Long-term care therapy advocates and peers from other healthcare sectors touted the potential savings of nearly a quarter billion Medicare dollars if the SMART Act is passed.
The bipartisan House bill would lessen administrative burdens on physical and occupational therapists and especially help therapy providers in rural and underserved areas of the country.
Those areas have been especially hard hit by ongoing staffing shortages compounded by a 15% Medicare payment cut that went into effect Jan. 1, 2022 for Medicare Part B services provided by an occupational or physical therapy assistant.
“We have the double-whammy of the workforce shortages — we just don’t have the clinicians — and the resources the government is giving us to pay for services has been reduced again,” noted Cynthia Morton, the executive vice president of the National Association for the Support of Long-Term Care Wednesday.
NASL is a member of a coalition endorsing the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act, which has 40 sponsors in the House and is now seeking a sponsor for a Senate version.
On Wednesday, the coalition hailed results of an independent, nonpartisan study it commissioned which showed that Medicare could save between $168 million and $242 million over 10 years by cutting back on administrative burdens for physical and occupational therapists. The study was completed by Dobson DaVanzo & Associates Aug. 18 but results were not publicized until this week.
“We were pleasantly surprised to see parts of this legislation would save money,” Morton told McKnight’s. “That is exciting because that savings could help offset the cost of reducing the cut for a period of time to give nursing homes and other places where therapy is provided a chance to get through this workforce shortage, thinking it’s got to get better in the next couple of years.”
Part B therapy providers already have a “general supervision” clause in place for all settings except private practices. In addition, 47 states already have such allowances in place, Morton added.
She said the legislation, HR 5536, would be especially helpful to Medicare beneficiaries in the 58% of counties considered to be in rural or underserved areas. Those are currently 50% more likely to receive therapy from a therapy assistant, according to a statement from the coalition.
“Through the SMART Act we can improve access to physical and occupational therapy services while cutting red tape in Washington,” said Rep. Jason Smith (R-MO) who joined Rep. Bobby Rush (D-IL) in introducing the bill in late 2021.
The coalition hopes the legislation will be taken up and included in the “usual melee of healthcare legislation” considered at the end of the year, Morton said.
“The proposal cost could be low enough to make it viable. That gives us some credibility,” she added. “Overall, the proposal could cost $1.4 billion, but the savings could get it down to $500 million. If Congress would ignore this, the costs would continue and we would face the costs of a greater number of people falling because we don’t have the therapists in those areas to start a course of therapy. . Operators providing these services are really at a turning point. Access to therapy in nursing homes and other areas is going to critically decrease.”
