Payment Updates
APTA Maryland Reimbursement Committees Meets 3rd Thursdays 8:00 pm
- Looks at trends to identify issues across insurance companies for potential advocacy, legislative or regulatory action.
- Addresses relevant issues and trends in the current environment (state and national) affecting payment of physical therapy.
- Identifies potential changes/evolution in the payment environment and recommend techniques, positions or policies to address these changes and to promote changes that will benefit physical therapists and physical therapy assistants.
- Identifies and addresses risk management considerations of changes in payment regulation and provide advice and recommendations to the Board of Directors and Chapter Office staff regarding risk management implications and changes in payment regulation. >>>More Information
News and Updates
Maryland Prior Authorization Reform Bill to Start Jan 1, 2025
APTAMD has identified the regulated insurers bound to the new law as reported by the Maryland Insurance Administration for 2024. This will be updated to reflect 2025.
- List - Carriers with Approved Individual Health Benefit Plans in Maryland
- List - Carriers with Approved Small Group Health Benefit Plans in Maryland
- List - Carriers with Approved Individual Short-Term Medical Plans in Maryland
Preserve Telehealth Access Act 2023-2025
As part of this legislation, the Maryland Health Care Commission was tasked with studying and making recommendations regarding the delivery of health care services through telehealth. We will be monitoring and providing testimony to support the continuation of:
- Payment parity
- Allowing the patient to be at home and not a regulated health setting to receive telehealth services.
- Impact on patient choice
Credentialing Delays with Commercial Insurers
At issue: credentialing can take 3-6 months while federal plans take an estimated 2 weeks. Systems and software exist that allow for greater efficiency and timeliness.
Delays getting new providers credentialed impact patients getting appointments, and postponing potentially critical diagnoses and treatment. In addition, providers taking on an excess workload while waiting for new staff to be credentialed increases the risk for burnout.
What's New in Payment - Opt In for APTA's Friday Focus
APTA members can opt in to receive any of four monthly electronic newsletters each with a different focus:
- Payment: Payment trends, initiatives, legislation/regulation, and other related issues. Typically delivers the fourth Friday of every month
- Professional Issues: Topics of concern to PTs and PTAs related to their careers and the state of the profession, including career development, ethics, practice management, licensure, and peer review. Typically delivers the first Friday of every month.
- Evidence & Care: Physical therapy evidence and research related to patient care and health services. Typically delivers the second Friday of every month.
- APTA & You: A focus on association and member issues. Typically delivers the third Friday of every month.
