CMS has withdrawn the Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics proposed rule, effective August 1. The withdrawal notice was announced via the unified agenda of Federal Regulatory and Deregulatory Actions. To view the regulatory agenda noting the action, please see: https://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201704&RIN=0938-AR84
Home health comments were due on Monday, September 25th. Majority of comments focused on the Home Health Groupings Model ((HHGM) proposal, urging CMS not to implement the model as currently proposed. Many PTs and different disciplines submitted for comments.
o 49 Senators submitted a letter to CMS urging them not to move forward; Senator Hatch sent his own letter telling CMS not to implement the HHGM.
Congress tried several more times to repeal the ACA, and several more times it failed. APTA was opposed to any repeal legislation that threatened the essential health benefits package, and is hopeful that any future attempts to amend or repeal the ACA will keep essential benefits intact. It’s likely the focus will shift to tax reform, though there have been rumors that the next round of reconciliation instructions could again include health care, so it may not be completely out of the woods yet.
APTA is also watching the discussions regarding CHIP, as this will likely be one of the last major health care vehicles this year. APTA has been working closely with staff from the House Ways and Means, Energy and Commerce committees, and Senate Finance committee on language that would provide a permanent fix to the therapy caps. In the past weeks, the Therapy Cap coalition met with committee staff and have been working on language revisions in case a bill like the CHIP reauthorization comes to the floor. Having this language ready to be added to any legislative vehicle will be important if things move quickly. The therapy cap exceptions process will expire on December 31, 2017 unless Congress acts.
We’ve also seen some progress on efforts to include physical therapist assistants as a provider under TRICARE. In June, the House passed a version of the National Defense Authorization Act (NDAA) that contained report language that asked the Department of Defense (DOD) a report exploring the feasibility of adding PTAs, OTAs, and some other providers. In July, Senate Armed Services Personnel subcommittee chairman Tillis (NC) dropped an amendment with the legislative language APTA proposed to the committees. In September, when the Senate debated NDAA, the amendment was included in the final piece of legislation and passed the Senate. We are thrilled that there is some language addressing this issue on both sides of the Capitol, and we are pushing the House to support the Senate language when the two sides come together to work out the differences.
If you have any questions please email Melissa.firstname.lastname@example.org. To get more involved please download the PTaction app.
Melissa Johnson PT, DPT , CWS
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