I am not going to go back and forth on our qualifications. As an athletic trainer, we know we are fully capable of custom orthotic fitting. We are skilled in gait analysis, anatomy and biomechanics to suffice the required training set by the CMS. The fact of the matter is that by limiting our fully capable scope of practice through Medicare and the CMS because athletic trainers cannot bill nationwide is where the burden comes on us as a profession. A few years ago, NATA pushed legislation for third-party reimbursement to include services to Medicare beneficiaries. Throughout the process, APTA , OPTA and other like organizations were concerned that we do not have the job specific training to be able to provide healthcare to this population sub-group. This proposed rule changed is the reason why we needed this legislation to pass. Typically, private insurance companies will base what they cover and exclude off government regulated healthcare such as Medicare. If athletic training was able to successfully obtain this niche with Medicare billing, we may be at the point that we could bill nationally for our services.
As an athletic trainer, I feel limited by the choice to bill for my services while other professions are able to do so. If this proposed rule change happens to go into effect, this will severely hurt the profession by limiting the number of clinics and doctors’ willing to hire an athletic trainer because they aren’t “capable” to do some of the required tasks and lack of reimbursement from insurance companies. It will also affect the athletic trainers working in emerging settings like military and industrial in which patients could be on Medicare.
Though you may think this change does not directly target me, please keep in mind AT THIS TIME. Be cautious of the implications of this rule change on our profession moving forward. The Affordable Care Act which opens access to healthcare is now being limited with this rule change. Yes, the person who wrote this rule change may have forgot us and we should give them the chance to edit the document. Yes, we could have been omitted on purpose for lack of specialized training. Now, it is your job to spread the word. I challenge you every time you fit someone for orthotics to snap a quick picture (as long as you follow HIPPA guidelines) and tag it on social media. Use the hash tag #at4at #at4all and #CMS to spread the word about the skills we can provide as athletic trainers.
-Zach Winkelmann ATC, LAT