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An APTA-supported bill that would make supervision requirements for PTAs more uniform across settings is back on the table on Capitol Hill. On the face of it, the legislation is a common sense idea: move the supervision of PTAs in private physical therapy practices under Medicare Part B from "direct" to "general" supervision. But APTA and other organizations believe the change could produce significant ripple effects that would be a win for providers, patients, and payers: reduced administrative burden for PTs and PTAs, increased access to needed care in rural and underserved areas, and Medicare cost savings of up to $271 million over 10 years.

The legislation, known as the Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation, or EMPOWER Act, (S. 2459, H.R. 4878), also applies to occupational therapy assistants, would bring private practice settings in line with supervision requirements in every other setting under Medicare. The bill was introduced in the Senate by Sens. Tom Carper, D-Del., and John Barrasso, R-Wyo, with a companion bill introduced in the U.S. House of Representatives by Reps. Debbie Lesko, R-Ariz. And Ann Kuster, D-N.H

Beyond the reduced administrative burden and increased patient access to care, the law could result in an additional benefit: Medicare cost savings of as much as $271 million over 10 years, according to results of an independent non-partisan study commissioned by APTA, APTA Private Practice, and other health care groups. The savings would be achieved through an anticipated increase in the use of PTAs and OTAs, particularly in rural and underserved areas, where beneficiaries are already 50% more likely to receive therapy from a PTA or OTA than patients in more populous or well-served areas.

"By reducing unnecessary administrative burdens, physical and occupational therapy assistants will be able to help patients get the services they need, right when they need it," Carper said in a press release on the bill.

Barrasso added, "As an orthopedic surgeon, I've seen firsthand the importance of therapy services for my patients. Our bill makes it easier for patients in Wyoming to access physical and occupational therapy."

Justin Elliott, vice president of government affairs for APTA, thinks the case for change in supervision has always been a solid one but has grown even stronger since last year, when an earlier version of the EMPOWER legislation was introduced.

"As we emerge from a years-long pandemic, our health care workforce is in crisis as it responds to a resurgent opioid crisis, increasing administrative burden, and the need for increased patient access to care," Elliott said. "It's now more apparent than ever that PTAs in private practice play a crucial role in meeting these challenges, and that unnecessary and inconsistent administrative burdens shouldn't stand in the way. APTA applauds the efforts of Senators Carper and Barrasso as well Representatives Lesko and Kuster in their support of increased patient access at this crucial time."

In an APTA press release, APTA President Roger Herr, PT, MPA said "The EMPOWER Act will help our health care system lower costs, reduce administrative burdens, and provide helpful flexibilities for physical therapists in small businesses. Changing the supervision requirement allows physical therapist assistants to practice at the top of their license, recognizing the valuable role they play in the health care system and providing critical support to therapy clinics."

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