Active Legislative Updates from ASHT
ASHT Legislative Alert re: Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R. 4315/S.3977)
Reimbursement of medically necessary orthotic devices is challenging for many hand therapists due to Medicare denials in response to the Reasonable Useful Lifetime restrictions. The American Society of Hand Therapists is pleased to report current legislative action that could assist therapists with this reimbursement issue.
Last summer, a bipartisan group of legislators introduced H.R. 4315, the Medicare Orthotics and Prosthetics Patient-Centered Care Act. Once section of the bill, led by Reps G.T. Thompson (R-PA), Mike Thompson (D-CA), Brett Guthrie (R-KY), and Angie Craig (D-MN), would increase Medicare beneficiary access to custom-fitted and custom-fabricated orthoses by removing application of Reasonable Useful Lifetime restrictions in many routinely encountered instances. We are pleased to report that, on March 19, 2024, a Senate companion bill (S.3977) was introduced by Senators Mark Warner (D-VA) and Steve Daines (R-MT). We now have bipartisan, bicameral legislation that would address this significant topic impacting Hand Therapists and our patients.
It takes only a few minutes to make your voices heard and make a difference in our profession. Please contact your Representative and Senators to let them know how important this bill is for patients and providers and ask them to sign on as a cosponsor.
Also, did you know non-members can also utilize our Legislative Action Center? Please share this link with any non-ASHT members with an interest in supporting this bill.
GOOD NEWS!
After many months of advocacy, President Biden signed a law on March 9 that mitigated the 2024 Medicare reimbursement cuts faced by hand therapists and many other provider types. Specifically, this measure reduces the 3.37% cuts by 1.68%; however, this will only be effective on a prospective basis for services performed after March 9, 2024.
While ASHT appreciates congressional action to address these cuts in part as they have done in prior years, it is clear significant reforms must occur within the Medicare program, and we will continue our work with our allied organizations to prioritize this advocacy in 2024 and beyond.
ASHT Legislative Alert re: Medicare Cuts and the REDUCE Act (H.R. 7279)
The American Society of Hand Therapists (ASHT) has been busy representing your interests before policymakers in Washington, DC. Constituent voices are always the most impactful when it comes to advocating with lawmakers, and we need your help to reinforce ASHT’s federal advocacy work on two important issues.
Medicare Cuts Impacting Hand Therapists and Patients
First, as you know, hand therapists have battled Medicare reimbursement cuts for several years due to outdated Medicare budgetary requirements. While ASHT has successfully urged Congress to mitigate these cuts in recent years, we are advocating with lawmakers to address the additional cuts currently in effect for 2024. Congress is working on a solution that we hope will be included as part of a large, upcoming legislative package, so it is critical that Congress hear from you too about how this will impact your practice and patients.
Co-Sponsor the REDUCE Act (H.R. 7279)
The second opportunity to weigh in with Congress relates to a brand-new piece of legislation that would cut red tape for hand therapists in private practice. Specifically, the bipartisan Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279), would eliminate the requirement that therapists obtain a referring provider’s signature on a plan of care certification. This bill was recently introduced by Reps. Don Davis (D-NC) and Lloyd Smucker (R-PA). Please contact your Representative to let them know how important this bill is for patients and providers and ask them to sign on as a cosponsor.
It takes only a few minutes to make your voices heard and make a difference in our profession. Please contact your members of Congress TODAY!
Also, did you know non-members can also utilize our Legislative Action Center? Please share this link with any non-ASHT members with an interest in supporting this bill.
ASHT Legislative Alert re: Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R. 4315)
Hand therapists have long been besieged by problematic Medicare denials of medically necessary orthotic devices due to application of Reasonable Useful Lifetime restrictions. The American Society of Hand Therapists is happy to report new action on the legislative front to address this challenge.
Recently, a bipartisan group of legislators introduced H.R. 4315, the Medicare Orthotics and Prosthetics Patient-Centered Care Act. One section of the bill, led by Reps G.T. Thompson (R-PA), Mike Thompson (D-CA), Brett Guthrie (R-KY) and Angie Craig (D-MN), would increase Medicare beneficiary access to custom-fitted and custom-fabricated orthoses by removing application of Reasonable Useful Lifetime restrictions in many routinely encountered instances.
Please contact your Representative to let them know how important this bill is for patients and providers and ask them to sign on as a cosponsor.
It takes only a few minutes to make your voices heard and make a difference in our profession. Please contact your members of Congress TODAY!
Also, did you know non-members can also utilize our Legislative Action Center? Please share this link with any non-ASHT members with an interest in supporting this bill.
Action Alert • Issue Brief
PROTECT HAND THERAPISTS’ MEDICARE REIMBURSEMENT IN 2023 AND BEYOND (H.R. 8800)
October 13, 2022
Hand therapists and many other health care providers have faced problematic Medicare reimbursement cuts over the past couple of years. Unfortunately, this threat once again looms, as additional reimbursement cuts are currently slated to take effect in January of 2023. Specifically, the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule includes a 4.42-percent reduction in the conversion factor that negatively impacts provider reimbursement. Medicare providers also face an additional 4-percent reimbursement reduction due to the Statutory Pay-As-You-Go (PAYGO) Act requirements that legislation may not increase the federal deficit. ASHT has been and will continue to remain at the forefront of efforts to combat these misguided reimbursement cuts, and your voices have been crucial in ensuring previous support from Congress to mitigate them.
ASHT is thrilled that Representatives Ami Bera (D-CA) and Larry Bucshon (R-IN) have introduced the Supporting Medicare Providers Act of 2022 (H.R. 8800), which would boost the MPFS conversion factor by 4.42% for 2023. This legislation also expresses that it is the sense of Congress that the Department of Health and Human Services and Congress should commit to take administrative and legislative actions to ensure financial stability and predictability in the Medicare program. ASHT is supportive of broader reforms to Medicare provider reimbursement that would prevent the continuation of these annual payment reductions. ASHT is also urging Congress to waive the PAYGO cuts in order to prevent the additional 4-percent reimbursement reduction.
ASHT encourages you to write a letter – ask your U.S. Representative and request that they co-sponsor and support enactment of H.R. 8800 by the end of the year in order to once again mitigate reimbursement cuts for hand therapists.
It takes only a few minutes to make your voices heard and make a difference in our profession. Please contact your members of Congress TODAY!
Also, did you know non-members can also utilize our Legislative Action Center? Please share this link with any non-ASHT members with an interest in supporting this bill.
Call to Action: Allied Health Workforce Diversity Act of 2021 (H.R. 3320)
October 29, 2021
The Allied Health Workforce Diversity Act of 2021 (H.R. 3320) would provide grant funding to colleges and universities to make physical therapy, occupational therapy, respiratory therapy, audiology and speech-language pathology programs more accessible to underrepresented communities, including racial and ethnic minorities. This legislation is being considered by the House Energy and Commerce Health Subcommittee during a legislative hearing this week. The bill is led by Representatives Bobby Rush (D-IL) and Markwayne Mullin (R-OK) in the House, and also has a Senate companion.
ASHT encourages you to contact your U.S. representatives and ask them to cosponsor this important legislation and ensure their underrepresented constituents have greater access and more grant funding in the fields of OT and PT. Please send a letter to your member of Congress. It takes only a few minutes to make your voices heard and make a difference in our profession. Please contact your members of Congress TODAY!
Also, did you know non-members can also utilize our Legislative Action Center? Please share this link with any non-ASHT members with an interest in supporting this bill.
Call to Action: Fight Cuts to Medicare Therapy Reimbursement
October 10, 2021
ASHT has been engaged in a multi-year effort to prevent harmful cuts to Occupational Therapy and Physical Therapy Medicare reimbursement. While ASHT is working with Congress and other stakeholders facing Medicare cuts to develop and implement long-term solutions to the reimbursement challenges stemming from the Medicare Physician Fee Schedule (PFS), it is imperative to provide short-term stability and prevent cuts from taking effect in January 2022. You will recall that Congress acted in late 2020 to mitigate these cuts, including by providing a 3.75% payment adjustment for all PFS services; however, this payment adjustment is set to expire at the end of 2021.
To help raise awareness about the need to prevent these cuts, Reps. Ami Bera (D-CA) and Larry Bucshon (R-IN) are circulating a bipartisan Congressional sign-on letter to House leadership requesting Congress “act before the end of the year to avert the imminent cuts, including extending the 3.75% payment adjustment, and provide continued stability for physicians and other health care professionals.”
While ASHT is thrilled that over 180 Representatives have already signed the letter, we need your help to successfully advocate that over 200 House members sign onto the Bera-Bucshon letter before next Wednesday, October 13th. Achieving this amount of support would send a tremendously strong message to House leadership and signal vast support for preventing these cuts.
Take Action
If your Representative does not appear on the list, please use the Legislative Action Center issue 'Fight Cuts to Medicare Therapy Reimbursement - - By Asking Your Member of Congress to Sign'
If your Representative appears on the list, please use the Legislative Action Center issue 'Fight Cuts to Medicare Therapy Reimbursement - -Thanking Your Member of Congress if They Have Signed'
Call to Action: Help End Medicare Coverage Denials of Medically Necessary Orthoses
December 22, 2020
Hand Therapists providing therapy services in Medicare have an opportunity to submit comments to the Centers for Medicare and Medicaid Services (CMS) on the 2021 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Proposed Rule.
The CMS proposed rule, released in November, fails to address the concerning pattern of Medicare denials of medically necessary custom-fabricated low temperature thermoplastic orthotics and prefabricated orthoses for the upper extremity. ASHT has been advocating that CMS address these denials, and feedback from practitioners is essential to convey the urgency of this issue.
Comments are due by January 4, 2021. To submit a comment, please follow the link here and click the “SUBMIT A FORMAL COMMENT” button on the top right-hand corner of the screen. ASHT is also submitting a comment letter on the proposed rule.
ASHT has prepared a suggested comment letter template for you to modify and personalize based on your personal practice experiences when submitting your letter. Please go to our Legislative Action Center (LAC) to send your comment today!
Also, did you know that nonmembers can utilize our LAC? Please share this link with any non-ASHT members who have an interest in commenting!
Call to Action: Help Preserve Telehealth Access
November 23, 2020
ASHT is pleased to report on an exciting telehealth policy development and requests your help in building support for this promising new proposal. Earlier this year, your advocacy was instrumental in ensuring that CMS used its authority to allow OTs and PTs to bill Medicare for services provided via telehealth during the Public Health Emergency (PHE). However, this ability only lasts as long as the PHE, which has currently been extended through January 20, 2021. Congress must make statutory changes to allow OTs and PTs to provide services to Medicare beneficiaries beyond the PHE, and recently introduced legislation in the U.S. House of Representatives will do just that!
Representatives Mikie Sherrill (D-NJ) and David McKinley (R-WV) have introduced the Expanded Telehealth Access Act (H.R. 8755), which would enable OTs and PTs to continue providing therapy to Medicare patients via telehealth after the PHE expires. The bill already enjoys strong bipartisan support, as it was introduced by Reps. Sherrill and McKinley along with 12 bipartisan cosponsors; however, we need your help to continue building momentum and support!
ASHT urges you to contact your U.S. representative and ask them to cosponsor this important legislation and ensure their constituents continue to have access to therapy services provided via telehealth. Please go to our Legislative Action Center (LAC) to send a letter to your member of Congress. It only takes a few minutes to make a difference in our profession and make our voices heard. Please contact your members of Congress TODAY!
Also, did you know that nonmembers can utilize our LAC? Please share this link with any non-ASHT members who have an interest in supporting this bill!
Outpatient Therapy Modernization and Stabilization Act (H.R. 7154)
August 4, 2020
On August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) released its proposed 2021 Medicare Physician Fee Schedule. The rule recommends significant payment reductions to more than three dozen health care professions, including occupational and physical therapy.
CMS is using the revenue from these cuts to offset an increase in payments for physicians. These cuts are the result of a Medicare statutory requirement known as "budget neutrality" which requires that any increase in costs to the Medicare program must result in decreased spending elsewhere in the Medicare program. The CMS proposal would cut reimbursement for Medicare Part B therapy codes (including 97165, 97110 and 97161 for example) by an estimated 9 percent.
ASHT, the American Occupational Therapy Association and the American Physical Therapy Association have been actively raising concerns with Congress and CMS about the impact these cuts on providers and patients in need of care, particularly amidst the COVID-19 pandemic.
Fortunately, bipartisan legislation has been introduced in the House of Representatives (H.R. 7154, the Outpatient Therapy Modernization and Stabilization Act). by Reps. Boyle (D-PA) and Buchanan (R-FL) that would prevent these proposed reimbursement cuts by waiving the statutory budget neutrality requirements.
ASHT will continue to advocate against these cuts with CMS, but we need you to take action now by asking your members of Congress to intervene to stop these payment reductions.
Stay tuned to ASHT's Legislative Action Center for updates on this issue.
CMS Telehealth Update
June 5, 2020
Submitted by: ASHT Leadership
As reported in April, the Centers for Medicare & Medicaid Services (CMS) announced the inclusion of occupational and physical therapy practitioners as Medicare telehealth service providers retroactive to March 1, 2020, for the duration of the coronavirus pandemic. We still have work to do to have telehealth permanence beyond the current public health emergency.
On June 1, 2020, ASHT submitted comments to Centers for Medicare & Medicaid Services (CMS) in response to the inclusion of occupational and physical therapy practicioners as medicare telehealth service providers.
ASHT Practice Division welcomes suggestions from members. Please use asht@asht.org or the Practice and Reimbursement Group on the E-community to submit your comments.
April 30, 2020
Submitted by: ASHT Leadership
CMS Announces Inclusion of OT and PT Practitioners as Medicare Telehealth Service Providers
We did it!
In response to COVID-19, Congress and the Administration took swift action to expand telehealth services. Although therapy CPT codes were added to the list of eligible telehealth services, CMS did not explicitly recognize therapists as eligible telehealth providers.
During this time, AOTA, APTA and ASHT continued to advocate for telehealth to be expanded in order to recognize therapists as eligible providers.
ASHT asked for your help to get across the finish line. Nearly 500 members took action on ASHT’s Legislative Action Center to urge CMS to add occupational and physical therapists as eligible Medicare telehealth providers.
WE DID IT!! Today CMS announced inclusion of occupational and physical therapy practitioners as Medicare telehealth service providers retroactive to March 1, 2020, for the duration of the coronavirus pandemic.
The professional impact of this announcement is immeasurable. During this unprecedented time, the ability for hand and upper extremity therapists to continue to work with patients has been critical. The ability to access our population remotely without risking exposure to the virus is profound. We couldn’t have done it without your advocacy.
We still have work to do to have telehealth permanence beyond the current public health emergency. But today, we have a victory and I couldn’t be prouder of us.
Thank you for your teamwork!!!
Mojca “Mo” Herman, MA, OTR/L, CHT
2019-2020 ASHT President
Relief Payments Made to Medicare Providers and OT Recognized in Home Health
April 13, 2020
Direct Relief Payments:
On April 10th, the Department of Health and Human Services initiated the first phase of CARES Act (P.L. 116-136) relief funding. As part of the new law’s Public Health Service Emergency Fund (PHSEF), HHS delivered $30 billion in direct deposits to providers, including therapists, and facilities based on their share of 2019 Medicare FFS billing. Importantly for Hand Therapists receiving payment through the PHSEF, you will not be asked to repay any of the distributed funds.
Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13, 2020 and will be linked from hhs.gov/providerrelief.
Visit hhs.gov/providerrelief for additional information.
OT and Home Health:
On April 9th, the Centers for Medicare & Medicaid Services (CMS) utilized new authorities under the recently passed pandemic response law to allow Occupational Therapists to open Medicare home health cases.
ASHT has long advocated for changes that would allow Occupational Therapists to perform the initial assessment for any home health patient with a plan of care that includes therapy. ASHT appreciates CMS’ efforts ensure Medicare beneficiaries, during this period, can access home health in a timely and efficient manner.
Please stay tuned for additional updates on these and other critical COVID-19 related topics.