Share your perspective to increase the power of advocacy!

We have three timely opportunities to advocate on behalf of the profession. Keep reading for a summary of these opportunities and information about how you can get involved.

Advocacy Opportunity #1:

Illustrate impact of an 8% cut

In November 2019, the Center for Medicare and Medicaid Services (CMS) finalized their proposal to reduce reimbursement for physical therapy in 2021.  PPS is working closely with APTA and a coalition of other impacted providers to challenge these cuts.  The most effective advocacy includes impact statements illustrating how policy proposals will cause harm or reduce access to care.  Please share your stories with PPS so that we may bolster our advocacy with these vivid examples.

 

Describe how an 8% cut to Medicare reimbursement will impact your practice and your patients.  Send your impact statement to PPS at info@ppsapta.org

 

Use this template:

My name is _________________ and I am a physical therapist in private practice.  My clinic is [near ________________landmark/in ___________ community, Town, State].  I see _____ patients a year, ___ % of whom are Medicare patients.  Through my work with them [share a success story of your work with a Medicare beneficiary patient].

There are ___ therapists in my practice.  We also employ ___ support staff.  We have been an important part of our local economy and small business community for ___ years. 

CMS has finalized regulations which would increase the value of E/M codes and has proposed to pay for it by cutting the reimbursement for specialist providers—physical therapy was cut 8%!  Physical therapists don’t bill E/M codes so we are unable to balance out this drastic cut.  As a private practice physical therapist, my margins are tight and an 8% cut in reimbursement would [briefly describe impact on your practice—would you lay off an employee, close doors, stop accepting Medicare patients, etc.  If you are comfortable disclosing your profit margin and it is at or below 8%, please do.]

[Name, credentials]

[Practice Name]

[Practice Address]

[Practice phone number]

 

Legislative Advocacy

We are now in the Second Session of the 116th Congress.  As with most election years, it is extremely likely that most of this year’s legislative activity will be completed before the 4th of July, if not earlier.  Therefore, it is important that your Members of Congress hear from you regularly for the first six months of the year about legislation that has been introduced this Congress.  This month we will focus on removing physical therapy from the In-Office Ancillary Services exception.

Physician Self-Referral exception for In-Office Ancillary Services (IOAS)

Current law bars physicians from referring Medicare patients to certain health care services or providers in which they have a financial interest, with certain exceptions.  The “in-office ancillary services” (IOAS) exception to the Stark Law was originally created to allow physicians to render non-complex services like x-rays and simple blood tests in their offices during the same patient office visit.  The exception was never intended to include complex and costly advanced imaging services, physical therapy, radiation therapy, or biopsy testing—services rarely provided at the time of the patient’s initial office visit. 

 

Advocacy Opportunity 2:

Contact your Representative/their health LA* and ask them to cosponsor H.R. 2143, the Promoting Integrity in Medicare Act, to remove physical therapy from the in‐office ancillary services exception of the prohibition on physician selfreferral.

Use the following talking points:

          - Legislation is needed to curtail the expansive use of the IOAS exception because it undercuts the original purpose of the law, is harmful to some patients, and wastes billions of dollars in taxpayer funds.

          - This bill will restore the original intent of the self-referral law by prohibiting self-referral for complex services.

          - Cosponsor H.R.2143 to ensure that incentives driving medical decisions are based solely on patients’ best interests, thereby reducing unnecessary and inappropriate services and costs to Medicare.

*If you are in Missouri or Delaware, please remind your Member of Congress that your state forbids such referrals and that you would like them to cosponsor legislation to do the same.

A one-pager that you can refer to and share with your Members of Congress and their legislative staff is available on the PPS advocacy page.  If you are on social media, follow up your request with a tweet or Facebook post tagging your legislator as well as PPS using #PPSAdvocacy. 

 

Advocacy Opportunity 3:
Submit your locum tenens stories

When you need to be away from your practice, does your clinic have enough credentialed PTs to be able to rearrange schedules so that all of your Medicare patients are able to be seen, without delay?  If not, then your practice and your patients would benefit if you were able to bring in a locum tenens—a qualified substitute PT—to fill in for the short time you are not able to be in the clinic.

In order to support our efforts to secure cosponsors (and possible passage) of the Prevent Interruptions in Physical Therapy Act (H.R.5453), PPS needs anecdotes illustrating how the inability to use locum tenens negatively impacts patient care as well as the effect it has on PTs themselves as small business owners. Please send PPS Lobbyist Alpha Lillstrom Cheng (alpha@lillstrom.com) a brief (up to 200 words) example of how your practice and patient care has been impacted when you or one of your colleagues has been unable to hire a qualified substitute (locum tenens) to provide care when you are unavoidably absent because of illness, pregnancy, continuing education, and more.  If you are located in a one of the geographic regions where PTs are allowed to use locum tenens, please send in an example of when you used this privilege to ensure your Medicare patients had uninterrupted access to physical therapy.  Please submit your story by March 31.

 

Thank you for your continued advocacy.  Together we can make a difference!

 

For information on PPS’s legislative priorities and activities,

visit the Advocacy section at www.ppsapta.org

 
 

Leave a Comment

 
 

Recent Posts