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Latest Efforts and Resources

Advocacy

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.


July 1 – New Medicare Prior Authorization Requirement for Facet Procedures

Jun 08, 2023

Effective July 1, the Centers for Medicare and Medicaid Services (CMS) has expanded its Prior Authorization for Certain Hospital Outpatient Department (OPD) Services program to include facet joint procedures.  Specifically, CPT codes 64490-64495 and 64633-64636, will require prior authorization when performed in a hospital outpatient department.  This includes both place of service 19, off-campus outpatient hospital) and place of service 22 (on-campus outpatient hospital).   Prior authorization is not required for facet procedures provided in other places of service. 

Providers who typically bill facet procedures performed in hospital outpatient departments should have received a letter describing this new requirement in the spring.  When the program begins next month, prior authorization requests can be submitted through the Electronic Submission of Medical Documentation (esMD) platform.  The addition of facet procedures to the OPD Prior Authorization program was finalized in the 2023 Outpatient Prospective Payment System final rule.  AAPM&R voiced concerns about this policy change in our comment letter last September.  Reducing physician burden associated with prior authorization policies is a key advocacy priority for the Academy.  If you have any questions, please contact healthpolicy@aapmr.org.