Bill Overview
Title: A bill to amend title XVIII of the Social Security Act to ensure appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy.
Description: This bill prohibits the supervision requirements for physical therapy assistants and occupational therapy assistants for covered outpatient services under Medicare from being different from supervision requirements under state law.
Sponsors: Sen. Carper, Thomas R. [D-DE]
Target Audience
Population: People enrolled in Medicare who receive outpatient physical or occupational therapy
Estimated Size: 60000000
- The bill specifically targets the Medicare program, which is a federal program in the United States.
- Medicare primarily serves individuals aged 65 and older, as well as some younger people with disabilities and people with End-Stage Renal Disease.
- The bill addresses outpatient services provided under Medicare, focusing on physical therapy and occupational therapy services.
- According to JUL 2023 data, there are approximately 60 million people enrolled in Medicare.
- Supervision requirements for therapy assistants impact the delivery of therapy services.
Reasoning
- The population directly affected are Medicare beneficiaries, primarily older adults, who require outpatient physical or occupational therapy. The policy would ensure that supervision requirements align with state law, potentially reducing administrative burdens and allowing for more flexible service delivery.
- The budget constraint suggests that the policy is not directly costing money but might affect regulatory implementation costs or have implications for state-level adjustments.
- Approximately 60 million Medicare recipients exist, and a fraction of these would utilize outpatient therapy services. We assume interviewees to be representative of the diverse Medicare recipient population across various states.
Simulated Interviews
Retired Teacher (Florida)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I hope this policy simplifies my therapy process. It's quite a hassle dealing with differing rules.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired Engineer (California)
Age: 72 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- I expect this policy might let my therapists work more effectively, which is crucial for my recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
Retired Nurse (New York)
Age: 65 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- Hopefully, it means less red tape and more focus on therapy outcomes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Retired Farmer (Texas)
Age: 80 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 2/20
Statement of Opinion:
- It might improve therapy delivery, making it less bureaucratic.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired musician (Illinois)
Age: 74 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 3/20
Statement of Opinion:
- This bill should streamline my care, hopefully improving recovery time.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired librarian (Ohio)
Age: 69 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 4/20
Statement of Opinion:
- Hopefully, the policy eases my treatment flexibility, which can be a barrier now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Retired Manager (Georgia)
Age: 77 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 4/20
Statement of Opinion:
- Aligning supervision requirements may simplify my ongoing treatment.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired Housewife (Virginia)
Age: 82 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 2/20
Statement of Opinion:
- Any policy that reduces complications for my care is appreciated.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired Scientist (Massachusetts)
Age: 70 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 3/20
Statement of Opinion:
- I expect more consistent care and less hassle if state laws guide supervision.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
Retired Bookkeeper (Michigan)
Age: 66 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 4/20
Statement of Opinion:
- Alignment with state laws should streamline services, which is always welcome.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 4 | 4 |
Cost Estimates
Year 1: $1000000 (Low: $500000, High: $2000000)
Year 2: $1000000 (Low: $500000, High: $2000000)
Year 3: $1000000 (Low: $500000, High: $2000000)
Year 5: $1000000 (Low: $500000, High: $2000000)
Year 10: $1000000 (Low: $500000, High: $2000000)
Year 100: $1000000 (Low: $500000, High: $2000000)
Key Considerations
- The bill addresses regulatory alignment between federal and state supervision requirements for therapy assistants.
- Potential administrative cost reductions may be offset by changes in service delivery rhythms or volumes.
- Supervision requirements may already be aligned in most states, minimizing financial impact for federal alignment.