As the primary medical society for physical medicine and rehabilitation, AAPM&R is the organization that advocates on behalf of PM&R physicians and their patients. We position PM&R physicians as essential leaders early and across the healthcare continuum, defend against threats to PM&R practices and provide members with a powerful voice and opportunities to advocate for the specialty.
With the support of our dedicated volunteers, we’ve achieved some major advocacy-related “wins” for our member physiatrists and the patients they serve:
Defending the Role of Physiatrists Against Encroachment from Non-PM&R Physicians and
Non-Physicians
- Monitored by the State Advocacy Committee (SAC2) and opposed by the New York Society of PM&R (NYSPM&R), NY Senate Bill 3361 failed to advance in the 2023-2024 legislative session. The bill would have removed limits on physical therapists treating patients without referral from a physician. NYSPM&R President and SAC2 Chair, Dr. Richard G. Chang, shared concerns directly with the Medical Society of the State of New York.
- In partnership with the Multi-Society Pain Workgroup, your Academy submitted comments to the Oklahoma State Legislature opposing Oklahoma HB 2168, which would allow certified registered nurse anesthetists to perform interventional pain procedures. Advocacy efforts were successful in defeating the bill.
- Solicited Academy members in New York to stop the elimination of oversight of physician assistants (PAs) in Part W of the Governor’s proposed Health and Mental Hygiene Budget (A.3007/S.4007) for the 2023-2024 state fiscal year. Local Academy members sent more than 80 letters to state officials. The final budget was signed by the Governor in 2023 and the provision eliminating the oversight of physician assistants was removed.
Fighting Against PM&R Physician Fee Cuts and For Improved PM&R Physician Payment
- After years of advocacy by AAPM&R and its physician volunteers, the Medicare Payment Advisory Commission (MedPAC) announced in its June 2024 report to Congress that it is halting its work on developing a recommendation for site-neutral payment policies for care provided in the Inpatient Rehabilitation Facility (IRF) setting. Over the years, the Academy worked to ensure that physiatry’s voice was taken into account during MedPAC’s ongoing deliberations on this issue and collaborated with other stakeholder organizations to advocate against site-neutral payment proposals and the development of a Unified Post Acute Care Prospective Payment System. These efforts included submitting and co-signing numerous comment letters, participating in multiple Technical Expert Panels (TEPs), meeting with Congressional offices and MedPAC staff, testifying before the U.S. Congress, and creating Principles for a Medicare Unified Post-Acute Care Payment System to advocate for prioritizing patient needs.
- Medicare physician payment reform was a top priority during Congressional meetings for our annual Hill Day in 2023, where we advocated for high-quality, high-value care and sustainable positive annual updates to the Medicare Physician Fee Schedule (MPFS) while meeting with more than 20 Congressional offices. Faced with the immediate threat of reduced payment in 2024, we continued to engage Congress and encourage members to contact their representatives via grassroots advocacy. On March 8, our voices were heard! Congress passed a partial government funding package that contained a reduction of approximately half, eliminating 1.68% of the 3.37% cut to the Medicare Physician Fee Schedule that went into effect January 1, 2024. While we appreciate Congress taking action to partially repeal this cut, AAPM&R has consistently advocated for lawmakers to eradicate the full cut. Physicians have faced two decades without positive updates to the MPFS, which is completely unacceptable, and we will continue advocating in 2024 for Congress to enact sustainable physician payment reform.
- AAPM&R hosted an educational session on navigating the changes to inpatient evaluation and management coding which took effect January 1, 2023. This session is now available on the Online Learning Portal free to Academy members.
Fighting to Reduce Physiatrist Burden by Removing Prior Authorization Barriers
- CMS released its long-awaited Interoperability and Prior Authorization Final Rule in January 2024. This rule, once implemented, will require covered payers to establish electronic prior authorization systems, transmit prior authorization decisions within 72 hours for expedited requests and seven calendar days for standard requests, provide a specific reason for denying prior authorization appeals, and publicly report metrics for prior authorization. The release of this final rule comes after years of advocacy efforts focused on prior authorization reform by the Academy and is a significant win for PM&R physicians and their patients.
- CMS released a rule implementing reforms to the prior authorization process under Medicare Advantage program in April 2023, the FY 2024 Medicare Advantage and Part D Final Rule. The Academy hosted a webinar, “Challenging Medicare Advantage Denials of PM&R Physician Services,” to inform Academy members of new tools that this rule has made available to physiatrists combatting prior authorization denials by Medicare Advantage plans. This resource is available for download in the Academy’s Online Learning Portal.
- We continue to push CMS on regulatory reforms to reduce the burdens imposed by unnecessary prior authorization requirements through individual Academy comments and coalition sign-on letters.
Advocating for Expanded Telehealth Innovations and Enhanced Ways for Physiatrists to Advance Patient Care
- We joined other organizations to advocate for keeping telehealth waivers in place through the end of 2024, and our advocacy efforts were successful! Payment parity, as well as an expanded list of covered services, remain in place through December 31, 2024. AAPM&R continues to advocate for legislation to make telehealth flexibilities permanent.
Advocating for Your Patients to Ensure Equitable Access to Care, Equipment and Community Inclusion
- CMS dramatically expanded coverage of seat elevation systems in power wheelchairs for Medicare beneficiaries, an advancement that comes after many years of advocacy from AAPM&R and our members who treat patients that rely on seat elevation systems to perform daily activities. This is a significant step forward in expanding equity and access to critically important medical technology and will dramatically improve the quality of life for patients that rely on power wheelchairs.
- The National Institute of Minority Health and Health Disparities (NIMHD) announced that it will designate people with disabilities as a health disparity population for research undertaken by the National Institutes of Health (NIH). This groundbreaking move, which follows years of advocacy from AAPM&R, will help address health disparities faced by people with disabilities and ensure that NIH research going forward will include their perspectives.
- The AAPM&R Delegation to the American Medical Association (AMA) successfully introduced and gained approval for two resolutions that addressed increasing accessibility for users of wheelchairs on airplanes and expediting repairs for power and manual wheelchairs. As a direct result of the AAPM&R Delegation’s work, the AMA will now…
- advocate Congress and the Federal Aviation Administration make air travel accessibility accommodations for wheelchair users.
- support health insurance coverage to eliminate barriers for patients to obtain safe, affordable and timely wheelchair repairs.
- Your Academy was asked by the U.S. Government Accountability Office (GAO) in 2023 to provide expert input for a study on the quality of care currently available for patients with limb loss and limb difference, as well as ways that our national healthcare system can be improved for this patient population.
Advancing Long COVID Advocacy to Position PM&R Physicians as Leaders in Multi-Disciplinary Care
- In July 2023, the White House answered our call to action and officially opened a new Office of Long COVID Research and Practice to lead the whole-of-government response and to implement the National Research Action Plan on Long COVID.
- Following advocacy efforts from AAPM&R, the U.S. Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality, published a funding opportunity for Long COVID research. HHS recently announced the grant awards, and we are thrilled to share that six of the nine Long COVID clinics to receive this funding are part of our Multi- Disciplinary PASC Collaborative. Each awardee will receive $1 million for up to five years and this grant goes directly to clinics to use at the point of care. Congratulations to the Kennedy Krieger Institute, UT Health San Antonio, University of Washington, Icahn School of Medicine at Mount Sinai, University of Colorado and Washington University in St. Louis.
Our Academy volunteers made these important “wins” happen! Thank you to our committees, workgroup members and liaisons for your ongoing efforts!
However, our work is just beginning. We need members like you to join our advocacy efforts. Learn more and get involved at aapmr.org/advocacy.