Update on #StopTheCap Efforts

A message from Dena Kilgore, CAE, from APTA:

I wanted to provide an update on the efforts to permanently repeal the hard therapy cap that went into effect January 1. As you know, the federal government had been shut-down since midnight on Friday, January 19 due an impasse on funding the federal government over the lack of a deal to protect young documented immigrants from deportation, known as the Deferred Action for Childhood Arrivals (DACA).

Yesterday, Monday, January 22, Congress passed yet another short-term spending bill that will re-open and provide funding for the government open until Thursday, February 8.  The Senate spending deal will also fully fund the Children’s Health Insurance Program for six years, ending a nearly four-month lapse in the program’s long-term federal funding.  In return, Democrats accepted a pledge from Republican Senate Majority Leader Mitch McConnell (R-KY) to bring a vote on DACA to the floor if an immigration deal is not reached by Feb. 8.  Despite an enormous turnout on social media, phone calls, grassroots, Hill meetings, etc. by APTA, AOTA, ASHA, and partners in the Repeal the Therapy Cap Coalition, the short-term spending deal does not include the permanent fix to repeal the hard therapy cap, nor does it include a whole host of must-pass critical Medicare issues, impacting everything from rural health funding to community health centers.

On Friday there appeared to be a glimmer of hope that the Therapy Cap fix might be added to the short-term spending deal; APTA and our partners had been working with Senate Minority Leader Chuck Schumer to have it added to a revised deal that was under discussion with President Trump. Those talks did not produce a deal addressing the broader range of critical issues, including repeal of the Therapy Cap. Two senators who we’d like recognize are Sen. Ben Cardin (MD) who took to the Senate floor Tuesday afternoon to implore his colleague to address the Therapy Cap and other Medicare extenders in the next spending deal that must be passed by February 8. In addition, Sen Stabenow (MI) offered an amendment over the weekend to include the Therapy Cap and other Medicare extenders to the short-term deal.

The message from Capitol Hill continues to be that there is broad agreement to repeal the cap; the bipartisan, bicameral proposal to permanently fix the hard cap appears to be one of the few issues Congress is in agreement on. However CHIP funding and DACA continue to overshadow the politics and process.  With the issue of CHIP funding now resolved, Congress can focus on the critical Medicare extenders and Therapy Cap repeal to include in the next spending deal. However until DACA is resolved, it will continue to play a major factor in the work of Congress, and could potentially result in another government shut-down in the near future.

APTA and our partners will continue to wage an aggressive lobbying, social media, paid media, and grassroots efforts between now and February 8. APTA will be sending out additional action alerts to our members this week, and we will continue our push on social media (#StopTheCap).

During this time of uncertainty under the hard cap, APTA is also pushing CMS to provide additional guidance and clarification on their handling of outpatient therapy claims.  Most recently CMS provided information that they have been holding all outpatient therapy claims since January 1 that go above the $2,010 cap. CMS is expected to begin processing those claims in the near future, but they have not yet provided a timeline, In addition, CMS has stated that providers should continue to submit claims with the KX modifier, even though the exceptions process is not in place, under the assumption that Congress will retroactively apply the permanently therapy cap fix. APTA issued a FAQ document earlier this month and we will be revising it this week based upon additional expected guidance from CMS.

False Advertising and Insurance Surface as Top Priorities for PTWA Members

At the PTWA December 2017 board meeting we reviewed and addressed results from our October PTWA member survey.

The largest areas of survey input included:

  • PTWA members want the world to know that physical therapy professionals provide physical therapy services. You want other provider groups to stop saying they provide PT and you want consumers to understand and care about what that means.
  • PTWA members want their state association to do something about the dramatically shifting payment environment and what it’s doing to their ability to provide effective and qualitative patient care.

Strategic planning expert Janet Bezner, PT, DPT, PhD, FAPTA, helped our PTWA board to identify goals, objectives and strategies surrounding these two areas. Here are the two goal statements we came up with:

Goal 1:

Providers, consumers, and key stakeholders know that physical therapist practice is the best choice to optimize movement.

Goal 2:

Physical therapists/physical therapist assistants, payers, and consumers value care that is compensated on the basis of quality and the achievement of meaningful outcomes.

You can find the full plan document on this page on our website: http://ptwa.org/about/bylaws-policies-and-other-governance-documents.

Because these areas of focus are not going to be achieved by just pressing the easy button, we will be working on plans for each of them with a due date of July 1 for the two plans.

Also at the December board meeting we addressed and made recommendations for the revision of the PTWA vision and mission statements. PTWA’s current vision statement models the APTA’s achieved and since revised Vision 2020 language. The current APTA vision is, “Transforming society by optimizing movement to improve the human experience.” Our PTWA vision statement needed an update.

Our proposed mission statement remains similar to our current mission statement, as this is unique to Washington.

The board proposes the following vision and mission statements.

PTWA Vision Statement:  The physical therapy profession is recognized as the best choice for optimizing movement to improve the human experience.

PTWA Mission Statement:  The PTWA Mission is to advance the physical therapy profession in the state of Washington through compassion, accountability, representation and excellence (CARE).

Governance of an association requires member approval of strategic plan/goals, mission and vision changes at a Chapter Meeting. Our next Chapter Meeting will be held on October 6, 2018 in Tacoma. We won’t wait until then to start work on what you have already said are your top priorities for our association.

The work derived from the strategic plan and vision/mission is done primarily by committees. PTWA has existing committees that will work on these goals. We would love your involvement at any level: committee work, volunteer, expert witness, professional opinion etc. Many hands make light work.

Your involvement is as easy as emailing me at president@ptwa.org.

Best wishes for a “movement” filled 2018.

Erik Moen, PT
PTWA President