Athletic Trainers' Litigation Against Medicare Dismissed

A recent news release by the National Athletic Trainers' Association described their opposition to a CMS ruling that went into effect June 6 prohibiting Medicare reimbursement for therapy services provided "incident to" a physician's office visit by anyone other than a physical therapist, occupational therapist or speech and language pathologist. They sued to prevent implementation of this "qualified provider" language, noting that they have been "deemed by the Secretary of Health and Human Services to adequately perform 'incident to' therapy services.

The news release reports that the Federal Court's 27-page order found in favor of NATA on a number of key points but ultimately concluded that it lacked jurisdiction to hear the case because the available lesser appeal remedies had not been exhausted. The NATA is reportedly considering an appeal to the Fifth Circuit Court but will presumably begin the internal appeals process simultaneously. NATA avers that their 30,000 members are "qualified and legitimate providers of rehabilitation services" including therapy for injured athletes and "the physically active".

This case illustrates how complex and sometimes contradictory qualified provider issues can become, and helps explain why CMS is so reluctant to take a definitive stand when there is a more expedient option open to them. Additional details regarding this lawsuit can be found online at .

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