Federal Regulation, Dry Needling and Licensure Compact Highlights from 2017 APTA State Policy and Payment Forum

HAPTA members Joanne Zazzera, Patti Taira-Tokuuke and I (Justin Ledbetter) recently traveled to Detroit, Michigan to attend the annual APTA State Policy and Payment Forum.

In addition to Joanne receiving the APTA State Legislative Leadership Award, we learned a lot about what’s going on around the country. Here are some highlights.

Federal Regulatory Affairs

  • PTs are currently not required to participate in MIPS (Merit-based Incentive Payment System) but will most likely have to in 2019. If you are not participating in MIPS you should participate in an Advanced APM (Alternative Payment Model).
  • If you receive a letter from an SMRC (Supplemental Medical Review Contractor) regarding a patient, please request a discussion period as soon as possible. You only have 30 days from the date of the letter to make this request and it gives you an additional period to make your case.
  • APTA is monitoring pending legislation to have PT excluded from the in-office ancillary services exception; however, it does not remove the exception for rural health.

Dry Needling (DN) Update

  • Legal challenges to dry needling in North Carolina, Iowa and Colorado
    • NC: Superior Court upheld the ruling in favor of PTs but the acupuncture board has appealed – there won’t be any movement on the federal anti-trust suit until the state’s case is decided.
    • IA: The PT board issued an order authorizing DN but the acupuncture board requested a judicial review of the declaratory order – the case is now in the state Supreme Court.
    • CO: The PT board issued an order for DN five-six years ago but a recent lawsuit was brought against the board – a motion by the PT board to dismiss the case was denied.
  • Payment for DN – APTA is looking to submit an application for a Catetory 1 CPT code for DN, along with the chiropractic association. This may have to be changed to a Category 3 code.

FSBPT Update on Physical Therapy Licensure Compact

  • 14 states have now passed legislation and the compact has been officially enacted. The Physical Therapy Compact Commission began meeting in June and will votes on draft rules at the Federation of State Boards of PT annual meeting in November.
  • Legislation has been introduced on two additional states.

Justin Ledbetter
HAPTA Legislative Committee

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