Urge your Senators to Introduce Legislation to Allow OMSs to Refer Patients for Physical Therapy

AAOMS-initiated legislation has been introduced in the U.S. House of Representatives and is looking for the introduction of companion legislation in the U.S. Senate to provide a legislative fix allowing OMSs the ability to refer Medicare patients for physical therapy. The Medicare Oral Health Rehabilitative Enhancement Act (H.R. 5590), championed by Congressmen Bill Pascrell, Jr. (D-NJ) and Eric Cantor (R-VA) in the House, seeks to amend section 1861(p)(1) of the Social Security Act to include dentists amongst the list of providers who can refer for physical therapy. Current statute only allows referral capabilities for doctors of medicine or osteopathy, podiatrists and optometrists.

Our champions on this issue will need our support to help generate action on this legislation. Please contact your constituent Senators and ask them to introduce companion legislation to HR 5590 to allow for OMS physical therapy referal under Medicare. Please personalize the sample message below with your own comments or patient experiences. Thank you!

Click here to contact your Representative about the Medicare Oral Health Rehabilitative Enhancement Act.

Note: This campaign is set up to target U.S. Senators. E-mails sent through this initiative will be directed towards your constituent Member of Congress. If you have questions on this campaign, please feel free to contact AAOMS governmental affairs staff at 800/822-6637.

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Talking Points

Section 1861(p)(1) of the Social Security Act prohibits dentists from referring their patients for outpatient physical therapy services by stating that such services are only allowed for an individual "who is under the care of a physician as defined in paragraph (1), (3), or (4) of section 1861(r)." Section 1861(r) (1), (3) and (4) defines physicians as doctors of medicine or osteopathy, podiatrists, and optometrists. Dentists are defined in this section under (r)(2).
The Medicare Benefit Policy Manual supports the Social Security Act's treatment of dentists with regard to ordering outpatient physical therapy services, stating that "chiropractors and doctors of dental surgery or dental medicine are not considered physicians for therapy services and may neither refer patients for rehabilitation therapy services nor establish therapy plans of care."
OMSs treat patients with medical conditions that would benefit from physical therapy, including, but not limited to, facial trauma such as jaw fractures, temporomandibular joint disorder (TMJ), or reconstruction procedures subsequent to pathological and or congenital anomalies. Nationally, OMSs treat thousands of patients each year with these types of conditions.
Current law requires that OMSs seek a referral from an allopathic or osteopathic physician and/or work with such a physician to establish a therapy plan when an OMS believes physical therapy should be part of a patient's treatment.
Such consultation not only is inefficient and cumbersome, but delays patient treatment and the continuum of care.

Subject:

Dear [ Decision Maker ],

(Edit Letter Below)

As an oral and maxillofacial surgeon and constituent in your district, I respectfully urge you to introduce companion legislation to the Medicare Oral Health Rehabilitative Enhancement Act (H.R. 5590), which would allow dentists and oral and maxillofacial surgeons to refer their patients for physical therapy under Medicare.

H.R. 5590 is a budget neutral bill that will strengthen and enhance the Medicare program by allowing dentists and oral and maxillofacial surgeons to refer their patients directly to physical therapy (PT) services.  Oral surgeons routinely treat patients for conditions that require physical therapy such as jaw fractures, temporomandibular joint disorder (TMJ), and reconstruction procedures subsequent to pathological and/or congenital anomalies.

Current Medicare statute prohibits dentists (including oral and maxillofacial surgeons) from the direct referral of patients for PT. Instead, current law requires a dentist to initially refer patients to an allopathic or osteopathic physician (including fields such as podiatry and optometry) and/or work with a physician to establish a therapy plan when a dentist believes PT should be part of a patient's treatment.  Such consultation has proven to be an unnecessary financial burden to the patient and the Medicare system and it ultimately delays patient treatment and disrupts the continuum of care.

This necessary legislation will save significant time and Medicare resources by allowing dentists to directly refer for outpatient physical therapy and to establish and monitor therapy plans of care for their patients.

I hope that you will introduce companion legislation to H.R. 5590 to provide patient access to necessary PT services, restore oral health and quality of life, and reduce unnecessary bureaucracy and cost that currently slow the rehabilitative process.

Sincerely,
[Your name]
[Your address]

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