Legislation, Advocacy, and the Government Affairs Committee

By Tom DiAngelis, PT, DPT

Well, it has certainly been an interesting start to the 115th Congress and Trump presidency. As I mentioned in my column last November, and was highlighted in our lobbyists’ February Advocacy in Action column by Alpha Lillstrom Cheng, JD, MA, and Jerry Connolly, PT, the Government Affairs Committee (GAC) of the Private Practice Section (PPS) meets every two years immediately after the new Congress is elected.

The GAC met in early December, and we were pleased to be joined by four members of your board of directors for a day and a half of analysis, discussion, and prioritizing. The purpose of the meeting was to begin to understand the make-up of the new Congress, as well as the new Administration, and what opportunities or barriers this might create so that the committee can discuss PPS priorities and make recommendations to the board. Following the meeting, the list of priorities is sent to the board for their input, recommendations, or changes and final adoption. Three of the key issues are highlighted here, along with our thought processes on each issue. To view the full document of our Legislative and Advocacy Priorities for the 115th Congress, follow this link: www.ppsapta.org/userfiles/File/Legislative%20Priorities_115th%20Congress_WEB.pdf

This year, your board informed the GAC that they felt a high priority had to be placed on working toward legislation that would allow physical therapists in private practice to opt out of the Medicare program. As many of you know, this has been an issue for several of our members for many years, and although there has been past legislation we have not been able to get this accomplished. This has had Republican support in the past, and with both houses of Congress being majority Republican this may be our best opportunity to finally get movement on this issue. Also, knowing that the exceptions process for the therapy cap will expire on December 31, 2017, high priority has been placed on the issue to repeal or replace this arbitrary cap. As you know, this has come down to the wire far too many times in the past and creates a lot of anxiety for not only our members but our patients as well. Our hope is that this will be resolved before we get to the final hour.

One area that garnered a lot of discussion and led to a new direction for PPS was what would be our position, if any, regarding reforming or replacing the Affordable Care Act (ACA), commonly referred to as Obamacare. If you recall, when the ACA was being debated and proposed in 2009 and 2010, PPS did not take a position on this. First, it was extremely volatile, and second, it was not always clear what exactly was in the legislation. I am sure many remember then House Speaker Nancy Pelosi’s infamous remark, “We have to pass the bill so that you can find out what is in it.” After discussing the potential for the ACA being changed or repealed, the GAC felt there are some provisions that we should promote such as retaining guaranteed access to health insurance if you have a preexisting condition, maintaining that children may remain on their parents’ health insurance up to the age of 26, and of course promoting physical therapy as an essential health benefit, to name a few. The board agreed with the idea of adopting these priorities and in doing so have provided our lobbyists with specific PPS concerns to discuss with Congress as they work on a repeal and/or replacement package.

Another area of new direction appearing in our priorities involves insurance reforms. Some of the areas that PPS will concentrate on in this arena include trying to mitigate the negative effects on private practice physical therapists (PTs) in markets that are controlled by insurers. PPS also wants to promote administrative simplification and will advocate for standardization of processes for eligibility and authorization, in addition to pursuing the elimination of arbitrary limits and denials for PT services. We will also work to support policies that require insurance networks to be appropriate in their size, scope, geography, and expertise to improve patient choice and access to private practice physical therapists.

Many more issues are addressed in our priorities document such as expanding locum tenens, standards for supervision of support personnel, payment reform, and payment for telehealth in addition to small business issues. I urge you to read Alpha’s and Jerry’s February column for additional detail and to review our priorities document on the website. If you have any questions, comments, or concerns, feel free to direct them to the GAC, your lobbyists, or the board of directors.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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