Legislative Update (Sam Schmidt):
APTA-MT had a full first half of the legislative session. We had one of the largest attended Hill Days on February 10, 2023, with the Occupational Therapy and Speech Language Pathologist state associations. Members who attended were able to have lunch and share our profession with lawmakers, sit in on the Senate and House hearings, and tour the capital. It was also great to connect with so many providers from across the state in supporting our profession and its role in saving healthcare dollars.
Lobbyist Update (Nate McConnell):
APTA-MT has made a splash in Helena! Thanks to the extraordinary efforts from the Legislative Team, PTs are on the map. It is hard to express how unique it is for a group to go from having no bill to push, no lobbyist to help push it, and no legislator to carry it all the way to getting a good bill, a good sponsor, and a great legislative push. Despite the unfortunate vote on HB 736, we got PTs on the map and, more importantly, we have a presence in Helena. Aside from getting APTA-MT’s voice heard, PTs are in line for an 8% increase in Medicaid reimbursement rates (4% per year over the biennium). While it’s not enough – and we’ll keep pushing for better rates – it is a start. We also have to celebrate the enormously successful HILL DAY on February 10th. PTs had a big presence and made some great connections with legislators. This sort of relationship-building is vital for future success! Big thanks to Sam, Emily, Ben, and the rest of you who helped make Hill Day happen, who voiced support for the bill, and who continue to make APTA-MT part of the conversation.
Thank you all who made the trip to Helena for Hill Day 2023!!
Here are some key bills and their status as we move into the next half of the session. (Sam Schmidt)
HB 736 Tabled: The Legislative Committee members and Payment Committee member, Ben Kingan worked with ATPA-MT’s Lobbyist Nate McConnell on getting a bill (HB 736) to address the inadequate reimbursement by Montana Medicaid for PT, OT, and Speech services. Representative Tony Brockman of the Flathead (HD9) and Representative Alice Buckley of Bozeman (HD63) worked with the APTA-MT to sponsor and introduce HB 736 in the Human Services Committee on March 3, 2023. There was a strong presentation of why this bill was so critical for access to cost saving therapy interventions and the trend of more and more small business providers no longer accepting Medicaid clients due to the inadequate payment to cover the provider. This bill tied PT, OT, and Speech services to a statute that Montana physicians use. This is critical as therapy services follow the same rate methodology that physicians use based on RVUs (Relative Value Units) yet physicians have increased their conversion factor to cover their costs.
Small business clinics reported a range of $25-40 loss with every visit in providing services to a Medicaid participant. This bill would close that gap almost fully.
While HB 736 was tabled for this session, the APTA-MT had great feedback and engagement around the value that PT brings to saving healthcare dollars. Many lawmakers understand there is and will continue to be a growing issue of access for those using Medicaid if the gap is not addressed. The APTA-MT will continue to meet on this issue and re-assess how to get this type of legislation across the line in 2025. Thank you all who took time to send emails or reach out to those who represent you in Helena. Your voice was heard and the APTA-MT will continue make sure to be heard.
HB 649 Passed Committee: This is a bill for increasing provider rates for Medicaid with most of the focus medical providers who do not use the rate methodology physicians and allied professional services (this includes PT, OT, and Speech). This bill was largely based on the Guidehouse Study which was completed in 2022 and reported physicians were well above adequate rates but did not specifically address the allied rehabilitative providers (PT, OT, SLP). If passed HB 649 would potentially offer PT an 8% increase over two years; this increase will not make the difference for closing the gap current reimbursement and actual cost to provide PT services. Whereas HB 736 would have provided nearly 30% increase in reimbursement. The APTA-MT is a proponent of HB 649 as it will help other healthcare workers provide services like medical transport, mental health, home aide assistance, and many more critical areas that support those who are on Medicaid to live their best lives.
PRECEPTOR TAX INCENTIVE:
HB 496 Passed Committee: Obtaining preceptors for our medical, nurse practitioner, physician assistant, counseling, and other graduate-level health professional students is very difficult. Private, for-profit, out-of-state institutions are sending their students to Montana in increasing numbers using the limited and precious resource of Montana preceptors with little chance that these students will relocate to Montana to serve our state's health care needs.
Other states such as Georgia, North Carolina, Hawaii, Colorado, and Maryland have addressed this issue by instituting a tax incentive for preceptors who help educate those students in their own state without compensation. HB496 is being put forward this session to change the landscape for Montana's preceptors and health professional programs. The APTA-MT is a proponent of this bill and has requested Physical Therapists be added to the bill as an amendment.
EXEMPTION FOR PRIOR AUTHORIZATION REQUIREMENTS:
SB 380 Passed Committee: This bill is for an act entitled: “An act generally revising health care insurance laws; providing for exemption for prior authorization requirements”. The APTA-MT is following this closely and is a proponent of this bill. At the national level there are shifts to reduce administrative burden and prior authorizations, so it is refreshing to see it being address at the state level too.
There are several other bills the APTA-MT is monitoring daily. There are over 4500 bills this session, a historic record which has resulted in a fast and furious kind of experience for all.
Please take time to write your local state representatives and senators a simple thank you note for their service as these folks are working around the clock to meet the budget and improve the lives of Montanans.
If you are interested in looking up the status of a bill use the link: https://leg.mt.gov/session/