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Advocacy

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Scope of practice expansion is a long-standing, continuous and complex concern in the health care field. AAPM&R is aware of the various concerns specifically plaguing physiatrists, from non-physicians to non-physiatrists, intent on expanding their scope of practice beyond their level of education, training and experience. 

AAPM&R is taking action.

Your Academy remains vigilant about ongoing efforts by non-physician and non-PM&R providers to expand their scope of practice beyond their level of education, training and experience, which may threaten the health and safety of patients and impact the livelihood of physiatrists.

Federal and State Advocacy Actions in 2023:

  • In August, AAPM&R launched an ongoing federal grassroots campaign to contact members of Congress and express opposition to H.R. 2713, the Improving Care and Access to Nurses (ICAN) Act. This legislation would inappropriately expand scope of practice for non-physician practitioners including nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists and physician assistants. Academy members, click here to participate in this campaign.
  • In June, AAPM&R joined the American Medical Association (AMA) and more than ninety medical societies and associations in submitting a letter to congressional leadership in opposition to H.R. 2713.
  • In May, AAPM&R organized an ongoing Federal grassroots campaign to contact members of Congress and express opposition to S. 131/H.R. 618. To date, Academy members have responded strongly to this campaign, sending more than 560 letters to Congress to stop the expansion of scope of practice for nurse practitioners and physician assistants under the federal Worker’s Compensation Program. Academy members, click here to participate in this campaign.
  • In March, AAPM&R launched a grassroots campaign for Academy members in New York to stop the elimination of oversight of physician assistants in Part W of the Governor’s proposed Health and Mental Hygiene Budget (A.3007/S.4007). Academy members sent more than 80 letters to state officials in this ultimately successful advocacy effort. The final budget was signed by the Governor on May 3 and the provision eliminating the oversight of physician assistants was removed.

AAPM&R's Scope of Practice Workgroup

Recognizing the growing concern of non-physician (and non-PM&R) scope of practice expansion, your Academy is addressing this issue through multiple committees, including a new Scope of Practice Workgroup. This workgroup is comprised of representatives from the Quality, Practice, Policy, and Research (QPPR) Committee, the Health Policy and Legislation (HP&L) Committee, and the Reimbursement and Policy Review Committee (RPRC), and AAPM&R’s representative to the AMA Scope of Practice Partnership (SOPP).

Scope of Practice Partnership with the American Medical Association (AMA)

Your Academy, as a member of the AMA Scope of Practice Partnership (SOPP), actively engages in the collaborative effort of the AMA, American Osteopathic Association (AOA), national medical societies, state medical associations and state osteopathic medical associations to oppose scope of practice expansions by non-physician providers that threaten the health and safety of patients. The SOPP achieves this goal through legislative activities, regulatory activities, judicial advocacy, and programs of information, research and education. Active participation in this collaborative ensures physiatry is represented and contributes to SOPP’s goal to protect the health and safety of patients whose well-being may be threatened by health care practitioners who lack the education, training or experience to perform procedures for which they seek licensure or recognition.

Resources

From ongoing collaborations with the American Medical Association (AMA) to a full toolkit of position statements, we plan to continue developing tangible resources to assist physiatrists in addressing scope of practice issues.

Your Academy's Latest Efforts to Defend Physiatrists' Scope of Practice

View the full list of AAPM&R advocacy letters.


AAPM&R Submits Comment Letter for 2021 Medicare Physician Fee Schedule Proposed Rule

Oct 05, 2020

In October 2020, AAPM&R submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) regarding the 2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule, which describes proposed payment and policy changes for next year.

Here are some key points in the proposed rule that might affect physiatrists, which were addressed in our comment letter:

  • A proposed 10.6% cut to the conversion factor (proposed decrease from $36.09 to $32.26). The conversion factor helps determine payment for all services in the fee schedule. CMS is proposing a statutorily required across-the-board cut, which will impact all of medicine, not just physiatry. AAPM&R is strongly advocating against this proposal.
  • Proposed expansion of telehealth services.
  • Expansion of scope of practice flexibilities established under the Public Health Emergency.
  • Implementation of updates to coding and documentation requirements for office and outpatient evaluation and management codes.
  • Proposed updates to the Quality Payment Program for 2021.

CMS estimates that the proposals in this rule, if implemented, would result in a 3% cut to payment for Physical Medicine and Rehabilitation. Because of the variability across our membership, we expect the exact impact on individual practices may vary substantially.

The final rule is expected in early December. Your Academy will continue to monitor these issues and will distribute updates when available.

Visit the Reimbursement Advocacy section of our website for additional details on the 2021 MPFS Proposed Rule.