APQTI Working for You
APTQI Advocates for PT on Capitol Hill
On April 1 and 2, APTQI Executive Director Nikesh Patel, PT, DPT met with bipartisan lawmakers to educate Members of Congress and new staff on the value of physical therapy as well as legislative opportunities and regulatory challenges facing physical therapists.
Patel met with the offices of Senators John Cornyn (R-TX) and Ted Cruz (R-TX) and Representatives Lizzie Fletcher (TX-07), Joaquin Castro (TX-20) and Pete Olson (TX-22).
Ohio BWC Incorporates APTQI Feedback in Workers’ Compensation Policy Change
On February 20, APTQI applauded the Ohio Board of Workers’ Compensation for removing a proposed provision in its physical therapy billing policy that would have burdened therapists with excessive documentation requirements, distracting them from patients and increasing the amount of time spent on redundant administrative tasks.
The proposed changes would have required physical therapists to document the start and stop times of each individual procedure performed in a session each time they see a patient. This would have required the therapist to stop after each and every procedure and enter information into a patient’s records.
To read APTQI’s statement on the policy change, CLICK HERE.
Tricare Proposes Changes to Physical Therapy Policies
On February 15, APTQI submitted a letter to Acting Secretary of Defense, Patrick M. Shanahan, providing comments on a recently-proposed rule to add physical therapy assistants and occupational therapy assistants as TRICARE-authorized providers. APTQI informed the acting secretary that it supports any changes made to the Tricare program that allow beneficiaries to access quality physical and occupational therapy performed by qualified professionals. It also offered several suggestions to strengthen the policy including codifying the term “physical therapy assistant.”
To read the full APTQI letter to Acting Secretary Shanahan, CLICK HERE.
APTQI In the News
Wall Street Journal Physical Therapy for Pain As Alternative to Opioids
On February 14, the Wall Street Journal published (print and online) a letter to the editor from Nikesh Patel, PT, DPT, Executive Director of APTQI in response to the Journal’s reporting on chronic pain in America. The letter highlights guidelines from the Centers for Disease Control and Prevention that recommend physical therapy as an alternative to opioids for the treatment of chronic pain.
To read Patel’s letter to the editor, CLICK HERE.
Toledo Blade: BWC Listened
On February 28, The Toledo Blade printed a letter to the editor from Nikesh Patel, PT, DPT. The letter praises the Ohio Bureau of Workers’ Compensation for working collaboratively with stakeholders to implement a rule that requires a more reasonable level of documentation than originally proposed.
To read Patel’s letter to the editor, CLICK HERE.
What’s Happening in Washington
Bipartisan Senate Bill Introduced to Address Physical Therapist Professional Shortage
On April 2, Senators Angus King (I-ME), Jon Tester (D-MT), and Roger Wicker (R-MS) introduced bipartisan legislation (S. 970) in the U.S. Senate to address the significant shortage of physical therapists and physical therapy professionals relative to high demand for PT services. If passed, the bill will enable physical therapists to participate in the National Health Service Corps student loan repayment program.
APTQI strongly supports S. 970 because it will allow physical therapists to invest in underserved communities by ensuring new PT centers would be able to recruit the professionals they need to properly serve underserved communities. APTQI is urging the Senate to pass this bipartisan legislation. Introduction of a House companion bill is expected in the near future.
APTQI was already on Capitol Hill the day S. 970 was introduced, advocating for additional cosponsors in the Senate.
To access information about the bill, CLICK HERE.
To read the APTQI statement supporting the bill, CLICK HERE.
Lawmakers Introduce Medicare for All Legislation
On February 27, Representative Pramila Jayapal (D-WA) introduced what is perhaps the most ambitious Medicare expansion legislation in modern America history. The Medicare for All Act of 2019 would transition the United States towards a single-payer, government-run healthcare system in which all treatment is free at the point of service for all citizens. While offering sweeping reforms to America’s healthcare system, the bill also leaves the Indian Health Services and the Veterans Health Administration intact. The legislation currently has more than 100 co-sponsors in the House of Representatives, signaling a major shift in the Democratic arty’s approach to healthcare policy.
To read the full bill, CLICK HERE.
Senate HELP Committee: Managing Pain During the Opioid Crisis
On February 12, the Senate Committee on Health, Education, Labor and Pensions (HELP) held a hearing on alternative ways to combat chronic and acute pain outside of opioid-based pharmaceuticals. The hearing featured four industry and medical professionals who spoke on a number of non-opioid treatments to address pain, including physical and restorative therapies, medicinal marijuana and certain acupunctures. One of the major themes of the hearing was the acknowledgment that, while alternative treatments exist, patients often lack access to such treatments due to Medicare’s current reimbursement structure.
To watch the full hearing, CLICK HERE.
FDA Examining Role of Opioids in Treating Chronic Pain
The FDA issued a press release on February 26 outlining the agency’s strategy to combat the opioid epidemic in 2019. Through a four-pronged approach, the FDA will pursue multiple avenues in preventing, treating, and managing the addiction crisis. One important aspect of the FDA’s approach is the research and development of non-addictive pain treatment alternatives. While the release did provide details about what such “alternatives” might entail, the agency stated that it would be updating “guidance” which will outline new ways to develop and approve novel treatment methods through clinical trial.
To read the full FDA release, CLICK HERE.
Lawmakers Plan to Introduce Legislation to Lower Medicare Eligibility Age
Representatives Joe Courtney (CT-2), Brian Higgins (NY-26), Peter Welch (VT-AL), and John Larson (CT-01) on February 13 announced plans to lower the Medicare Eligibility Age to enable those between the ages of 50-64 to buy into the program. The plan would also authorize HHS to negotiate volume discounts on prescription drugs in an attempt to achieve greater savings for current Medicare beneficiaries. The proposal comes as a rising confluence of progressive activists, as well as declared Democratic presidential candidates, have voiced support for a single-payer, “Medicare for all” healthcare system. The plan is supported by Senators Stabenow (D-MI) and Baldwin (D-WI), who plan on introducing similar legislation in the Senate. According to a recent poll conducted by the Kaiser Family Foundation, the Medicare buy-in proposal is supported by 77 percent of the public.
To see the lawmakers full statement on the Medicare Buy-In and Health Care Stabilization Act, CLICK HERE.
In the News
Study Examines Fall Prevention in Older People
In a new study, “Exercise for preventing falls in older people living in the community,” researchers assess the effects (benefits and harms) of exercise interventions for preventing falls in older people living in the community. The study concludes that certain exercise programs can reduce the rate of unexpected falls experienced by older individuals.
To view the study, CLICK HERE.
Study: Medicare Outpatient Physical Therapy Expenditures Vary by Diagnosis and Functional Mobility
In the February edition of Oxford Academic’s Physical Therapy, researchers examine the clinical characteristics driving variations in Medicare outpatient physical therapy expenditures, finding significant variations in physical therapy expenditures based on primary diagnosis and baseline functional mobility which supports their utility for predicting outpatient physical therapy expenditures. Although Medicare's annual therapy spending cap was repealed effective January 2018, the data from this study provides an initial foundation to inform any future policy efforts, such as targeted medical review, risk-adjusted therapy payments, or case mix groups as potential payment alternatives.
To read the Oxford Academic’s Physical Therapy study, CLICK HERE.
More U.S. Adults Reporting Chronic Pain
A new study published in The Journal of Pain, “Eighteen-Year Trends in the Prevalence of, and Health Care Use for, Noncancer Pain in the United States: Data from the Medical Expenditure Panel Survey,” examines trends in the overall rates of noncancer pain prevalence and pain-related interference, as well as in health care use attributable directly to pain management. The data illustrates changes in the management of painful health conditions including strong opioid use. The researchers recommend additional education of both health care providers and the general public on the risks of opioid use.
To read The Journal of Pain study, CLICK HERE.
Patients With Chronic Pain Continue Using Opioids Despite Little Clinical Improvement
In the December edition of Oxford Academic’s Pain Medicine, researchers study trends and patterns of opioid therapy over two years in a cohort of chronic noncancer pain (CNCP) patients and assess predictors of long-term opioid use and clinical outcomes. The study finds a pattern of increasing opioid prescription in chronic pain patients despite limited improvement of clinical outcomes– with most patients keeping their long-term opioid prescriptions.
To read the Oxford Academic’s Pain Medicine, CLICK HERE.
Health Affairs: Hospital Price Growth is Driving Healthcare Spending
A study in the February 2019 edition of Health Affairs analyzed growth in prices for inpatient and hospital-based outpatient services using actual negotiated prices paid by insurers. Researchers found hospital prices grew substantially faster than physician prices between 2007 and 2014, suggesting efforts to reduce health care spending should be primarily focused on addressing growth in hospital rather than physician prices.
To read the Health Affairs study, CLICK HERE.
AMA Survey Finds Prior Authorization Barriers Cause Negative Health Outcomes
On February 5, the American Medical Association (AMA) released findings from a survey indicating current prior authorization policies result in negative health outcomes. The survey included a poll of 1,000 practicing physicians. Key findings include:
To view the survey, CLICK HERE.
- 91% said the prior authorization procedures held up patient access to necessary care.
- 88% felt burdens tied to prior authorizations increased during the past five years.
- 86% reported burdens tied to prior authorizations were “high” or “extremely high.”
- 75% indicated prior authorizations at least sometimes resulted in patients calling off a recommended course of treatment.
- 36% reported having at least one staff member whose sole purpose was to work on prior authorizations.