Jan 29, 2015
Medicare Rule Threatens Clinic ATC Work

Athletic trainers who work in clinical settings face a new threat thanks to a change in Medicare regulations.

In August, the U.S. Centers for Medicare and Medicaid Services said it plans to no longer pay for therapy incident to a doctor’s care in physicians’ offices or clinics unless it is given by physical therapists, occupational therapists, speech and language therapists, or by doctors themselves. CMS says the move, part of its 2005 physician-payment rates, is designed to implement Congress’s wishes to make sure therapy is given only by the most qualified people and to hold down Medicare costs.

While the change directly affects only Medicare patients, many other insurers follow the government’s lead, and a major ripple effect could limit future payments for services provided by clinic-based athletic trainers.

The National Athletic Trainers’ Association says the change will only make it harder for patients to be adequately served while removing physicians’ ability to choose what other practitioners their patients see. Many physicians have weighed in, too, saying athletic trainers are qualified to provide the therapy-related services and that without them, there may not be enough practitioners available to help patients.

The American Medical Association, and at least three members of Congress, have asked CMS to stop the proposal or at least reconsider. Unless CMS withdraws its plan, the rule will take effect Jan. 1.

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