Being an active advocate in an election year is easy to do and can be very impactful. Lawmakers and candidates are eager to talk to potential voters, especially community leaders such as you. Through advocacy you can educate policy makers, then ask for their help improving payment and reducing administrative burden so you can focus on providing physical therapy care to members of your community. Your ability to build rapport with your lawmakers could impact the laws they pass. This summer and fall is prime time for you to meet up with them to reinforce their understanding of the important role you play in the local economy. With each engagement, you enhance a candidate’s understanding of the unique value of physical therapy provided in a small-business, private practice setting.

Please call both your incumbent legislator and the opposing candidate’s local offices this week and follow up with an email to request a meeting with your Member of Congress or the candidate when they are in town next. This could be in August or sometime this fall. Customize your communications by filling in the blanks and following the prompts in red:


Phone script:

“Hello, my name is ___________. I am a voter, small business owner, and physical therapist. I’m calling to request a meeting with Representative/Senator __________/(candidate’s name). Thank you.”

You may be told the Member or candidate’s schedule is full. If so, ask when you can meet with the local staff and offer 2 or 3 dates and times that work for you. Offer a site visit to anyone in the lawmaker’s office.

 

If you get their voicemail, leave the following message:

“Hello, my name is ___________. I am a voter, small business owner, and physical therapist living/working in [town]. I’m calling to request a meeting with Representative/Senator __________/(candidate’s name) when they are next in town. My email is _____________, my cell phone number is _________. I look forward to hearing back from you so we can set up a time for me to come meet with them. Thank you.”

 

Email script:

“Dear Representative/Senator __________/(candidate’s name);

I am a voter, small business owner, physical therapist, and member of APTA Private Practice. My ___-person practice is located in [town]. [#] percent of my patients are Medicare beneficiaries.

I am writing to request a meeting with you, Representative/Senator __________/(candidate’s name) when you are in the area this summer or early fall. I understand that your schedule is very busy during election season, but I hope you can spare a few minutes to meet with me to discuss the important role physical therapy plays in the local economy, health care and wellness, as well as the role federal laws play in ensuring access to care.

I look forward to hearing back from you so we can set up a time for me to meet. Thank you.

Name

Email

Cell phone number

Address of practice in the Congressional District/state”

 

In addition to scheduling in-office meetings, there are many other ways to engage with those running for office. You can attend rallies, town halls, and community meetings and introduce yourself to their staff (be sure to hand them your business card). If you feel comfortable, consider volunteering for a campaign or attending a fundraiser—both great ways to meet anyone running for elective office. Check out the “Advocacy in Action” article in the August issue of Impact for more details and ideas.

Once you schedule a meeting with your legislator, candidate, or their staff, check out the Nuts and Bolts of Lobbying for tips on how to conduct the meeting. Be sure to bring print-outs of the issue one-pagers to leave behind. Ask to take a picture at the conclusion of the meeting then post that picture, tagging the candidate or Member of Congress, along with a “thank you for meeting with private practice physical therapists #PPS Advocacy” message to your social media. If you have any questions, please reach out directly to Alpha Lillstrom Cheng, the Section’s lobbyist.

 

BACKGROUND AND TALKING POINTS FOR MEETINGS:

General Introduction

  • APTA Private Practice is an organization of nearly 4,000 physical therapists in private practice.
  • Physical therapists specialize in providing neuromusculoskeletal interventions and should be the point of entry for treatment of movement disorders.
  • Private practice PTs provide rehabilitative and habilitative care that restores function, improves mobility, relieves pain, and prevents or limits permanent physical disabilities in patients with injury or disease.
  • As small business owners, we are interested in policies that will grant our patients the flexibility to choose which clinician and type of practice in their community through which to access affordable, high-quality physical therapy.


Legislative Issues

Locum Tenens

If you need to be away from your practice, are there enough credentialed physical therapists in your clinic to ensure that all of your Medicare patients are still able to receive care without delay? If not, then your practice and your patients would benefit if you were able to hire a locum tenens—a qualified substitute physical therapist—to fill in for the short time you are not able to be in the clinic.

 

Talking Points:

  • Since 2017, physical therapists whose outpatient clinics are located in rural, health professional shortage areas, and medically underserved areas have been able to hire a locum tenens on a short-term basis. However, physical therapists are the only providers whose use of locum tenens is limited geographically.
  • The Prevent Interruptions in Physical Therapy Act (S. 2612/H.R. 1611) seeks to enable all private practice physical therapists in the United States to use a locum tenens to provide their Medicare patients continued access to services at their clinic.
  • The need for a locum tenens hinges upon the number of therapists who regularly work at a clinic and that clinic’s Medicare patient mix. When a therapist is not be able to be at work, smaller clinics are unable to reshuffle the schedules of those therapists present to absorb the full Medicare beneficiary caseload—this results in delayed care as well as a interruption in revenue flow for the small business.


Telehealth

As a result of the success of using telehealth to provide services during the pandemic, there is genuine bipartisan interest in maintaining this type of care. The Consolidated Appropriations Act of 2022 included an extension of the current Medicare coverage for rehabilitation services provided by therapists and therapist assistants via telehealth. As a result, Medicare beneficiaries treated by private practice physical therapists, physical therapist assistants (PTAs), occupational therapists, occupational therapy assistants (OTAs), and speech language pathologists will retain coverage for care provided to them via telehealth for additional 151 days (approximately five months) of after the COVID-19 Public Health Emergency (PHE) expires.

 

Talking Points:

  • Permanent legislative change is needed to ensure long-term coverage for care provided by rehabilitation therapists via telehealth.
  • The Expanded Telehealth Access Act (S.3193/H.R.2168) would permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the statutory list of “distant site providers” that Medicare pays for telehealth.
  • This patient-centered policy will allow you to use technology to better serve your patients and your community.
  • Share examples of how you have used telehealth in the past two years to ensure continued access to care.


Physical Therapist Supervision and Payment Differential

As you know from the May 2022 Advocacy in Action article, we are attempting to reduce the impact of the therapist assistant differential with the passage of the bipartisan Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act (H.R.5536). Enactment of this bill would provide financial support for outpatient therapy clinics and protect Medicare beneficiary access to physical and occupational therapy by designating PTAs and OTAs working in rural and Medically Underserved Areas as exempt from the 15% payment differential. H.R.5536 would also require Medicare to change its supervision requirement of therapy assistants in private practice settings from direct to general supervision. In addition to reducing administrative burden, this change would better align with state law and result in a general supervision requirement for PTAs in 44 states.

 

Talking Points:

  • As a result of the PHE, supervisors of PTAs and OTAs are currently able to “meet the immediate availability requirement for direct supervision through the use of real-time, audio/video technology”. This policy has provided therapists in outpatient settings an approximation of general supervision but is only in place until the end of the year in which the PHE ends.
  • Policy change is necessary to permanently reduce this administrative burden and prohibit Medicare from requiring the increased level of direct supervision in outpatient therapy settings.
  • Share how your clinic utilizes PTAs to ensure that the therapy needs of your community are met. Candidates and lawmakers are probably unaware of how common it is for the PTAs providing care in these areas to also be long-term members of these same communities. Let them know if you will have to change staffing patterns, reduce hours, or potentially even close your clinic in order to survive these drastic payment cuts. Your input will help them realize that ultimately the differential and the direct supervision requirement can lead to delays in delivery of care, reduction in services provided, and an increased need for more costly interventions.

Be sure to ask your lawmakers to cosponsor each of these crucial bills, if they haven’t already. Follow up your meeting with an email that includes one-pagers for the issues you discussed. If you have yet to host them for a site visit, invite your legislator and their staff to visit your clinic to see physical therapy in action, as well as an opportunity for them to meet potential voters.

 

Resources Are Available:

 

Thank you for your continued advocacy! Have a great time engaging with your lawmakers and the candidates!

 

 

 
 
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