PM&R Advocacy Update (Member Resource)-Session Recording

Video Transcription

Video Summary

The PM&R Advocacy Update session featured a comprehensive discussion on federal and state advocacy efforts impacting the physical medicine and rehabilitation (PM&R) field. Peter Thomas of Powers Law Firm provided insights on the federal legislative landscape amidst a prolonged U.S. federal government shutdown and discussed major issues such as potential Medicaid cuts from the OB-3 Reconciliation Act, risks to Medicare funding, regulatory changes under the Trump administration, and concerns about competitive bidding on durable medical equipment. He highlighted critical audits and reviews affecting inpatient rehabilitation facilities, emphasizing the high administrative burden despite high claim affirmation rates.<br /><br />Dr. Jayabalan, chairing the Health Care Policy and Legislation Committee, emphasized ongoing advocacy priorities including physician fee schedule reforms, scope of practice battles, prior authorization burdens, and the protection of rehabilitation research funding from NIH and other federal cuts. She mentioned the upcoming CMS WISER model that risks expanding prior authorization using AI, targeting interventional pain management procedures.<br /><br />Lauren Shapiro, chair of the Reimbursement and Policy Review Committee, reported on the 2026 Medicare Physician Fee Schedule proposal, noting a modest conversion factor increase but concerns about efficiency cuts disproportionately impacting proceduralists. She discussed challenges with Medicare Administrative Contractor policies on botulinum toxin use and peripheral nerve blocks, urging members to submit comments opposing restrictive coverage. She also highlighted new member educational resources on coding and billing.<br /><br />Justin Bishop, chair of the State Advocacy Committee, discussed the crucial role of state-level advocacy in addressing scope of practice expansions by physical therapists and others, emphasizing the importance of grassroots engagement and coalition-building to preserve physiatry’s scope and reimbursement.<br /><br />The session concluded with interactive Q&A addressing concerns over non-physician scope expansion, liability issues, VA and DoD practice changes, and system fragmentation in patient transitions across care settings. Panelists stressed the need for continued member engagement and advocacy to safeguard PM&R practice and patient care.

Keywords

PM&R advocacy

federal legislative landscape

Medicaid cuts

Medicare funding risks

Trump administration regulations

durable medical equipment bidding

inpatient rehabilitation audits

physician fee schedule reforms

scope of practice battles

prior authorization burdens

rehabilitation research funding

state-level advocacy