Tonko, D-N.Y. The Senate version of the bill was introduced by Sens. Ben Ray Luján, D-N.M., and John Thune, R-S.D.
Locum tenens provisions allow a PT to arrange for another qualified PT to treat the PT's patients during a temporary absence due to illness, vacation, continuing education, pregnancy, and other events, and still receive payment from Medicare. APTA has been a leading advocate for expansion of that ability to all PTs to better support patient access to care.
The limited locum tenens allowances for PTs have been in place since 2017, and this isn't the first attempt to expand the provisions: A similar bill was introduced in the House in 2021 but never made it to a vote. Michael Matlack, APTA's director of grassroots and political affairs, says that the wait for expansion has only strengthened the profession's case.
"Over the years locum tenens has been in place for a limited number of PTs, and data showing how well the program is working has grown," Matlack said. "Expansion made sense when it was proposed in 2021, but the argument is even more compelling today as the entire health care system deals with lingering challenges brought about by the pandemic and the ongoing opioid crisis. Giving PTs another tool that can help businesses stay open while saving health care dollars is a win-win."
Bilirakis believes the time has come for change.
"In recent years, we've seen countless examples of how important it is for our healthcare providers to have greater flexibility to meet patient needs," he said in a press release. "Physical therapy is a vital component of our healthcare system, and these providers must also have the flexibility to ensure access to quality care. This legislation will enable them to better achieve that goal."
The legislation is in step with APTA's Public Policy Priorities, 2023-2024, which makes eliminating barriers to patient access to care a pillar of its advocacy efforts on Capitol Hill and with policymakers. APTA members can urge passage of legislation by visiting the APTA Legislative Action Center. The association's Patient Action Center is also available to members as well as patients and other supporters.
"Consistent care by a physical therapist is essential to a patient's clinical outcome and should be available to everyone," said APTA President Roger Herr, PT, MPA. "The Prevent Interruptions in Physical Therapy Act opens important opportunities for treatment by providing physical therapists support and flexibility to ensure that patient care is not interrupted no matter where a patient lives."
APTA national and APTA Private Practice worked together to promote reintroduction of the locum tenens expansion, which APTA Private Practice President Mike Horsfield, PT, MBA, sees as a change that will be felt by patients.
"Occasionally, a physical therapist must be away from their outpatient clinic for short periods of time for medical, professional, or family reasons. When this happens, they need to be able to bring in a licensed and qualified physical therapist to ensure their patients' care can continue without interruption," Horsfield said. "APTA Private Practice thanks Senator Luján and Representative Bilirakis for reintroducing this impactful, bipartisan legislation to ensure that all seniors can retain continued access to highly skilled care by a qualified physical therapist while also protecting the livelihood of private practice physical therapists."
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