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APTA’s Practice Advisory on Anxiety Screening

Be prepared to take part in patient screenings for anxiety in your role as a primary care clinician with APTA's Practice Advisory on Anxiety Screening

The United States Preventive Services Task Force has released a draft recommendation that primary care clinicians screen all adult patients under 65 for anxiety. The draft recommendation complements guidance that the task force formally adopted in 2022, recommending anxiety screening in children and teens ages 8-18, essentially recommending screening for all people ages 8 to 64.

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APTA Statement on Medicare Cuts

The following statement was released on December 20, 2022 by American Physical Therapy Association President Roger Herr, PT, MPA.

Congress has delivered the 2023 omnibus spending bill, and while it contains some positive aspects it does not nearly go far enough.

APTA and other health care organizations representing over 1 million providers across the country made a compelling case for a full restoration of the unsustainable payment cuts included in the 2023 Medicare Physician Fee Schedule. While lawmakers did provide a 2.5% funding increase in the recently released bill to mitigate the impending 2023 cuts, they unfortunately failed to deliver on the full 4.5% increase needed to ensure patient access to care and the financial viability providers’ practices. 

These cuts to the conversion factor used in calculating payment will affect 27 specialties, including physical therapy. Our patients are now at risk of losing access to our services.

APTA agrees with the American Medical Association in our mutual dismay over Congress’ failure to fully commit to protecting patients’ access to needed care. This spending bill underscores our belief that the entire fee schedule system needs an overhaul. Providers should not be made to carry an outdated system’s dysfunction on their backs, and we cannot expect Congress to come to the rescue year after year.

The path ahead is clear: We will continue to lead the charge and advocate before Congress in 2023 to overhaul and reform Medicare payment. And we will continue to fight for patients' access to essential health services and reduced administrative burden. We are committed to finding long-term solutions, not temporary fixes, when the 118th Congress convenes in January.

The voices of our members are critical to these efforts. APTA has published a summary of relevant elements of the omnibus package, including other APTA-supported bills that were included. And please continue to monitor the APTA Advocacy Center for up-to-date information on our 2023 legislative priorities and what you can do to fuel real change.


Final Spending Bill Falls Short in Offsetting Fee Schedule Cuts


The omnibus package likely to pass provides insufficient relief, but it does include several wins for the profession in other areas.

In a disappointing response to advocacy that brought the concerns of millions of health care providers to Capitol Hill, the U.S. Congress is poised to approve an end-of-year spending package that fails to fully restore cuts included in the 2023 Medicare Physician Fee Schedule. Rather than provide the needed full 4.5% in funding that would offset reductions in the conversion factor, lawmakers opted for a smaller 2.5% increase this year and an even smaller 1.25% increase in 2024. The resulting cuts will affect 27 specialties, including physical therapy.

The spending decision was included in sweeping omnibus legislation that incorporates elements of multiple bills whose fates hadn't been resolved. While the resulting last-minute legislative mixed bag is short on fee schedule fixes, the bill does include APTA-supported gains in other areas including telehealth, workforce diversity, lymphedema treatment, and the role of PTs and PTAs in the Department of Veterans Affairs. 

'Failure to Fully Commit to Protecting Patient Access'

For the health care provider community, the most significant feature of the omnibus package — the provision of a 2.5% conversion factor funding increase rather than the needed 4.5% infusion — was the final chapter in a yearlong fight to convince Congress to once again intervene to buffer the harm included in the upcoming Medicare Physician Fee Schedule.

As it has for the past two years, in 2022 the U.S. Centers for Medicare & Medicaid Services finalized a fee schedule for 2023 that offsets increases to payment for codes related to evaluation and management with significant cuts to the conversion factor, a key element used in determining payment associated with codes used by a wide range of providers.

APTA and 100 other provider and patient organizations joined in an effort to press Congress to provide a 4.5% spending increase to fully offset the fee schedule cuts. In the end, rather than stepping in at the 11th hour to provide full or nearly full offsets as it did for the past two years, Congress opted to scale back the relief. 

While the 2.5% funding increase will lessen the severity of the cuts, providers will still be left to deal with reductions just as the country's health care system continues to recover from the coronavirus pandemic. The response from provider groups was immediate, with organizations such as the American Medical Association and the Surgical Care Coalition expressing their frustration at Congress’ failure to provide the full 4.5% funding.

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Seasonal Influenza Health Alert

Seasonal influenza activity is high across the United States. The Centers for Disease Control and Prevention (CDC) estimates that in the 2022-2023 season to date, there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from influenza (Weekly U.S. Influenza Surveillance Report | CDC). While the Food and Drug Administration (FDA) has not indicated shortages of oseltamivir (generic or Tamiflu) in any of its forms (capsules, oral suspension), CDC has received numerous anecdotal reports of availability issues for generic oseltamivir in some locations [1]. This may continue to occur in some communities as influenza activity continues.

This Health Alert Network (HAN) Health Advisory provides clinicians and public health officials with guidance for prioritizing oseltamivir for treatment and information on other influenza antivirals that are recommended for treating influenza in areas where oseltamivir is temporarily unavailable.


White House to Resume Program Sending Free COVID Tests by Mail

The Hill | By Nathaniel Weixel

The Biden administration is restarting its program to send free COVID-19 testing kits through the U.S. Mail to any households that request them.

The White House on Thursday said households can begin ordering a total of four at-home tests from the website to be mailed directly to them for free, regardless of how many tests they have ordered previously. 

The tests will start to ship out the week of Dec. 19th, according to an administration official.

The White House first began sending out the kits last January during the peak of the omicron wave, but the program was halted at the beginning of September due to a lack of funding from Congress. Administration officials at the time indicated they were concerned the stockpile of tests would run out before the winter.

By the time the program ended, the federal government distributed an estimated 600 million tests.

Now, the program is restarting as part of the White House’s broader winter preparedness plan. According to a senior administration official, leftover American Rescue Plan money is being repurposed to purchase and distribute additional tests.

The administration has requested about $10 billion in COVID response money from Congress as part of the year-end government funding bill, but the prospects of it being included amid major GOP opposition are slim.

Public health officials have repeatedly warned that the U.S. will likely face another wave of COVID-19 infections as the weather gets colder and people travel and gather for the holidays. White House officials have said they are prepared for any potential surge in infections, noting that widespread vaccinations have made the virus far less disruptive than it was two years ago.

But it doesn’t seem to be convincing a checked-out public to get vaccinated. New COVID-19 booster shot uptake remains extremely low heading into the Christmas and New Year’s holidays, with fewer than 14 percent of the eligible population receiving a shot. In the meantime, infections, hospitalizations and deaths are all rising, according to data from the Centers for Disease Control and Prevention

Aside from mail-order tests, the winter plan will include distributing tests and masks at more locations, the White House said. 

Nursing homes and long-term care facilities will also see additional resources and flexibilities to help boost lagging vaccination rates, including allowing nursing home staff to administer shots. 

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