APMA would like to congratulate the Tennessee Podiatric Medical Association (TPMA) on a major legislative victory after its scope of practice modernization bill passed both chambers of the Tennessee General Assembly with overwhelming bipartisan support.
APMA advocacy staff met with Aetna leadership to discuss prior authorization, the use of artificial intelligence (AI) and digital tools in coverage and payment decisions, and ongoing questions related to skin substitute coverage and review processes.
National Government Services (NGS) is one of the seven Part B Medicare Administrative Contractors in the US. NGS will begin operating under a new name on April 1: Wellpoint Federal. Wellpoint reported that this change should have no impact on claims processing or the timing of payments.
During APMA's Legislative Conference, more than 100 podiatrists met with elected officials and congressional staff to address critical issues facing the profession, especially the burden of outdated Medicare and Medicaid policies. The recently introduced Diabetes Foot Health Access and Modernization Act took center stage, driving conversations in more than 200 meetings with congressional offices, including 25 directly with members of Congress.
APMA called on CMS to reverse its decision to require prior authorization for HCPCS code L1932—an ankle-foot orthosis essential for treating conditions that impact mobility and function. APMA warns that this requirement could delay access to medically necessary care and negatively affect patient outcomes, particularly for those with ambulatory challenges.
HHS Office of Inspector General (OIG) added a new Work Plan project which will examine evaluation and management (E/M) services billed on the same day as minor surgical procedures without modifier 25.
APMA participated in a CAC Engagement Coalition meeting with CMS staff and coalition partners, to discuss ongoing efforts to strengthen engagement with the Medicare LCD process. APMA’s continued engagement is an important part of its larger strategy to ensure podiatrists’ expertise is represented in coverage policy discussions.
APMA responded to a Department of Health & Human Services’ “Request for Information: Diagnostic Imaging Interoperability Standards and Certification,” expressing strong support for improving standards for imaging interoperability.
APMA has two new resources to help with wound care documentation: a webinar hosted by APMA RUC Advisor, Susan Walsh, DPM, MBA, and an article in APMA News from Coding Committee member Jonathon Huey, DPM, and Dr. Walsh.
APMA has submitted a letter to Acumen and CMS regarding the development of the Non-Pressure Ulcer Episode-Based Cost Measure (NPUECM) and requested a meeting to advocate for podiatrists.
APMA staff participated in the AMA National Advocacy Conference that focused on how to advance shared legislative priorities, including meaningful Medicare Physician Payment Reform, reducing administrative burdens caused by prior authorization, and protecting and strengthening access to Medicaid. Following policy briefings from members of Congress, CMS officials, and national health-care leaders, APMA staff took these priorities directly to meetings on Capitol Hill.
APMA’s advocacy impact is strengthened through active participation in the Alliance of Wound Care Stakeholders (Alliance). We are proud to share the Alliance’s 2025 Advocacy Impact Report, which highlights the collective progress made to advance fair reimbursement, appropriate coverage, and equitable patient access.
APMA adopted a formal position statement on artificial intelligence (AI) and submitted comments to HHS in response to its national Request for Information on the use of AI in clinical care. APMA emphasized that AI should support, not replace, physician judgment. We also raised concerns that opaque algorithms and broad datasets can lead to inappropriate denials, downcoding, and delays in patient care.
APMA continues to work closely with state components on legislative strategy, stakeholder engagement, testimony development, grassroots advocacy, and regulatory outreach across multiple states, including Tennessee, Massachusetts, and Mississippi. Several states are also actively considering adoption of the IPMLC, including Arizona, Florida, Iowa, Maryland, and Ohio.
Last week, CMS announced a moratorium on enrollment (and enrollment expansion) for certain medical supply companies. This enrollment moratorium affects medical supply companies whose principal function is to furnish DMEPOS supplies, which does not represent most physician suppliers.
In the MLN Connects Newsletter for February 26, CMS highlighted that it has identified fraud involving stolen Medicare Beneficiary Identifiers (MBIs) and is increasing monitoring of the Medicare Administrative Contractor (MAC) MBI lookup tool.
APMA recently submitted testimony to the Senate Committee on Aging for its hearing titled "The Doctor Is Out How Washington’s Rules Drove Physicians Out of Medicine," highlighting how excessive prior authorization requirements in Medicare Advantage are delaying care and increasing administrative burdens for podiatrists.
APMA submitted comments to the House Committee on Veterans' Affairs expressing concern that the ongoing VHA reorganization and recent workforce reductions are threatening veterans' access to timely foot and ankle care. With approximately 30,000 VA positions eliminated in 2025 and new staffing caps in place, shortages are straining critical limb-preservation programs and limiting care for clinically complex veterans.
Last week, CMS reminded practitioners in nine states that they are required to report postoperative evaluation and management visits provided to Medicare patients if the practitioner practices in a group of 10 or more practitioners.
Following sustained advocacy and multiple rounds of direct communication with CMS and the DME MACs, APMA has secured critical clarification regarding coverage criteria for therapeutic shoes for persons with diabetes. We have confirmed that co-signed notes are not required when specific documentation standards are met.