Federal Advocacy Information

June 2022

Support of H.R. 5365: Expand Care at Community Health Centers

The American Physical Therapy Association (APTA) is supporting Congress to pass the Primary Health Services Enhancement Act (H.R. 5365). This bipartisan legislation would expand patient access to essential physical therapy services to children and adults who receive care at rural health clinics and federally qualified health centers, also known as community health centers (CHCs).

CHCs provide primary health services to more than 30 million people in over 12,000 rural and urban communities across America, including nearly 3 million Medicare beneficiaries and one in five Medicaid beneficiaries. Presently, CHCs cover a range of necessary health services, including access to physicians, advanced practice nurses, dentists, and other services. However, community health centers are restricted in how physical therapy services are provided and reimbursed. H.R. 5365 would address this problem by allowing physical therapists to provide care to patients in CHCs and bill Medicare and Medicaid directly. In such a rural state our Connecticut residents would benefit from this access to needed services.

This link better explains the current limitations on the provision of Physical therapy in CRCs but also identifies why physical therapy is a true clinical support of the other necessary health services.

Position Paper: Primary Health Services Enhancement Act | APTA

The link also offers you a letter for asking your representative to cosponsor H.R. 5365: Primary Health Services Enhancement Act. 

Complete act can be found on Congress.gov  H.R.5365 - 117th Congress (2021-2022): Primary Health Services Enhancement Act | Congress.gov | Library of Congress

Text of H.R. 5365: Primary Health Services Enhancement Act (Introduced version) - GovTrack.us

School-Based Therapy 

Rep. Jahana Hayes (D-CT) and Rep. Brian Fitzpatrick (R-PA) introduced bipartisan resolution designating and celebrating the week of April 25 through April 29, 2022, as “National Specialized Instructional Support Personnel Appreciation Week.” Schools are home to more than one million specialized instructional support personnel across the United States, including physical therapists, nurses, speech-language pathologists, audiologists, and more. This resolution builds on the Save Education Jobs Act, an APTA-endorsed bill introduced by Rep Hayes to help mitigate the impacts of students’ learning loss as a result of the COVID-19 pandemic and support specialized instructional support personnel, including physical therapists.

Supervision of PTAs in Outpatient Settings:

On April 23, 2022, Rep. Bobby Rush (D-IL) led a bipartisan letter to the U.S. House Appropriations Committee requesting that the committee include report language in the upcoming annual appropriations bill clarifying Congressional intent surrounding supervision requirements for PTAs and OTAs. The report language directs CMS not to limit access or alter reimbursement for outpatient therapy services by imposing supervision requirements for assistants in outpatient settings that are more stringent than what is required by state law. Rep. Rush was joined by Rep. Jason Smith (R-MO), along with Representatives Budd (R-NC), Carter (D-LA), Cohen (D-TN), Horsfield (D-NV), McBath (D-GA), McEachin (D-VA), McKinley (R-WV), Panetta (D-CA), and Wild (D-PA). 

Pelvic Health:

Rep. Jamie Herrera Beutler (R-WA) and Rep. Lisa Blunt Rochester (D-DE) plan to introduce the Optimizing Postpartum Outcomes Act in the near future. This bipartisan legislation instructs the Centers for Medicare and Medicaid Services (CMS) to issue guidance on coverage under Medicaid and CHIP (Children s Health Insurance Program) for pelvic floor services, including pelvic floor physical therapy, performed during the postpartum or neonatal period. The legislation also requires Government Accountability Office (GAO) to conduct a study on pelvic floor programs that address gaps in coverage for covered pelvic health services, including pelvic floor physical therapy, for postpartum individuals and other services postpartum women received during their pregnancies. Additionally, the bill instructs the HHS Secretary to carry out a program to educate and train health professionals on the benefits of pelvic floor physical therapy and to educate postpartum women on the importance of pelvic floor examinations and physical therapy, what pelvic floor examinations and physical therapy are, and how to obtain an examination for pelvic physical therapy. APTA Government Affairs and representatives from APTA Academy of Pelvic Health worked with Rep. Herrera Beutler’s office in the drafting of the legislation.


May 2022

WORKFORCE DIVERSITY: On March 10, 2022, Senators Patty Murray (D-WA) and Richard Burr, (R-NC) unveiled a new legislative package known a known as the PREVENT Pandemics Act (S. 3799). This sweeping bill aims to modernize the country’s pandemic response, to include increasing federal and state preparedness, improving epidemiologic data collection, accelerating research and development, and improving the medical supply chain. The legislation also focuses on supporting and improving the health provider workforce and addressing health disparities. The PREVENT Pandemics includes language from the APTA’s supported ALLIED WORKFORCE DIVERSITY ACT (S. 1679), sponsored by senators Bob Casey (D-PA) and Lisa Murkowski (R-AK). The legislation was passed by the Senate Health, Labor, and Pensions Committee (HELP) on March 15, 2022, and will next be considered by the full Senate.


SISP: On March 24, 2022, U.S. Representatives Marie Newman (IL-03), Brian Fitzpatrick (PA-01) and Susan Wild (PA-07) introduced the Growing, Recruiting, and Obtaining Workers in Specialized Instructional Support Personnel Services (GROW SISPS) Act (H.R. 7219) as part of an effort to ensure students receive the individualized support they need to succeed in the classroom. The new bill will create a grant program at the Department of Education to increase partnerships between school districts and colleges to train and certify various Specialized Instruction Support Personnel programs (SISPs) to better serve rural and lower-income school districts. In school districts across the nation, Specialized Instructional Support Personnel, or SISPs, work with teachers, school support staff, parents, community members, and other education stakeholders to help students remove learning barriers. They include physical therapists and assistant that work with students with disabilities and provide crucial services to students to address students’ needs in school.


LONG COVID: On April 6, 2022, the Targeting Resources for Equitable Access to Treatment for Long COVID (TREAT Long COVID) Act was introduced in the U.S House by Reps. Ayanna Pressley (MA-07), Don Beyer (VA-08) and Lisa Blunt Rochester (D-DE), and in the Senate by Senators Tim Kaine (D-VA), Tammy Duckworh (D-IL) and Edward Markey (D-MA). The legislation aims to increase access to medical care and treatment for communities and individuals struggling with Long COVID. The TREAT Long COVID Act would expand treatment for Long COVID nationwide by authorizing the Department of Health and Human Services to award grants up to $2,000,000 to health care providers, including community health centers; grant funding for the creation and expansion of multidisciplinary Long COVID clinics to address the physical and mental health needs of patients; prioritize funding for health providers that plan to engage medically underserved populations and populations disproportionately impacted by COVID-19; and ensure that treatment is not denied based on insurance coverage, date or method of diagnosis, or previous hospitalization.


PTAs: On April 6, 2022, Rep. Bobby Rush (D-IL) sent a “Dear Colleague” to his House colleagues requesting their support and signature on a letter to the House Appropriations Committee on the current PTA/OTA direct supervision requirement under Medicare. Specifically, the letter requests that report language be added to the FY 2023 Congressional appropriations legislation that would require the Centers for Medicare and Medicaid Services (CMS) to change the current ‘direct supervision’ regulatory requirement of PTAs and OTAs to instead defer to the supervision requirements found in states’ physical therapy licensure law.


March 2022

Consolidate Appropriations Act of 2022

On Wednesday night (3/9/2022) the U.S House passed the Consolidated Appropriations Act of 2022 the $1.5 trillion omnibus spending package to fund the federal government through September 2022.  On March 10, 2022 the U.S. Senate passed the House legislation before tonight’s midnight deadline to prevent a government shutdown.

For physical therapy the spending package includes language specifically providing a 151-day (5 month) blanket extension of the current Medicare telehealth waivers for Physical Therapy, OT, SLP and Audiology after the date the Public Health Emergency (PHE) is declared over.  The specific inclusion of physical therapy in the package was critical and sets the stage for a permanent or longer extension of the current telehealth waiver.  APTA is grateful to our champions in Congress on this issue.

The legislation also extends for 151 days after the end of the PHE the removal of the geographic requirements for originating sites, allowing for telehealth services to continue to be provided to Medicare beneficiaries in the home and all areas of the country.  The legislation also requires that the Medicare Payment Advisory Commission (MedPAC) provide a report to Congress no later than June 15, 2023, examining Medicare telehealth utilization, expenditures, payment policy, and impacts on beneficiary access to care and quality.  It requires the Secretary of HHS to make publicly available on a quarterly basis data on Medicare claims for telehealth services.  It also requires the HHS Office of Inspector General (OIG) to provide a report to Congress no later than June 15, 2023, on program integrity risks associated with Medicare telehealth services. 

At this time there are indications that the Biden Administration could end the PHE in July, likely driven by the upcoming midterm elections and declining infection rates of COVID. Should the PHE end in July, the 5-month extension of the current telehealth waivers for therapy provided by the legislation would kick-in and last until mid-December of 2022.  In December Congress would need to extend the blanket telehealth waiver for therapy into 2023 and do so via a year-end Medicare package or other end-of-year must-pass legislation.  Either way, the language in the spending package ensures that there will not be a “telehealth cliff” for therapy after the PHE ends and provides Congress more time work on a more permanent telehealth solution.

SMART Act (PTA Differential)

On the downside, the House-passed Consolidated Appropriations Act did not include language from the SMART Act, APTA-supported legislation aimed at mitigating the impact of the PTA/OTA differential.  Rep. Bobby Rush (D-IL), sponsor of the bill, led a bipartisan effort with his colleagues on the House Energy & Commerce Committee aimed at House leadership to have the SMART Act be included in the package; you can read more about that effort HERE.  APTA met yesterday with the office of House Majority Leader Steny Hoyer to discuss possible future legislative vehicles this year for the SMART Act. 


last chance to show their support for H.R. 5536, the Stabilizing Medicare Access to Rehabilitation and Therapy Act, or SMART.  We all need to think about how this impending reduction will affect how we practice and how we run our businesses.  If implemented this may also affect how other payers may consider payment reduction.  The 15% cut piles on top of other reductions to the Medicare fee schedule and is simply not sustainable in ensuring access to therapy services.  There could be nothing easier as APTA has already had all of the info completed with just a sign on letter to be completed


Workforce Diversity and Social Determinant of Health

On Wednesday, March 9, Chairwoman Patty Murray (D-WA) of the Senate Health, Education, Labor, and Pensions Committee (HELP) and Ranking Member Richard Burr (R- NC) released the PREVENT Pandemics Act, bipartisan legislation focused on strengthening the nation’s public health and medical preparedness and response systems in the wake of the COVID-19 pandemic.  

**Of note
 language from our Allied Health Workforce Diversity bill (Senate Bill 1679) is included in the PREVENT Pandemics Act legislative package.  Our senate sponsors (Senators Casey and Murkowski who also sit on the HELP Cmte) were able to get the Workforce Diversity bill language included the PREVENT Pandemics legislative package. 

The PREVENT Pandemics Act also includes language from the APTA-endorsed Improving Social Determinants of Health Act (S.104) which requires the Centers for Disease Control and Prevention (CDC) to establish a program to improve health outcomes and reduce health inequities by coordinating activities across the CDC. As part of the program, the CDC must award grants to eligible organizations to build capacity to address social determinants of health. The Senate HELP Committee has scheduled a mark-up on the PREVENT Pandemics Act for this Tuesday, March 15.


October 2021 

The APTA is actively advocating for several issues in the House and Senate.


3.5% Medicare Pay Cut Proposed

In July, Centers for Medicare & Medicaid Services (CMS) released its proposed 2022 Medicare Physician Fee Schedule rule. The proposed rule would cut physical therapy payment by an estimated 3.5%. This is on top of the 3.3% cut in 2021. Additionally, CMS is set to implement a 15% cut in 2022 for services provided by a physical therapist assistant. Additionally a 2% cut will go into effect when Medicare sequestration returns in 2022. The APTA has garnered support for a Dear Colleague letter (the Bera-Buschon letter) which asks the House leadership to act to halt these proposed cuts and to give time to develop a long-term reform to the Medicare Fee Schedule.


Policy Solution for PTA Differential Pay Cut

As above, a 15% cut for services provided by a PTA is set to begin in 2022. This bipartisan legislation was proposed on Friday October 8, 2021 by Rep. Bobby Rush (D-IL) and Rep. Jason Smith (R-MO). The legislation has three primary policy goals:

  • Delay implementation of the PTA/OTA payment differential until Jan. 1, 2023.
  • Provide an exemption to the 15% payment differential for rural and underserved areas.
  • Allow for general supervision of PTAs and OTAs under Part B (instead of the current direct supervision requirement).

There will be opportunities coming for a grassroots effort to encourage support for this bill.


Expanded Telehealth Access Act of 2021 (H.R. 2168)

Currently physical therapists and physical therapist assistants may provide telehealth services under Medicare during the declared public health emergency. At this time, PTs and PTAs have not been granted the permanent ability to furnish services through telehealth. This bill adds PTs, PTAs as well as occupational therapists, occupational therapy assistants, audiologists and speech language pathologists as authorized providers of telehealth under Medicare.


Physical Therapist Workforce and Patient Access Act (H.R. 3759/S. 2676)

This bill adds physical therapists to the National Health Service Corps Repayment Program, allowing PTs the ability to apply for tuition reimbursement when choosing to work in underserved areas.


The Allied Health Workforce Diversity Act (H.R. 3320/S.1679)

This bill would provide grants for accredited higher education programs to recruit qualified individuals from underrepresented backgrounds in the fields of PT, OT, SLP, respiratory therapy, and audiology.


Please see the APTA Advocacy App where you can see if your representatives have signed on to the letter or any of these bills. Please consider calling or emailing your representatives about these issues.

To learn more about these issues, please see the APTA Patient Action Center at https://www.apta.org/advocacy/take-action/patient-action-center or reach out to our Federal Affairs Liaison, Maryclaire Capetta, at Maryclaire.capetta@uconn.edu.


We are looking for people who are interested in federal issues affecting physical therapist practice to serve as Key Contacts for our CT legislators. Please reach out to Maryclaire if you are interested in serving in this role.


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APTA CT PO Box 459
Tolland, CT 06084
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