The Stabilizing Medicare Access to Rehabilitation and Therapy Act (SMART) is a bipartisan legislation proposed by Representatives Bobby Rush, D-Illinois and Jason Smith, R-Missouri in response to Medicare payments and healthcare accessibility in rural communities.
At the start of the year, payment for Medicare Part B services furnished by physical and occupational therapist assistants (PTA/OTA) had been reduced by 15% as a result of the Balanced Budget Act of 2018. This significant cut, among others, was designed to offset the recent boost in payment to primary care physicians for Evaluation and Management services.
Unfortunately, the payment reduction for services offered by PTA/OTAs will threaten access to care in rural, underserved areas, where the flexible availability of assistants benefit patients who may otherwise not have access to therapy and rehab services at all.
In addition to these difficulties, the current Medicare verbiage allows “general supervision” for therapy assistants in all capacities except for outpatient private practice, where instead they only allow “direct supervision.” This language prevents private practices from offering services to patients in need and increases the workload on physical and occupational therapists.
What is the SMART Act Intended to Accomplish?
To mitigate these changes, the SMART Act proposes the following:
- Exemptions to the reduced payments in designated rural and medically underserved areas
- A delay in the payment cut, postponing the reduction to January 2023
- Changing the supervision requirement from “direct” to “general” for private practices in states with licensure laws that allow for “general supervision”
How Is Raintree Involved?
With Raintree’s strategic partnership with the Alliance for Physical Therapy Quality and Innovation (APTQI), we share a common goal: To provide patients with efficient and excellent care. Take a stand with us and urge your member of congress to pass the SMART act.
