In what feels like an increasingly rare moment of clarity on Capitol Hill, lawmakers could be moving toward a simple solution that would relieve a nagging administrative burden faced by PTs treating Medicare Part B beneficiaries: being held responsible for chasing down signatures from referring physicians for PT plans of care within 30 days.
The APTA-backed Reduce Duplicative Unnecessary Clerical Exchanges, or REDUCE, Act focuses on a Medicare provision around plans of care developed by PTs for beneficiaries who receive a physician order for physical therapy. Currently, PTs are required to send their plans to the referring physician, who has 30 days to sign off on the physical therapist services that they ordered in the first place. If the deadline is approaching and the physician still hasn't returned the signed plan of care, the rules say it's up to the PT to obtain that signature; without it, the PT is faced with the prospect of not getting paid by Medicare, and patients can experience interruptions in care.
The REDUCE Act would change that requirement. Instead, when outpatient therapy services are provided under a physician's order, the plan of care certification requirement will be considered fulfilled if the PT simply submits the plan of care to the referring provider — no more tracking down signatures while the clock is ticking. The change would apply only to plans developed for patients who have been referred to a physical therapist.
The bill, introduced by Reps. Don Davis, D-N.C., and Lloyd Smucker, R-Penn., is a key element of Medicare Physician Fee Schedule reform policy principles that APTA released in June 2023 in collaboration with APTA Private Practice, the American Occupational Therapy Association, and the American Speech-Language-Hearing Association.
"Physical therapist practices are currently facing many challenges under Medicare, from unsustainable cuts to workforce shortages," said APTA President Roger Herr, PT, MPA, in an APTA press release. "Dealing with unnecessary red tape just adds to those challenges and gets in the way of care. This legislation helps reduce obstacles. "
APTA Private Practice President Mike Horsfield, PT, MBA, characterizes the legislation as an effort to enhance care.
"Our members are in the business of caring for their communities," Horsfield said. "The REDUCE Act will allow our members to spend more time with their patients rather than tracking down unnecessary paperwork."