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With Medicare Pay Cuts Looming, Rush, Smith Introduce Bipartisan Legislation to Mitigate Impact of Cuts Threatening Access to Physical and Occupational Therapy in Underserved Areas

October 8, 2021

WASHINGTON — Today, U.S. Representatives Bobby L. Rush (D-Ill.) and Jason Smith (R-Mo.) introduced new bipartisan legislation to support Medicare beneficiaries’ access to physical and occupational therapy and the workforce providing these essential services. The Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act would delay and mitigate the impact of a looming 15% cut to the Medicare reimbursement rate for physical and occupational therapy assistants.

These pay cuts, which are set to go into effect in January 2022, will jeopardize employment opportunities for physical and occupational therapy assistants and leave many seniors — especially those in underserved and rural areas — with less access to critical therapy services. Specifically, the legislation would exempt therapy assistants in rural and medically underserved areas from the pay cuts, reduce burdensome requirements for direct supervision of therapy assistants in private practice settings, and delay the reimbursement cuts for non-exempt providers to January 2023.

“Many seniors and Medicare recipients rely on physical and occupational therapy services to maintain their independence and stay healthy and mobile after illness or injury,” said Rep. Rush. “These misguided pay cuts will cause severe harm to older Americans in underserved communities and to physical and occupational therapy assistants — many of whom are people of color. I thank my colleague Rep. Smith for joining me in introducing a bipartisan solution to mitigate the worst impacts of these looming changes and postpone their implementation.”

“Having access to physical and occupational therapy is a vital resource for our nation’s seniors and patients with mobility issues,” said Rep. Smith. “Medicare cuts to these services will reduce access to care, which is why I’m proud to work with Congressman Bobby L. Rush to ensure these patients — particularly those in rural areas — continue having these services available.”

The Medicare pay cuts to occupational and physical therapy assistants will go into effect at the same time, and compound, additional reductions to the Medicare fee schedule that were made to a wide range of health care disciplines to offset the recent boost in payment to primary care physicians for E/M services. Barring action by Congress, payment for therapy services will face an overall 6% cut in 2022. The additional 15% cut to therapy assistant services means these providers will be paid a staggering 21% less in 2022 than they were in 2020. These dramatic cuts are being imposed as practices and facilities are still trying to recover from the impacts of the COVID-19 pandemic.

“Access to physical therapy is critical to good health, yet Medicare beneficiaries, particularly those in underserved urban and rural areas, face a variety of barriers to accessing care. Implementing the 15% cut on physical therapist assistant services while we are still tackling a public health emergency will hurt these areas the most,” said American Physical Therapy Association President Sharon L. Dunn, PT, PhD. “APTA is grateful to Reps. Rush and Smith for their leadership to support access to care in those communities that need it most.”

“Occupational therapy assistants, in partnership with occupational therapists, are a critical component of the occupational therapy workforce,” said Wendy C. Hildenbrand, PhD, MPH, OTR/L, FAOTA, President of the American Occupational Therapy Association. “This collaborative partnership ensures that Medicare beneficiaries have access to necessary occupational therapy services. We would like to thank Rep. Rush and Rep. Smith for introducing the SMART Act which will ensure that beneficiaries in medically underserved and rural communities can receive the occupational therapy services they need to regain or maintain function and maximize independence.”

“Our physical and occupational therapy assistants play a critical in role in helping Medicare patients manage chronic pain conditions, particularly those in rural and underserved communities,” said Ron Rodgers, CEO of Athletico. “This legislation underscores the need for increased access to services and diversity among therapy assistants to ensure they can deliver quality care to the diverse populations they serve. We are proud to support these initiatives, and we thank Congressmen Rush and Smith for their continued commitment to improving health care access.”

The SMART Act is supported by groups including: ACCSES, Alliance for Recovery Care, Association of Assistive Technology Act Programs, Athletico, American Congress of Rehabilitation Medicine, American Health Care Association/National Center for Assisted Living, American Medical Rehabilitation Providers Association, American Occupational Therapy Association (AOTA), American Physical Therapy Association (APTA), American Therapeutic Recreation Association, Brain Injury Association of America, Clinician Task Force, National Association of Rehabilitation Providers and Agencies, National Association for the Support of Long Term Care, Private Practice Section of APTA, Select Medical, and United Cerebral Palsy.

The full text of the SMART Act is available HERE.

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Issues:Health Care