In the past month, legislation has been introduced to address two of PPS’ top legislative priorities!

The House and Senate are only scheduled to be in session for the first two weeks of December before heading back home for the rest of the year.  To have the biggest impact, please make an effort to connect with their offices the first week of December.

Telehealth

On October 30th a revised CONNECT for Health Act (H.R.4932/S.2741) was introduced in both the House and the Senate.  This bipartisan bill seeks to reduce the financial burden on Medicare by providing a tailored approach to lift current restrictions which providers, including physical therapists, face for coverage of care provided to Medicare beneficiaries via telehealth:

  • Allowing Medicare enrolled providers or suppliers to be reimbursed for care provided via telehealth when the quality of the care is the same or better and certain costeffectiveness criteria met. This would enable Medicare enrolled physical therapists to provide qualifying care via telehealth;
  • Requiring HHS to review and improve the process for adding telehealth services to those which are covered by Medicare. This could be a path that would enable physical therapists to furnish covered telehealth services to Medicare beneficiaries; and
  • Authorizing CMS’ Center for Medicare and Medicaid Innovation (CMMI) models to allow additional health professionals, including physical therapists, to furnish telehealth services.

Advocacy Opportunity 1:

Effective advocacy can come in many forms.  One of which is sharing examples of how existing policy limits your ability to provide the best care for your patients.  Anecdotes can vividly illustrate to policy makers why they need to act to improve conditions for their constituents—both your patients and you as a small business owner and provider. 

Please send examples and stories to alpha@lillstrom.com that tell me how you use, or would use, telehealth in a way that would align with the following policy objectives that are included in the CONNECT for Health Act:

1. Expand access to telehealth, especially in rural or otherwise underserved communities;
2. Improve patient outcomes or ease the day-to-day patient experience;
3. Support easier and expanded use of existing telehealth technologies; and
4. Reduce healthcare costs for both patients and federal programs, including Medicare.

Advocacy Opportunity 2:

Contact your lawmakers (both of your senators and your representative) and ask them to cosponsor the CONNECT for Health Act of 2019 (H.R.4932/S.2741) to expand access, promote cost savings, and ensure quality care in Medicare through the use of telehealth and remote patient monitoring using the following talking points:

  • Only a portion of the care physical therapists provide is manual therapy. While the use of telehealth would not wholly replace inperson visits, using telehealth can reduce disparities in care as well as provide high-quality care without increasing costs.
  • Studies have shown that physical therapists' use of telehealth for telerehabilitation can result in costsavings, improved outcomes, increased access, and higher patient satisfaction.
  • This bipartisan legislation would enable physical therapists to provide assessments, care, and interventions via telehealth—this type of care could prevent falls, reduce functional decline, avoid costly emergency room visits, and reduce hospital admissions as well as readmissions—all features which save money in the long-run.
  • Cosponsor H.R.4932/S.2741 in order to allow PTs to provide quality care to Medicare beneficiaries via telehealth.

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 with a tweet or facebook post tagging your legislator as well as PPS using #PPSAdvocacy. 

Opt-out

On November 7th, Sen. Rand Paul (R-KY) introduced the Medicare Patient Empowerment Act (S.2812) which seeks to modernize the Medicare statute by allowing a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether a participating or non-participating physician or practitioner) for any item or service covered by Medicare. The bill provides beneficiaries the option to submit a claim to, and be reimbursed by, Medicare for the amount that would be paid if the professional were a participating practitioner. The Act includes consumer protections by prohibiting private contracting with patients who are facing an emergency medical condition or urgent health care situation.  It also preempts state laws from limiting the amount of charges for physician and practitioner services for which Medicare payment is made.  At this time there is only a bill in the Senate.  A one-pager is available on the PPS website.

Advocacy Opportunity #3

Use these talking points when asking both of your senators to cosponsor the Medicare Patient Empowerment Act (S.2812):

  • S.2812 is a patient-centric bill which allows Medicare beneficiaries to contract with any provider at Medicare rates or at rates established between the patient and physician or practitioner;
  • Provides patients with greater choice of eligible professionals;
  • Allows providers to continue as a participating or non-participating Medicare provider with respect to those patients or services not covered under the contract. 
  • S.2812 empowers individual beneficiaries at no additional cost to the Medicare program.  In fact, every time a patient opts to not bill Medicare, it SAVES the program money.

Advocacy Opportunity #4

As mentioned above, anecdotes can help lawmakers better understand why a policy change is needed.  Please send examples to alpha@lillstrom.com of how being able to opt-out of Medicare would improve your ability to care for all members of your community.  The best examples highlight specific instances of the unintended and illogical consequences of the current policy forbidding PTs from opting out of Medicare. 

 

This Thanksgiving, I am grateful for all of your advocacy on behalf of PPS,

your profession, and your patients.  Thank you!

 

For information on PPS’s legislative priorities and activities, visit the Advocacy section at www.ppsapta.org

 
 

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