On Friday, October 18th, we asked our grassroots in the 18 states that have a member of the Senate Finance Committee to call, write and email their Senator(s) in support of an amendment that Senator Lincoln (D-AR) was offering on Medicare direct access. Senator Lincoln's amendment would have, if passed, provided a 10 state demonstration project over a 2 year period to assess the quality, cost-effectiveness, patient satisfaction, and safety of direct access for Medicare beneficiaries to outpatient Physical Therapy services. Unfortunately, to reach an agreement on the 10 billion dollars in cuts to Medicare and Medicaid from the Senate Committee, all Republican amendments were withdrawn or negotiated to include in the revised budget package. The democratic amendments were withdrawn, offered then withdrawn, or failed. Due to the trend that amendments were failing on a 9 to 11 party line, APTA in consultation with Senator Lincoln agreed to have the Senator speak on the amendment and its value to patients served by physical therapists under Medicare, then withdraw before the vote.
Although the outcome was that the amendment was not considered, we gained considerable visibility, awareness, and respect for our grassroots efforts and the services physical therapists provide seniors and persons with disabilities. We greatly appreciate your work in making your Senator(s) on this Committee aware of this issue. We believe that we have gained support on the Committee and proved once again that our grassroots network is flexible, quick to action, and powerful. Thanks!
Besides this amendment, numerous physical therapy related provisions were passed by the Committee including:
A one-year moratorium on the therapy cap;
A 1% increase in the Medicare Physician Fee Schedule for 2006;
A provision holding the admissions criteria for Inpatient Rehabilitation Facilities (IRF) at 50% compliance until June 30, 2007 and the establishment of a national rehabilitation advisory commission;
Inclusion of the Family Opportunity Act, a program allowing families of children with disabilities to "buy into" the Medicaid program for such children;
Transition to value-based purchasing or pay for performance under Medicare for physicians and physical therapists;
Prohibition of new physician specialty hospitals under the whole hospital exemption to the Stark laws from June 8, 2005.
The Senate Budget Committee has reported this bill with the above provisions out of Committee and the bill will be on the Senate Floor this week. The House budget reconciliation bills do not contain Medicare provisions at this time. We expect that the battle to keep the above provisions will occur in the House-Senate conference on this legislation. We will need to continue the grassroots pressure to ensure that the cap and the fee schedule cuts do not go into effect on January 1, 2006.
Again, we appreciate your dedication to advocacy for physical therapists and the patients you serve!
Justin Moore, PT, MPT Director, Congressional Affairs American Physical Therapy Association
