December 2021 Federal Advocacy Update

Congressional Update:

  • Allied Health Workforce Diversity Act (H.R. 3320) passed committee
  • Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667) passed committee
  • IDEA Full Funding Act introduced
    • Sen Van Hollen (D-MD)
    • Rep. Jared Huffman (D-CA)
  • Expanded Telehealth Access Act – Senate companion S. 3193
    • Sen. Daines (R-MT), Sen Smith (D-MN), Sen. Moran (R-KS), and Sen Rosen (D-NV).
  • The National Center for Medical Rehabilitation Research (NCMRR) has released the new NIHWide
  • Research Plan on Rehabilitation, which will guide NIH’s rehabilitation research activities for
  • the next five years. The plan is available online here: 2021 NIH Research Plan on Rehabilitation.

Regulatory Update:

  • Physician Fee Schedule Final Rule
    • CMS made no changes to implementation of the EM code policy.
    • Conversion factor drops from $34.89 to $33.59 in 2022
      • 3.75% decrease from 2021
    • CMS did not adopt APTA’s recommendations on the PTA differential:
      • No 1-year delay
      • No exemption for rural and underserved areas
      • No supervision change
    • Direct supervision through virtual presence not permanently adopted
      • Still lasts until the end of the year in which PHE ends (2022)
    • CMS confirmed PTA differential does not apply to co-pays
      • Only the 80% paid by Medicare, thus the PTA cut is 12%, not 15%.
    • CMS reversed position on RTM codes
      • PTs and PTAs will be permitted to bill all 5 codes
      • APTA will create guidance
    • Telehealth codes not added to permanent list.
  • CMS Vaccination Rule
    • Issued Nov. 4
    • Applies to facilities subject to CoPs NOT: PTs in private practices
    • Exemptions: 100% telehealth; allergies, medical and religious exemptions
    • Two phases of implementation
    • APTA is monitoring legal challenges to the mandate
      • 12/2/21 - The Centers for Medicare & Medicaid Services (CMS) has announced that they will not enforce the new rule regarding vaccination of health care workers or requirements for policies and procedures in certified Medicare/Medicaid providers and suppliers (including nursing facilities, hospitals, dialysis facilities and all other provider types covered by the rule) while there are court-ordered injunctions in place prohibiting enforcement of this provision.
      • CMS Memorandum regarding rule suspension
  • OSHA Vaccination Rule
    • Issued Nov. 4
    • Employers with 100 or more employees must get employees vaccinated by Jan. 4, 2022, or require unvaccinated employees to produce a negative test on at least a weekly basis.
    • Development of mandatory COVID-19 vaccination policy
    • Alternatively, employers can adopt a policy requiring employees to either get vaccinated or elect to undergo regular COVID-19 testing and wear a face covering at work in lieu of vaccination
    • APTA is monitoring legal challenges to the rule
  • Resources

Grassroots Update

  • Important grassroots action on Medicare cuts/PTA differential. It’s time to reach out to your members of congress

    • We urgently need your help today: Contacting your members of Congress to stop devastating cuts to payment for physical therapy services under Medicare. The next two weeks are critical, as Congress must act to stop Medicare cuts to dozens of providers, including physical therapists. In addition, Congress must act to prevent the impending 15% payment differential under Medicare when services are provided by a physical therapist assistant.
    • APTA has a template letter that makes contacting your members of Congress quick and easy. Please do so as soon as possible and urge them to include the bill language from the Support Medicare Providers Act (H.R. 6020) and the Stabilizing Medicare Access to Rehabilitation and Therapy Act, or SMART Act (H.R. 5536) in any end-of-year legislation package. Both bills would prevent deep cuts slated to take effect on Jan. 1, 2022—H.R. 6020 addresses the Medicare Physician Fee Schedule pay cuts, and H.R. 5536 provides relief from the PTA pay differential.
    • Go to the APTA’s take action webpage and click on the Legislative Action Center link or open your APTA Action App. Find the Help Stop Medicare Cuts Before the End of the Year option and Add Your Voice