Hard-Fought Victories and Other Accomplishments Mark the Closing of 2018 for APTA

Two times each year, APTA hosts an hour-long virtual component leadership meeting to provide updates about federal and state government affairs, payment issues, and other activity highlights in the recent past or the near future. In November, I listened to the latest recording on this update – my first one as your newly elected president elect.

We achieved a lot in 2018! Here are some of the victories and accomplishments that APTA staff and President Sharon Dunn talked about during the meeting, some of which you may already know about:

Legislative and Payment Advocacy Victories

  • Congress passed a permanent fix to the hard cap on Medicare services in February 2018 after a 21-year advocacy effort. (The law took effect retroactively to January 1, 2018.) No more temporary requests for patches in January (there have been 17 over the past 21 years)! An unfortunate last-minute addition to the bill was a PTA pay differential of 85 percent beginning in 2022, which APTA strongly opposed and is working to change before the effective date.
  • Congress also voted to include PTAs as authorized providers in the TRICARE system. On December 18, the Department of Defense published draft rules so by PTAs should be able to get paid to provide treatment to TRICARE patients by early 2020 at the latest.
  • The Centers for Medicare and Medicaid Services (CMS) will eliminate mandatory Functional Limitations Reporting as of January 1, 2019.
  • Legislation that protects PTs and other health care providers who travel across state lines with a sports team became law, after several years of effort. The law provides added legal protections for sports medicine professionals when they’re traveling with professional, high school, college, or national sports teams by extending the provider’s “home state” professional liability insurance to any other state the team may visit. This cooperative effort also involved the National Athletic Trainers’ Association and the American Association of Orthopaedic Surgeons. We are #bettertogether!
  • Physical therapists who are ABPTS Board Certified Electrophysiological Clinical Specialists (ECS) are Medicare approved for reimbursement for the performance of nerve conduction velocity and electromyography studies, and for sensory-evoked potentials studies when permitted by state law.
  • The US Department of Veterans Affairs will permit reimbursement for physical therapy services provided via telehealth or virtual technology, regardless of where the provider or patient is located.
  • CMS and the Joint Commission agreed that pulse oximetry in the home does NOT require a physician’s order.
  • The Physical Therapy Licensure Compact law has passed in 21 states and six are issuing license privileges. An additional 8-10 states are expected to introduce licensure compact legislation in 2019. (Washington will probably begin issuing compact privileges in a few months.)
  • Looking forward in 2019: Efforts to support Medicare Advantage plans to include telehealth as part of a basic benefit package will continue.
  • The APTA PT Outcomes Registry will meet the requirements for approval by Medicare for the Qualified Clinical Data Registry status reports. Physical therapists will be able to use this registry to meet one of the merit-based incentive reporting requirements, eliminating some duplicative documentation demands.

More Good News

  • #Choose PT – our national public relations effort focused on the opioid crisis – continues to have an impact. APTA introduced a second PSA. They also held an online panel discussion with seven perspectives including a patient, a PT, a physician and others. They conducted a one-day September media tour that resulted in 463 airings and reached nearly 109 million people!
  • APTA purchased the land on which our new APTA headquarters building will be constructed. More details about building design and a ground breaking to come.
  • The American Society of Association Executives awarded a Power of A Gold Award to the APTA, AOTA and ASHA for our cooperative, successful effort in the permanent elimination of the Medicare therapy cap.
  • APTA received the Alexandria (VA) Chamber of Commerce Best in Business Award.
  • The APTA Minority Scholarship fund exceeded $1 million in scholarship distributions.
  • There is a new Council on Prevention, Health Promotion, and Wellness.
  • 16 clinical practice guidelines have been published with content from the sections and academies. 44 more are in the works

Anniversary Celebrations

  • Physical Therapist Assistants will celebrate their 50th anniversary in 2019; the first PTAs graduated from PTA programs in 1969. There will be celebrations throughout the year, including an event at CSM. Various chapters are participating in fitness-based PTA10Ks (including Washington) as a way to promote PTA membership in APTA with the goal of increasing it to 10,000 during this anniversary year. It’s currently just below 9,000.
  • The APTA will celebrate our 100th (centennial) anniversary in 2021 with the theme “connect, celebrate, inspire.” Stay tuned for more updates as we move forward to toast this magnificent milestone.

I hope you feel as energized by all of these accomplishments as I do. Many of you participated directly in helping to achieve these victories. Our hard work is paying off!

Meryl Gersh
PTWA President-Elect
PTWA Professional Enhancement Panel Director

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.

What Emilie Said About PTs Performing a Singular Technique – Dry Needling

PTWA Legislative Committee Chair Emilie Jones delivered this eloquent testimony during yesterday’s dry needling sunrise review at the Washington State Department of Health.

My name is Emilie Jones and I’m a physical therapist and legislative chair for PTWA.

We are here today to discuss whether physical therapists can perform a singular technique – dry needling.

In the American Academy of Medical Acupuncture’s website, Dr. Joseph Helms describes acupuncture as “one discipline extracted from a complex heritage of Chinese medicine – a tradition that also includes massage and manipulation, stretching and breathing exercises, and herbal formulae.” Physical therapists do not desire to perform acupuncture. We do not want to treat patients for allergies, stress, fatigue, poor digestion, menstrual discomfort, hormonal issues, ileus, asthma, hiccups, constipation or sleep disorders.  These patients are not seen in our practice.

Acupuncture is a well-respected profession with a long history and extensive body of knowledge.

We do not ask massage therapists to go to physical therapy school to perform manual therapy techniques.

We do not ask phlebotomists to go to nursing school to puncture veins.

We do not ask nurses or medical assistants to go to medical school to give injections.

None of these practitioners are performing acupuncture when they insert a needle into a patient’s arm to give them a TB test. They do not know whether they are interacting with an acupuncture point when they do this.

Physical therapists do not need to go to medical acupuncture school to perform a single technique just because the tool is the same. We desire to use our extensive background in anatomy, physiology and manual treatment techniques to assist the patients we are already treating with myofascial trigger points to get better, faster. This is allowing patients to receive care in the model they choose, helping the most patients by improving their access to care, and  help us provide the most effective care to our patients with neuromuscular dysfunction.

The Beat Goes On

The political process is just that…a process. It has its ups and its downs. The history of Abraham Lincoln and his eventuality of president is an excellent tale of persistence and learning along the way. We will have more information for you regarding our legislative session as we can. We are not done. You may see further details of the legislative session in our weekly lobbyist’s report that is sent privately to members. You should receive it at your email address of designation.

I would like to highlight a little work our state has done in conjunction with APTA. APTA now has an expanded legislative Action App that includes specific state information.  Washington is one of twenty nine states that is working to provide information for this centralized app. For those of you (and it should be all of you) who follow legislative issues….this is an excellent resource. It is highly educational and allows you greater ease with interacting with your state and federal legislators. By the way, your voice and the number of your voices matter. The app is available for free download in the Apple and Google Play app stores. The app includes an action center, Congressional and state directory, talking points and more. For those who already have the app please update your app to obtain the new version.

Search “APTA Action” in your Apple or Google Play app store to download the app today!

I will be attending the PTWA King County District Meeting on February 11, 2016. Please plan to attend if you can as there are excellent speakers with a very interesting topic. I will be available for your individual questions after we listen to the presentation and Q&A.

Thank you for your active membership!
Erik Moen, PT
PTWA President

Advocacy Opportunities for 5th District Constituents

We are still looking to gain Rep. Cathy McMorris Rodger’s cosponsorship on our national PT priority legislation. Here are two opportunities to put APTA’s legislation priorities in front of her in the next couple of weeks.

McMorris Rodgers will host a “Coffee with Cathy” public event at the Port of Walla Walla Conference Room, 310 A. St. Walla Walla Thursday, August 25. Local citizens will be able to speak directly with the Congresswoman and express their opinions on key issues affecting our community and our nation — including jobs, government spending, health care, energy, and national security.

McMorris Rodgers will also host a public town hall at Lincoln Center, 1316 N. Lincoln, Spokane August 31.

Position papers are available for download and print at apta.org/advocacy

Questions? Contact PTWA Federal Affairs Liaison Sharon McCallum sharonemc@comcast.net.

Advocacy Opportunity for 8th District Constituents

Congressman Dave Reichert invites constituents to Puyallup for a breakfast with special guest Senator John Boozman (R-AR) Saturday, August 27 at 8: 30 a.m. at the Elks Lodge314 27th Street Northeast, Puyallup. Cost is: $35 per person or $325 for a table.

 Consider attending this event. Bring along the position papers for our priority bills available to download and print at www.apta.org/advocacy. Approach the representative or staff before or after the event. Hand them the position papers and let them know you will be in touch!

The bills currently of concern to the physical therapy profession are:

HR 1546/S829 -The Medicare Access to Rehabilitation Services Act.
HR 1426/S 975 “The Physical Therapist – Student Loan Repayment Eligibility Act of 2011 HR 531 Access to Frontline Health Care Act.
HR 469-The Protecting Student Athletes from Concussions Act

To attend, Please R.S.V.P to Keith Schipper at 425-455-3283 or kschipper@davereichertforcongress.com.

Sharon McCallum, PT, DPT
PTWA Federal Affairs Liaison

Rep. Adam Smith Holding Town Hall Meeting Aug. 25

Rep. Adam Smith invites 9th District constituents to a budget town hall meeting Aug. 25 at 7 p.m. Consider attending this meeting. Bring along the position papers for our priority bills available to download and print at www.apta.org/advocacy. Approach the representative or staff before or after the meeting. Hand them the Position papers and let them know you will be in touch!

The bills currently of concern to the physical therapy profession are:

HR 1546/S829 -The Medicare Access to Rehabilitation Services Act.
HR 1426/S 975 “The Physical Therapist – Student Loan Repayment Eligibility Act of 2011 HR 531 Access to Frontline Health Care Act.
HR 469-The Protecting Student Athletes from Concussions Act

What: Town Hall discussion on the national budget, debt reduction, and economic recovery
When: 7 p.m., August 25th, 2011
Where: Burien City Council Chambers
400 SW 152nd St., in Burien Town Square
Council Chambers are on ground floor of City Hall/Library building.
Space is limited and attendees are encouraged to RSVP, please call 253-593-6600 or email rsvpsmith@mail.house.gov.

Sharon McCallum, PT, DPT
PTWA Federal Affairs Liaison