DoD Moves to Include PTAs in TRICARE

Nearly a year after being signed into law, the wheels are finally turning: a proposed rule to include physical therapist assistants (PTAs) as authorized providers under TRICARE, the health care system used throughout the military, has been issued by the US Department of Defense (DoD). APTA strenuously advocated for the change and says it's time for supporters to help push the rule over the finish line.

The proposed rule is a fairly straightforward plan that seeks to have the TRICARE system adopt Medicare's requirements for PTAs and occupational therapy assistants (OTAs). "This rule will align TRICARE with Medicare's policy, which permits PTAs and OTAs to provide physical or occupational therapy when supervised by and billed under a licensed physical therapist or occupational therapist," DoD writes in its summary of the proposal.

According to Kara Gainer, APTA's director of regulatory affairs, the proposal, while strongly supported by APTA, has a few issues that need to be addressed.

"The rule references 'physical therapy assistants' when it should be 'physical therapist assistant'—that area, and a few other places in which DoD uses inconsistent language around physical therapist qualifications, are easy fixes and something that we'll be recommending," Gainer said. "Overall, however, the release of this proposed rule is a very positive step because it starts the clock ticking toward final implementation."

The timeline for when PTAs could actually begin participating in TRICARE was an uncertainty that lingered throughout 2018—although DoD intended to have the change in place no later than 2021, nobody seemed to know just when the rulemaking process would begin. The publication of the proposed rule kicks off a series of timelines that put progress on a more trackable schedule, beginning with a 60-day deadline for public comment. According to an APTA chart on possible implementation of the rule (scroll down to view), PTAs could be participating in TRICARE as early as fall of 2019, or as late as early 2020 if all goes according to plan.

What's next? APTA urges supporters of the change to make that support known to DoD by providing comments on the proposed rule by the February 19, 2019, deadline. In early January, APTA will offer a template letter that will make the comment process easy—be on the lookout for an announcement when that becomes available, or look for the letter on APTA's "Take Action" webpage sometime after January 1, 2019.

Here is a letter template from APTA.