APTA Congressional Update: Priority Legislation Summary

1. 2012 Congressional Update Federal Affairs Liaisons (FAL) For use at 2012 Fall Chapter Meetings

2. APTA Priority Legislation • TheMedicare Access to Rehabilitation Services Act: On April 14, Congressmen Jim Gerlach (R-PA) and Xavier Becerra (D-CA) in the House of Representatives and Senators Ben Cardin (D-MD) and Susan Collins (R-ME) introduced "The Medicare Access to Rehabilitation Services Act (H.R. 1546/S. 829)." This legislation will repeal the cap on therapy services for Medicare beneficiaries once and for all. • The Physical Therapists Student Loan Eligibility Act: On April 7, 2011, Representatives Jo Ann Emerson (R-MO) and Mike Ross (D-AR) introduced the Physical Therapist Student Loan Repayment Eligibility Act (HR 1426), legislation that would authorize physical therapists to participate in the National Health Service Corps Loan Repayment Program. An identical bill (S.975) was introduced in the Senate by Senator Jon Tester on May 12, 2011. • Protecting Student Athletes from Concussions: On January 26, 2011, Congressman Timothy Bishop (D-NY) introduced HR 469, the Protecting Student Athletes from Concussions Act, legislation that would allow for the development of concussion management guidelines that address the prevention, identification, treatment, and management of concussions in school-age children • The Traumatic Brain Injury Act: On March 21, 2012, Representatives Bill Pascrell, Jr. (R-NJ) and Todd Platts (D-PA) introduced HR 4238, the Traumatic Brain Injury Act of 2012. This legislation would reauthorize funds for states to sustain and build traumatic brain injury programs, serve patients, and allow better collaboration between agencies.

3. APTA Priority Legislation • Medicare Access to Rehabilitation Services Act: • H.R. 1546 – 172 Cosponsors • APTA’s goal is to generate 200 cosponsors by December 31, 2012 • S. 829 – 22 Cosponsors • Physical Therapist Student Loan Eligibility Act: • H.R. 1426 – 121 Cosponsors • APTA’s goal is to generate 150 cosponsors by December, 31, 2012 • S. 975 – 6 Cosponsors • Protecting Student Athletes from Concussions • H.R. 469 – 41 Cosponsors • Traumatic Brain Injury • H.R. 4238 – 16 Cosponsors

4. Expiring Provisions Without congressional action… • 27% cut for payments under the Sustainable Growth Rate (SGR) beginning January 1, 2013. • A hard therapy cap will be imposed on Medicare-covered therapy on beginning January 1, 2013.

5. Lame Duck “To Do” List • Doc Fix/SGR cuts • Therapy Cap Exceptions Expiration • Expiring Bush Tax Cuts • Sequestration • Business Tax Credits • Payroll Tax Holiday Expiration

6. Therapy Cap Update • The therapy cap has applied in the past to all outpatient therapy settings except hospitals. • Starting October 1, 2012 the therapy cap with an exceptions process will also apply to hospital outpatient settings (critical access hospitals are exempt). • Hospitals would no longer be subject to the therapy cap after December 31, 2012 unless Congress extends the provision in future legislation.

7. Therapy Cap Update • January 1-October 1, 2012: an automatic exception to the therapy cap may be made when documentation supports the medical necessity of the services beyond the cap. Providers should use the KX modifier. • October 1, 2012-December 31, 2012: an automatic exception may be made for claims between $1880-$3700 (use KX modifier). • October 1, 2012-December 31, 2012: Claims exceeding $3700 in expenditure will be subject to manual medical review to be paid.

8. Therapy Cap Resources In order to help make the transition as smooth as possible, APTA has developed a Medicare Therapy Cap Resources website.  This website compiles relevant information available from APTA and CMS in one place.  The Resource page includes: • APTA resources, including FAQ sheet, webinar, and a podcast • Links to the  MAC websites where information on manual medical review is posted • Manual medical review complaint form • CMS resources, including fact sheet, FAQ sheet, open door forum transcript and transmittals • Information for Medicare beneficiaries • Medical Necessity and documentation resources • Advocacy information  http://www.apta.org/Payment/Medicare/TherapyCap/2012/Changes/

9. Student Loans Student Loan Forgiveness • National Health Service Corps • Rural/Urban Underserved areas • $60K/2yr… $170K/5yr • Legislation to add physical therapists to the primary health services section of the National Health Services Corp (NHSC) for student loan repayment programs

10. How Can You Get Involved? • Join APTA’s Grassroots Network (www.apta.org/pteam) • Utilize Legislative Action Center (www.apta.org/TakeAction/) • Write Your Legislators • View Town Hall Schedule • Conduct a Practice Visit • Set up a District Meeting • Attend a Local Fundraiser (www.ptpac.org) • Plan to attend the 2013 Federal Advocacy Forum in Washington DC on April 14-16. For additional questions about advocacy activities, contact Lindsay Still, Senior Grassroots and Political Affairs Specialist at lindsaystill@apta.org

11. Federal Advocacy Forum In 2012, over 200 physical therapists, physical therapist assistants, and students of physical therapy met with their members of Congress as part of PT Day on Capitol Hill Plan to join us in 2013! April 14-16 in Washington, DC. www.apta.org/FederalForum/

12. Policy Resources Visit www.apta.org/advocacy • 2011-2012 Public Policy Priorities • Position Papers • Links to Legislation • Background Information • Frequently Asked Questions Sheet • Cosponsor Drive Information

13. Critical Issues Survey Help shape APTA’s 2013-2014 public policy priorities. This is your chance to weigh in and let APTA know what issues are important to you, your patients, and the physical therapy profession! Fill out the survey online by OCTOBER 15: http://vovici.com/wsb.dll/s/449dg51241

14. Legislative Action Alerts • The action alert email comes into your inbox. The subject line will highlight the advocacy request/need. 2) Click on the highlighted icon, typically labeled “click here” to go to the next step via APTA’s website to contact your member of Congress.

15. Legislative Action Alerts • The next page you will see will be your personalized page on the legislative action center. This page contains information about your legislators and the issue. • Once you are ready to contact your member of Congress, you will click on the “Take Action” button. • This is the final stage of your action alert process. On this page you will see your profile identified in the upper right hand corner (please do not forward action alerts as your alerts are unique to you; if you forward them, the individuals receiving them will pull up your information and your legislators). APTA’s legislative action center identifies which members this alert will go to, as evidenced by message recipients.

16. Legislative Action Alerts 6) The letter has been drafted by APTA to carry a standard message that outlines the general points of the issue. It is important to note that APTA requests that you PERSONALIZE this message. You have the capability to include a few sentences about the impact this legislative issue has on you professionally, as well as the patients/clients you serve.

17. Legislative Action Alerts When you have personalized your letter, click the “Go” button and you are all done! Congratulations you have successfully advocated on behalf of the physical therapy profession and the patients/clients you serve!!! JOIN PTEAM TODAY TO BEGIN ADVOCATING FOR PHYSICAL THERAPY!

18. PT-PAC allows the physical therapy profession to channel its financial and grassroots support to help elect candidates to Congress who are responsive to the physical therapy profession's goals and viewpoints • PT-PAC can assist you in setting up an event for your Member of Congress • PT-PAC can assist you in setting up a fundraiser for your Member of Congress or to attend on behalf of PT-PAC a fundraiser back in your state. • Check out PT-PAC’s new website www.ptpac.org For additional questions, contact Michael Matlack, APTA's Director of Political Affairs at 1/800-999-2782, ext. 3163 or at michaelmatlack@apta.org.

19. APTA Contact Information Michael Matlack Director Grassroots and Political Affairs michaelmatlack@apta.org Lindsay Still Senior Specialist Grassroots and Political Affairs lindsaystill@apta.org Justin Moore, PT, DPT Vice President Public Policy, Practice and Professional Affairs justinmoore@apta.org Mandy Frohlich Senior Director Government Affairs mandyfrohlich@apta.org