MedPAC Stalls on Direct Access to Physical Therapy Services Decision is Temporary Setback for SLPs News in Brief
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News in Brief  |   March 01, 2005
MedPAC Stalls on Direct Access to Physical Therapy Services
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Practice Management / News in Brief
News in Brief   |   March 01, 2005
MedPAC Stalls on Direct Access to Physical Therapy Services
The ASHA Leader, March 2005, Vol. 10, 3. doi:10.1044/leader.NIB1.10032005.3
The ASHA Leader, March 2005, Vol. 10, 3. doi:10.1044/leader.NIB1.10032005.3
Promoting direct patient access to audiology and speech-language pathology services for Medicare beneficiaries is one of ASHA’s highest public policy priorities in 2005. But in a temporary setback, the Medicare Payment Advisory Commission (MedPAC) recently weighed in on the side of physician referral.
MedPAC recently issued a report assessing whether it was feasible and advisable to allow Medicare fee-for-service beneficiaries to have “direct access” to outpatient physical therapy (PT) services and comprehensive rehabilitation facility services. Congress requested that MedPAC study direct access to PT services as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). Visit the Medicare Payment Advisory Council Web site [PDF] to download the report.
In brief, the commission found no remarkable waiting time for Medicare beneficiaries to access PT services. Moreover, they said that removing physician referral and certification requirements would not save money. MedPAC wrote that, “if the referral requirement were lifted, these beneficiaries would still see their physicians for their other medical conditions.”
The commission concluded that “several reasons argue for retaining Medicare’s current requirements that physicians refer beneficiaries to PT services and oversee their care. These requirements are in place so that beneficiary health care needs are correctly diagnosed, referred for treatment and followed up.” They found that more rather than less control was necessary to help beneficiaries receive outpatient PT services that are needed and appropriate for their clinical conditions. MedPAC recommended that providers become more aware of coverage rules, better data should be made available regarding the efficacy of physical therapy, and that evidence-based guidelines be developed and disseminated to physicians and physical therapists.
In support of efforts by the American Physical Therapy Association (APTA), ASHA submitted a letter to MedPAC in support of direct access to Medicare services in response to its draft report released last October. Although the report represents a setback for the direct access movement, ASHA lobbyists have been in discussions with the sponsors of the Hearing Health Accessibility Act to reintroduce this legislation that seeks direct access to audiologists for Medicare beneficiaries.
For more information about the MedPAC report, contact Steven White by e-mail at swhite@asha.org or by phone at 800-498-2071, ext. 4126. For more information on the Hearing Health Accessibility Act, contact Reed Franklin at rfranklin@asha.org or by phone at 800-498-2071, ext. 4473.
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March 2005
Volume 10, Issue 3