Kudos to PT Advocate Achievement in 2018!

Reflecting back on 2018 and the numerous achievements accomplished this year. A permanent fix to the Medicare therapy cap was achieved after 20 years of temporary exceptions and implementation delays. Other important legislative and regulatory achievements, included enactment of comprehensive opioid legislation that increases awareness and access to nonpharmacological treatment options, enactment of the Sports Medicine Licensure Clarity Act to ensure physical therapists have liability insurance when working with teams across state lines, the elimination of functional limitation reporting, and the expansion of telehealth services in the Veterans Administration and Medicare Advantage. The Physical Therapy Interstate Licensure Compact continued to make progress, with the first licensure privilege being issued and compact legislation enacted in 21 states. These wins help advance the profession of physical therapy. Please join the effort to move physical therapy forward with the start of the 116th US Congress this January and become a grassroots advocate.  The 2019 Federal Advocacy Forum will take place Sunday, March 31-Tuesday, April 2 at the JW Marriott near the White House in Washington, DC. Registration and housing will open January 2019 and end March 18, 2019.

APTA’s PT-PAC continues to be a force for people seeking federal offices; roughly 91% of the candidates (challengers, incumbents, and newcomers) who we believe will help push the physical therapy profession forward won their races. However, the 116th Congress will have dozens of new faces and new committee chairs, which will continue to require hours of relationship building. Time with new and returning members of Congress will be needed in the early days of 2019. Please consider donating to PT-PAC, so that we can do the work necessary to ensure physical therapy remains at the forefront of health care discussions on the Hill.

The 115th Congress is set to adjourn at the end of December. Here is a summary of legislation of interest to the profession that likely will be reintroduced in 2019.

Medicare Telehealth Parity Act (H.R. 2550)

• Legislation would expand the list of health care providers who are eligible to provide telehealth services to include physical therapists, certified diabetes educators, respiratory therapists, occupational therapists, speech language pathologists, and audiologists.
• Bill was introduced by Reps Mike Thompson (D-CA), Gregg Harper (R-MS), Diane Black (R-TN), and Peter Welch (D-VT).
• Bill was referred to the Energy and Commerce (E&C) and Ways and Means (W&M) committees.
• As of November 14, 2018, H.R. 2550 had 26 cosponsors.
• APTA will continue to work with the sponsors of this legislation and the CONNECT for Health Act (H.R. 2556, S. 1016) to come up with a bill that is more inclusive to physical therapists and more feasible in terms of cost and, therefore, more likely to see progress in the next Congress.

CONNECT for Health Act (H.R. 2556/S. 1016)

• Legislation would expand the use of telehealth services under the Medicare program. Specifically, it would allow PTs to furnish telehealth services to individuals enrolled in Medicare Advantage Plans (MA plans) and include PTs involved in alternative payment models.
• H.R. 2556 was introduced by Reps Diane Black (R-TN), Mike Thompson (D-CA), Peter Welch (D-VT), Gregg Harper (R-MS), Bill Johnson (R-OH), and Doris Matsui; and S. 1016 was introduced by Sens Brian Schatz (D-HI), Roger Wicker (R-MS), Thad Cochran (R-MS), Ben Cardin (D-MD), John Thune (R-SD), and Mark Warner (D-VA).
• As of November 14, 2018, H.R. 2556 had 49 cosponsors and S. 1016 had 26 cosponsors.
• APTA will continue to work with members of Congress to advance this legislation.

Physical Therapist Workforce and Patient Access Act (H.R. 1639/S. 619)

• Legislation would authorize physical therapists to participate in the National Health Service Corps Loan Repayment Program. This legislation would provide greater access to physical therapist services in rural and underserved areas and help meet the growing demand for physical therapists in the future.
• Bill was introduced by Reps John Shimkus (R-IL) and Diane DeGette (D-CO), and Sens Jon Tester (D-MT) and Roger Wicker (R-MS).
• Bill was referred to the E&C Subcommittee on Health, and to the Senate Health, Education, Labor, and Pensions (HELP) Committee.
• As of November 14, 2018, H.R. 1639 had 49 cosponsors, and S. 619 had 2 cosponsors.

Lymphedema Treatment Act (H.R. 930/S. 497)

• Legislation would ensure the provision of improved Medicare coverage for compression supplies, including compression garments, bandaging systems, and other devices necessary for lymphedema treatment. Currently, Medicare beneficiaries lack this coverage.
• Bill was introduced by Reps David Reichert (R-WA), Earl Blumenauer (D-OR), Leonard Lance (R-NJ), and Janice Schakowsky (D-IL); and Sens Maria Cantwell (D-WA), Chuck Grassley (R-IA), and Chuck Schumer (D-NY).
• On June 8, 2016, Rep Reichert delivered testimony on the importance of H.R. 1608 (bill in last Congress) during a W&M Health Subcommittee hearing.
• As of November 14, 2018, H.R. 930 had 381 cosponsors, and S. 497 had 65 cosponsors.

Promoting Integrity in Medicare Act (H.R. 2066)

• Legislation would eliminate physical therapy and other services from the in-office ancillary services (IOAS) exception under the Stark laws.
• Bill was introduced by Rep Jackie Speier (D-CA).
• Bill was referred to the E&C and W&M committees. Ideally, this legislation will move with a larger piece of legislation that needs monetary offsets. The Congressional Budget Office estimates that this change could save over $3 billion.
• H.R. 2066 was introduced on April 6, 2017. As of November 14, 2018, it has 2 cosponsors.

Ensuring Access to Quality Complex Rehabilitation Technology Act (H.R. 750)

• Legislation would establish a separate benefit category under the Medicare Part B program for complex rehabilitation technology.
• Bill was introduced by Reps Jim Sensenbrenner (R-WI) and Joseph Crowley (D-NY).
• Bill was referred to the E&C and W&M committees.
• As of November 14, 2018, H.R. 750 had 116 cosponsors.

Improving Access to Medicare Coverage Act (H.R. 1421/S. 568)

• Legislation would require all days spent in a hospital, whether inpatient or on “observation status,” to count toward the 3-day requirement for a patient to qualify for Medicare coverage of a skilled nursing facility stay after being discharged from the hospital.
• Bill was introduced by Reps Joe Courtney (D-CT) and Glenn Thompson (R-PA); and Sens Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL), and Shelley Moore Capito (R-WV).
• Bill was referred to the E&C and W&M committees and the Senate Finance Committee.
• As of November 14, 2018, H.R. 1421 had 93 cosponsors, and S. 568 had 21 cosponsors.

Save Rural Hospitals Act (H.R. 2957)

• Legislation would stabilize rural hospitals by providing regulatory relief, stopping Medicare cuts that are causing closures, and create innovative delivery models that will ensure emergency access to care for rural patients.
• Bill was introduced by Rep Same Graves (R-MO).
• Bill was referred to the E&C and W&M committees.
• As of November 14, 2018, H.R. 2957 had 24 cosponsors.

Medicare Patient Empowerment Act of 2017 (H.R.4133)

• Legislation would permit physical therapists to privately contract with Medicare beneficiaries.
• Bill was introduced by Rep Pete Sessions (R-TX).
• Bill was referred to the E&C and W&M committees.
• As of November 14, 2018, H.R. 4133 had 5 cosponsors.

Local Coverage Determination Clarification Act of 2017 (H.R. 3635)

• Legislation would: o Require open and public MAC meetings that are on the record,
• Require disclosure by MACs of the rationale for an LCD and the evidence for that decision at the beginning of the LCD process
• Provide a meaningful reconsideration process for an LCD.
• Bill was introduced by Reps Lynn Jenkins (R-KS) and Ron Kind (D-WI) and is the companion bill to S. 794.
• The bill passed the House on September 12, 2018.

HEADS Up Act (H.R. 6611)

• Legislation would designate people with Intellectual and Developmental Disabilities as a Medically Underserved Population under the Health Services and Resources Administration.
• Bill was introduced by Rep Seth Moulton (D-MA).
• Bill was referred to the E&C committee.
• As of November 14, H.R. 6611 had 6 cosponsors.