Federal Affairs Update

Regulatory Update

  1. TRICARE and PTAs: In accordance with the FY2018 National Defense Reauthorization Act, TRICARE is engaging in rule-making to add physical and occupational therapy assistants as TRICARE-authorized providers. The rule proposes that these providers will be added as TRICARE-authorized providers, under the same qualification requirements established by Medicare. We are hopeful DoD will release the proposed rule in Q4 of 2018 or Q1 of 2019.

  2. MedPAC: APTA submitted comments to the Medicare Payment Advisory Commission (MedPAC) in response to its June 2018 Report to Congress. MedPAC recommends that CMS increase reimbursement for ambulatory evaluation and management (E&M) services. To offset this payment increase, MedPAC recommends reducing reimbursement for non-ambulatory E&M services, including physical therapy. APTA also submitted a comment letter with PPS and APTQI.

  3. 2019 SNF/IRF Final Rules: The final 2019 rules for skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are substantially similar to the proposed rule and include increases in payment of 2.4 percent for SNFs and 0.9 percent for IRFs effective October 2018. The final SNF payment rule adopts the PDPM effective October 2019. In doing away with the RUG-IV process, CMS adopted a model that bases payments on a resident's classification among five components, including physical therapy. Final payment is then calculated by multiplying the patient's case-mix group with each component (both base payment rate and days of service received) and then adding those up to establish a per diem rate.

  4. Reforms to Stark Law: APTA met with House Ways & Means majority and minority staff following the July 17 hearing “Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program,” which examined options to reform the Physician Self-Referral Law (Stark Law) to shift Medicare to a value-based system. Indications are that there will be legislation introduced this fall aimed at reforming the Stark law. APTA submitted a statement for the record. We also submitted comments in response to CMS’s Request for Information on suggestions for reforms to Stark.

Congressional Update                

  1. The Senate is hoping to pass numerous Committee bills regarding opioid legislation and put it on the floor in September. The Senate and the House opioids legislative priorities are different and will require a conference after the elections during the lame duck session.
  2. APTA will be providing comments to the Department of Education regarding accreditation since PROSPER seems to be dead in the House. Should the Democrats take the majority in the House after the upcoming elections, APTA expects Rep. Foxx to try and get the bill passed before the new Congress.
  3. In regards to Clarity Act, APTA is working closely with Senators Klobuchar and Thune to get it on the floor — they, along with Rep. Guthrie, are eager to get this on the floor so the House can pass it with the amendment and get it to the President’s desk.

 District, Practice, Program Congressional Visits

I encourage each district, practice and educational program to host a meeting or visit with a congressional leader prior to the end of the year. This would be a great way to maintain the relationships that have been built between members of Congress and their Key Contacts.  Please make sure that you send me every event, town hall meeting and fundraiser you attend, as well as practice visits, so that we can maintain a full list of activities. It is extremely important for the APTA to have this information in order to connect our “ask” with experiences that have had in each district.

Upcoming Events and Opportunities:  The APTA will have booths and host PT-PAC parties during the National Student Conclave in Providence in October and the Private Practice Section conference in Colorado Springs in November.

REMINDER: Federal Advocacy Forum 2019:  The 2019 Federal Advocacy Forum will take place Sunday, March 31, to Tuesday, April 2!  It will take place at the JW Marriott near the White House in Washington, D.C. Registration is going to open in January 2019, and room reservations (hotel rooms are $309 a night plus taxes and fees) will be able to be made soon thereafter. We will talk about regulatory affairs, federal priorities, have numerous speakers and some new information that comes with a new Congress.  Registration will be free for PT-PAC Eagles, $100 for Component Executives/Student APTA Members, and $250 for APTA Members. Do not miss this opportunity to learn more, network with fellow colleagues, meet with congressional staff and spend time in a great city filled with opportunities.

Mark Bouziane, PT, MSPT, MEd
VPTA Federal Affairs Liaison