Medicare beneficiaries who need physical therapist services would find it easier and more efficient to obtain treatment under legislation introduced recently in the House of Representatives. The Medicare Patient Access to Physical Therapists Act (HR 1829), introduced by Representatives Earl Pomeroy (D-ND), Tim Murphy (R-PA), and Tammy Baldwin (D-WI), eliminates the need for beneficiaries to obtain a physician referral for physical therapy services.      

“Direct access under Medicare would remove unnecessary barriers to the cost-effective rehabilitation services provided by physical therapists," said APTA President R Scott Ward, PT, PhD. "Currently these health care consumers, which include seniors and people with disabilities, often have the greatest need for physical therapy services and experience unnecessary burdens to access these services. The referral process can often cause delays that can impede a patient’s ability to achieve his or her optimal functional outcome. In light of today’s economic environment, timely access to cost-effective physical therapy services for Medicare beneficiaries is critical.”      

Forty-eight states and the District of Columbia have eliminated the physician referral requirement for patients to access PTs for an evaluation, while 44 states and DC allow access to some form of physical therapy treatment without referral. This legislation would defer to the state law on access regarding physical therapy.

“Requiring Medicare patients to get a physician referral before they can see a physical therapist puts an undue burden on residents of rural areas who often travel long distances just to see their doctor,” Pomeroy said. “Removing the physician referral requirement would save valuable time and money for Medicare patients in North Dakota and across the country.”

The United States Department of Defense allows licensed physical therapists to act as primary care providers for military personnel and their dependents without an initial physician referral, Murphy said, adding that we should extend this option to Medicare patients.

“Health care delivery must be a collaborative and cooperative effort,” said Representative Baldwin. “This legislation acknowledges the important roles of physical therapists in patient care and of individual states in influencing health care policy. As we strive to improve the quality of care, increase accessibility, and lower costs, allowing states to give Medicare patients direct access to physical therapists is one piece of the solution.”

A Senate companion bill is expected to be introduced in the next several weeks.

On another front, the APTA, Alexandria, Va, backs new health care recommendations. "As a supporting organization of Stand for Quality, a diverse coalition of more than 165 organizations from across the spectrum of health care, the APTA is pleased to announce the coalition’s recommendations to improve the quality and affordability of health care for all patients through a public-private partnership," says R Scott Ward, PT, PhD, the group’s president. "The recommendations build on existing improvement efforts and aim to harness the energies of the public and private sectors to enhance the quality of health care—ensuring reform not only expands coverage, but also improves the care patients receive."

Stand for Quality proposes setting national priorities and providing coordination for quality improvement; endorsing and maintaining nationally standardized measures; developing measures to fill gaps in priority areas; ensuring that providers and other stakeholders have a role in developing policies on use of measures; collecting, analyzing, and making performance information available and actionable; and supporting a sustainable infrastructure for quality improvement, he says.

[Source: APTA]