Two provisions of the PPS-endorsed CONNECT for Health Act (H.R.2556/S.1016) became law after they were included in the February 9th government funding bill. The first provision allows the use of telehealth to assess a patient for stroke regardless of the patient’s geographic location (also known as the Furthering Access to Stroke Telemedicine or “FAST” Act). The second provision allows Medicare Advantage (MA) plans to expand their basic benefit coverage to include reimbursement for telehealth services. However, before MA plans can start offering telehealth as a basic benefit at comparable rates to in-person services beginning in 2020, CMS must solicit comments from stakeholders in order to determine what types of care and which services should be considered eligible for telehealth coverage.
Advocacy Opportunity 1:
PPS intends to submit comments to CMS in support of including physical therapy as a type of care eligible for telehealth coverage as a MA plan basic benefit. Therefore, we are seeking stories to illustrate how you have used, or would use, technology in order to increase access to care for any of your patients. For example, what kind of therapy would you be able to provide via a video link or webcam setup? Please write up a short example and send it to your PPS Lobbyist at firstname.lastname@example.org.
One of PPS’ top legislative and advocacy priorities is to support legislation that would allow PTs and other Medicare enrollees to opt out of Medicare on a case-by-case basis. In the House, the Medicare Patient Empowerment Act (H.R.4133) has 3 cosponsors; we are working on getting previous House cosponsors back on the bill. The bill language remained the same as last Congress and would allow Medicare enrolled providers (including physical therapists) to contract directly with their patients who are Medicare beneficiaries. The decision to opt-out would not affect the entire practice, only the billing relationship between that patient and therapist.
- Allow providers to contract directly with their patients who are Medicare beneficiaries—on a case-by-case basis.
- Allow Medicare beneficiaries to contract with their choice of provider at Medicare rates or at rates established between the patient and physician or practitioner.
- Allow providers to continue as a participating or non-participating Medicare provider with respect to any patient or service not covered under the contract.
- Empower individual beneficiary choice at no additional cost to the Medicare program.
Advocacy Opportunity 2: Reach out to your Representatives using the PPS "Find Your Rep" portal, and use the above talking points to explain how you would use the patient-centered policy to better serve your patients and your community, include an example if you have one. Ask for your Representative to cosponsor the Medicare Patient Empowerment Act (H.R.4133). Please include the one-pager found on the PPS Advocacy Tools & Resources page with your outreach.
Keep up the good work and remember, it is an election year so all seats in the House of Representatives and 1/3 of the Senate seats will be contested. Your legislators need your vote and to hear from you.
Thank you for your continued advocacy and engagement.