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2010 PQRI Measures for Medicare part B

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***APTA Legislative Action Alert***

Urge Your U.S. Legislators to Co-sponsor Legislation That Fully Funds IDEA (H.R 3578/S. 1652)

APTA needs you to assist building support for full funding of IDEA.
  
H.R. 3578/ S.1652 authorizes increasing amounts of mandatory funding in six year increments that, in addition to the discretionary funding allocated through the Appropriations Committee, will finally meet the federal government's commitment to educating children with disabilities by 2015.  By increasing the federal investment in special education, the bill would also free up local and state funds that had previously been used to meet IDEA requirements.  "This is a win-win-win bill," Chairman Harkin said.  "With these advance appropriations, students with disabilities will get the public education they have a right to and school districts will be able to provide services without cutting into their general education budgets." 

Please contact your legislators to encourage support for this legislation.

 BACKGROUND

The Individuals with Disability Education Act (IDEA) was enacted to provide all children with free and appropriate public education in the least restrictive environment possible. The hallmark legislation has been around for over 30 years and was most recently reauthorized in 2004 through the year 2010. However, the total amount of necessary funding is not mandatory, and Congress has routinely under-funded the IDEA program in discretionary spending through the Appropriations process. In order to adequately cover the services of IDEA implementation, the funding burden has been shifted to various local and state institutions. The legislation, introduced by Senators Harkin and Roberts (S. 1652) and Representative Van Hollen (H.R.3578), will increase the amount of IDEA funding each year by a sliding mandatory amount that will ensure that the total annual funding for IDEA will be fully realized by the year 2015.

PHYSICAL THERAPY AND IDEA:

Physical therapy is essential to making sure that all school-aged individuals, especially children with physical impairments, limitations, and disabilities, have appropriate, unencumbered access to public education. Physical therapy interventions improve the movement and function of these students to enhance their participation in the least restrictive educational, home, or natural environment. Students who attain the full potential in their physical abilities and movement through physical therapy intervention will improve their opportunities to make the most of their talents in the educational, home, or natural environment. 

Physical therapy is an integral part of the Individuals with Disabilities Education Act (IDEA) as a related service critical to improve the educational opportunities of children with disabilities and enable students to benefit from public education. Physical therapy also plays a critical role under IDEA to improve the motor function of infants and young children, as well as support and educate parents in early intervention programs.

TALKING POINT ON H.R.3578 / S. 1652

Congress Must Fully Fund IDEA. Efforts to improve the funding level that the federal government contributes to the implementation of IDEA at the local level will better serve infants, young children, and students with disabilities. The increased funding would free-up state and local funds that are often used in compensation for the lack of federal funding to meet the IDEA required services. Without adequate funding, the efficacy of related services cannot be fully evaluated and improved upon. 

What You Can Do
Contact your Members of Congress and request that they support fully funding IDEA (H.R.3578 / S. 1652)
* Send an email letter through APTA's Legislative Action Center (click on the "TAKE ACTION" tab below). 
Please personalize the letter provided in APTA's Legislative Action Center (between the first and second paragraph) by adding some information about yourself, your practice, the community you serve or any other information that personalizes this letter.

If you have any questions or need additional information regarding H.R 1378 / S. 1652 contact Nate Thomas at 1/800-999-2782, ext. 8527, natethomas@apta.org. Thanks for your help in getting the message through to Congress!

CMS Releases Final Medicare Physician Fee Schedule

posted: Saturday, October 31, 2009

On Friday, October 30, 2009, the Centers for Medicare & Medicaid Services (CMS) announced final changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by physical therapists, physicians and non-physician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS).  The final rule contains several provisions that are of importance to physical therapy:

•  Due to the flawed Sustainable Growth Rate (SGR) formula, CMS finalizes a fee schedule update that will result in a negative 21.2 percent cut in Medicare payments. Congressional action is necessary to stop the negative 21.2 percent update from going into effect.  Health Care Reform legislation in Congress currently includes updates to avoid this 21.2 percent reduction.   Please visit Legislative Action Center to support legislation to address the flawed SGR formula and its negative updates.
• The rule also finalizes a provision to implement a 4-year transition of practice expense changes developed using the new Physician Practice Information Survey (PPIS) data that would ultimately result in a 10% positive update for physical therapy payments.   It is estimated that physical therapists will receive a 2.5% update each year during this 4 year transition.
• The therapy cap amount for CY 2010 will be $1860. CMS' authority to provide for exceptions to therapy caps will expire on December 31, 2009, unless the Congress acts to extend it. If the current exception process expires, the only exceptions to therapy caps will be for services billed by the outpatient hospitals.   Congressional Action is needed to extend the therapy cap exceptions process.   Health Care Reform legislation includes an extension of the therapy cap exceptions process.  To advocate for an extension to the arbitrary therapy caps, please visit APTA's Therapy Cap Resource Center and click on the Legislative Action Center.
• The final rule finalizes a proposal to provide for a new comprehensive pulmonary rehabilitation program and also provides for an expansion of the current cardiac rehabilitation program to contain services for intensive cardiac rehabilitation. The final rule also contains a brief discussion on how physical therapy services can be billed outside of a cardiac and pulmonary rehabilitation program.
• CMS finalizes its plans for continuation of the Physician Quality Reporting Initiative (PQRI). For 2010, physicians and other health care professionals (including physical therapists) that successfully participate in the PQRI program will receive a bonus payment equal to 2.0% of the estimated total allowed charges for all services in 2010. Physical therapists will be able to utilize claims based and registry based reporting.
• For canalith repositioning, CMS finalizes a proposal to change the status indicator from B (Bundled) to I (Invalid) and notes that physical therapists can continue to bill for this service with CPT code 97112 (neuromuscular reeducation). 

APTA is currently analyzing the final rule to determine the full impact on physical therapy and will have a more detailed summary and analysis available shortly.   To stay informed, please visit www.apta.org and encourage your colleagues to sign up for PTeam by visiting www.apta.org/advocacy and clicking on the navy "Keep Alert" icon to received these updates and action alerts.  Thank you for your advocacy for physical therapy.

Keri Bratcher, PT, MPT
Director of Government Relations, APTAnj
On behalf of APTA