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The interested parties stated that Medicare's direct supervision policy, which requires the PTPP and the PTA to both be present when a Medicare patient is treated, does not allow small practices with one PT and one or two PTAs, for example, to work different or overlapping schedules in order to accommodate all patients' availability by allowing the OTA/PTA to work before or after the OTPP/PTPP normal hours

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Cardiovascular crisis: Severe blood pressure spikes, cardiac arrhythmias, and in rare cases stroke or myocardial infarction during DTs, driven by uncontrolled autonomic hyperactivation