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Giving Voices to Our Women’s Health Patients: Highlights from the APTA Federal Advocacy Forum  

Posted on: April 7th, 2017 by Aika Barzhaxynova No Comments

 

Federal Affairs Forum 2017By April Ritz, DPT

First, I want to give a huge shout-out to the Section on Women’s Health for sponsoring me to attend my first American Physical Therapy Association Federal Advocacy Forum in Washington, D.C., March 26-28, 2017.

Second, I’m giving special thanks to Gail Zitterkopf, SOWH federal affairs liaison, for taking me under your wing, showing me the city, and sharing your knowledge.

This was a memorable experience for me. We covered so many issues before heading to Capitol Hill to voice our opinions and to educate our elected officials on the following legislation:

  • The Medicare Access to Rehabilitation Services Act (a.k.a., Therapy Cap Repeal, H.R. 807/ S. 253). The Therapy Cap currently limits Medicare patients to a total of $1,980 for speech and physical therapy services. While extensions can be added, this can delay care. The bill has failed to be implemented 16 times since 1997, and extensions have just been added, but the current extension ends December 31.
  • Physical Therapist Workforce and Patient Access Act (H.R. 1639/ S. 619). My Representative, John Shimkus is a co-sponsor of this important bill, which would add PTs to the pool of health professionals able to serve in shortage areas (National Health Service Corps). In my district of central Illinois alone, there are 43 health professional shortage areas. Being part of the NHSC also would qualify PTs to be part of the loan repayment program.
  • The Sports Medicine Licensure Clarity Act of 2017 (H.R. 302/ S. sister bill). This bill lets physicians, PTs, and athletic trainers travel with their professional or collegiate team across state borders and still practice. Passed by the House of Representatives, it is awaiting Senate approval.
  • SAFE Play Act. APTA is trying to standardize protocol for concussion management and return-to-play guidelines for youth athletes. Currently, without standards, most states have a wide variety of rules.
  • Lymphedema Treatment Act (H.R. 930). Lymphedema compression garments are not considered Durable Medical Equipment under Medicare, which limits patients’ recoveries and boosts medical costs due to complications from lymphedema.

I know it’s a lot of information, but it would be great if you would contact your state representatives or senators this week. Those of us on Capitol Hill met with or gave an APTA folder to every senator, representative, and/or legislative assistant. Please follow up with them and let them know that you care! They need to hear from their constituents.

Here’s a true story: A representative stopped supporting a PT bill solely because he had not heard from any of his PT constituents that year on the issue. You can use the templates online through the APTA website (http://www.apta.org/TakeAction) or download the PTaction app on your phone. Try to customize it, though, to reflect that you are their constituent and that you support what the APTA stopped in their office to discuss March 28.

I highly recommend attending the FAF or at least your state PT Day on the Hill! We need to realize that if we do not stand up for our profession, we will be in trouble down the road. If not for APTA and PT-PAC, our profession would not have locum tenens, the ability to practice dry needling and many PT-friendly laws and policies. We would be a lot worse off than we are now!

I know our profession is facing a lot of issues, but we need to remember the Section on Women’s Health, APTA, and PT-PAC are fighting for us. To have the greatest leverage, though, we need to donate to the political action committee. As an APTA member, our annual dues are not allowed to go to the PAC, so we need to make an additional contribution to them. I urge you to do so yearly.

If every APTA member gave $20 a year, we would have the largest health professional PAC. This would help us tremendously! Here is a link for you to donate and support our profession for the future: http://www.ptpac.org/support_ptpac. As a side note, you must be an APTA member to donate to the PAC (it’s the law).

Remember the words of Thomas Jefferson: “We in America do not have government by the majority. We have government by the majority who participate.”

AUTHOR: April Ritz, DPT, works in outpatient orthopedics and women’s health in Mattoon and Champaign, Ill., for Carle Foundation Hospital. She also works as needed in the acute inpatient setting for HSHS St. John’s in Springfield, Ill.

 

 

 


 

 

 

Speak Out on Proposed Orthotics and Prosthetics Rule: Here’s How

Posted on: March 2nd, 2017 by Aika Barzhaxynova No Comments

By Gail Zitterkopf, PT, DPT

A proposed rule from the Centers for Medicare and Medicaid Services (CMS) is drawing criticism from physical therapists (PTs) over additional requirements that PTs would need to meet to qualify as providers of custom orthoses and prostheses—and the Section on Women’s Health is making it easy for members to let CMS know what they think!

Please use the attached template to notify CMS of your concern, since CMS is accepting comments until March 13. This would impact members’ ability to determine the need and fitting for pessaries.

CMS’s proposal is to eliminate the Medical Improvements for Patients and Providers Act exemption and require physical therapists to become qualified practitioners subject to the licensure and accreditation requirements of § 424.57(d)(3).

These additional proposed licensure and accreditation requirements are unnecessary, because licensed physical therapists already receive extensive education in orthotics and prosthetics, and orthotics and prosthetics are part of the recognized practice of physical therapy.

For these reasons, the Section on Women’s Health is asking members and others to send this letter to CMS as soon as possible. We thank you in advance for your much-needed advocacy for the profession and will keep you posted on this important issue.

AUTHOR: Gail Zitterkopf, PT, DPT, is chair of the SOWH Federal Affairs Subcommittee.

YOUR ADDRESS:
DATE
Patrick Conway, MD, MSc,
Acting Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Room 445-G, Hubert H. Humphrey Building
200 Independence Avenue SW
Washington DC, 20201

Re: CMS-6012-P; Proposed Rule: Medicare Program; Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics

Dear Acting Administrator:

I would like to submit the following comments in response to the Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics proposed rule. The standards that CMS is putting forth in the proposed rule are so restrictive that the effect will be to limit Medicare beneficiaries’ access to my services that are safe and effective.

  • Include a paragraph about yourself, the O&P services you provide, your practice setting, the patients you serve, and how the proposed rule would negatively impact you and your patients, etc.

CMS’s proposal to eliminate the MIPPA exemption and require physical therapists to become qualified practitioners subject to the licensure and accreditation requirements of § 424.57(d)(3). These additional proposed licensure and accreditation requirements are unnecessary as licensed physical therapists already receive extensive education in orthotics and prosthetics, and orthotics and prosthetics are part of the recognized practice of physical therapy.  In addition, pelvic floor physical therapist must obtain additional training beyond that which is required for licensure to treat in this practice pattern.

The use of orthotic devices, such as a pessary is an integral part of the practice of physical therapy.  Physical therapists use specific tests and measures to determine the need for a pessary, in patients not currently using them and to evaluate the appropriateness and fit of pessaries presently in use. Physical therapists have extensive training and education in the fabrication of pessaries which makes additional regulations and certifications are needless, anti-competitive, and serve no practical purpose.

It is not uncommon for a woman to need a pessary after the birth of a child or before having pelvic surgery. It is most often used for prolapse of the uterus which is caused by the weakening or sagging of the muscles and/or ligaments. Pessaries are often used in conjunction with pelvic floor therapy to assist the patient in successfully achieving their health goals.

A vaginal pessary is a plastic, or rubber device inserted through the vagina to help support the uterus, vagina, bladder or rectum. This device is also helpful if you have stress urinary incontinence (the leaking of urine when you cough, strain or exercise), or experience incontinence while pregnant.

Prohibiting physical therapists from performing interventions with orthotics including pessaries would place an undue burden on patients by forcing them to see alternative providers.  This would increase the cost to the patient and the amount of time spent using health care practitioners. Currently no U.S. jurisdictions prohibit physical therapists’ ability to use orthotics and prosthetics as a component of physical therapist practice.

The proposed rule specifies that a qualified practitioner needs to be certified either by the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) or the Board of Certification/Accreditation (BOC). The proposed rule also states that certification may be granted by “A Secretary-approved organization that has standards equivalent to the ABC or BOC.”  At the current time, there are no Secretary-approved organizations with standards equivalent to ABC or BOC that are granting certification.  The fact that there are currently only two organizations granting certification will make it difficult for any provider seeking to become a qualified practitioner to meet the certification requirements of the proposed rule. In addition, neither of these two organizations provide regulation nor training for pessaries, thus eliminating orthotic fitting of pessaries from daily practice.

HOW TO SUBMIT YOUR LETTER:

In commenting, please refer to file code CMS-6012-P. You may submit comments in one of four ways (please choose only one of the ways listed):

  1. Electronically.You may submit electronic comments on this regulation to http://www.regulations.gov. Follow the “Submit a comment” instructions.
  2. By regular mail.You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-6012-P, P.O. Box 8013, Baltimore, MD 21244-8013.

Please allow sufficient time for mailed comments to be received before the close of the comment period.

  1. By express or overnight mail.You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-6012-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

 

 

 


 

 

 

Sports Medicine Licensure Clarity Act Awaits Senate Action

Posted on: January 24th, 2017 by Aika Barzhaxynova No Comments

By Gail Zitterkopf, PT, DPT, CLT, CKTP

The Sports Medicine Licensure Clarity Act of 2015 would provide certain licensure clarifications and legal protections to physical therapists, physicians, and athletic trainers as they travel across state lines with high school, collegiate, professional, or nationally governed sports teams. The legislation passed the house Sept. 12, 2016, but died with the close of the 114th Congress.

The 115th Congress is now in session, and on January 9, the House once again passed the bill as introduced by Reps. Brett Guthrie (R-KY) and Cedric Richmond (D-LA). The new bill, H.R. 302, had been introduced January 8 and immediately scheduled for a House floor vote.

Under the laws of many states, sports medicine professionals who travel from their primary state to a secondary state do not receive the liability coverage they would receive in their primary state. This creates a serious problem for physical therapists, physicians, and athletic trainers as they move across state lines to attend sporting events with teams that employ them. Since their malpractice insurance may not apply during such travel, they are put at significant professional and financial risk when treating injured athletes.

The Sports Medicine Licensure Clarity Act was introduced to address this issue and to allow sports medicine professionals–specifically physicians, PTs, ATCs, and other licensed professionals–to travel with high school, collegiate, professional, and national governing body sports teams without fear of repercussions from being uninsured.

Physical therapists’ work with athletes on teams who cross state lines, as well as requirements by sport organizations such as the National Football League that state every team must have a physical therapist traveling with the team across the country, make it crucial for Congress to approve this legislation and for the President to sign it into law.

Please consider using the PTaction app to email both of your state’s U.S. Senators. Although currently waiting for introduction of similar Senate legislation, members of the APTA Sports Physical Therapy Section have already reached out to Sens. John Thune (R-SD) and Amy Klobuchar (D-MN) to consider sponsorship of the bill. Please consider emailing your support for their co-sponsorship and votes to pass the bill.

For more information on this and other important physical therapy-related legislation, visit policy.apta.org.

AUTHOR: Gail Zitterkopf, PT, DPT, CLT, CKTP, chairs the Section on Women’s Health Federal Affairs Subcommittee. She can be reached at [email protected]

 

 

 


 

 

 

2016 State Policy & Payment Forum Sets Stage for 2017 Advocacy

Posted on: January 20th, 2017 by Aika Barzhaxynova No Comments
Jennifer Hungate, Kelly Huestis, and Gail Zitterkopf (left to right) represented SOWH at the 2016 State Policy & Payment Forum.

Jennifer Hungate, Kelly Huestis, and Gail Zitterkopf (left to right) represented SOWH at the 2016 State Policy & Payment Forum.

By Gail Zitterkopf, PT, DPT, CLT, CKTP

The 2016 State Policy & Payment Forum was held September 17-18, 2016, at the Omni William Penn Hotel in Pittsburgh, PA.

The State Policy & Payment Forum increases attendees’ knowledge of state legislative issues that impact physical therapy practice and payment, as well as improve individual advocacy at the state level. Such legislation can become a precursor for federal changes and are closely monitored and worked on by APTA and SOWH Federal Affairs Subcommittee members.

The forum provided state legislation updates on the following critical issues:

  • Louisiana – Direct Access
  • Kansas – Dry Needling
  • Wisconsin – Ordering X-rays
  • Florida – PTA Accreditation
  • Tennessee, Pennsylvania, Arizona, and Oregon – Physical Therapy Licensure Compact
  • New Mexico – Youth Concussions
  • Florida – Direct Access and Term/Title Protection
  • Pennsylvania – Fair Copays.

National payment policy updates included the use of tiered evaluation, Medicaid, infringement challenges, effective legislative testifying, reevaluation codes, and state licensure issues.

Want to learn more on the topics that impact your daily practice? Contact Gail Zitterkopft at [email protected] with questions or view forum highlights on the members-only section of the APTA website at “StateForum/2016/Highlights.” You might also consider attending the next State Policy & Payment Forum. For more information, visit the APTA State Policy & Payment Forum website: http://www.apta.org/StateForum.

AUTHOR: Gail Zitterkopt, PT, DPT, CLT, CKTP, chairs the SOWH Federal Affairs Subcommittee. She will be attending the 2017 Combined Sections Meeting in San Antonio, Texas, February 15-18 and would be delighted to answer questions. Questions also may be addressed to Director of Practice Jennifer Hungate at the SOWH Business Meeting February 17 at 6:30 p.m. at the Grand Hyatt San Antonio.

 

 


 

 

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