Federal Legislative Issues Update - August 2010
Policy makers throughout Washington have been working at a frenetic pace to complete their work before the August recess. Proposed rules related to Medicare, health reform, and a Medicaid Supplemental have dominated the political scene and all have significant impact on occupational therapy practice.
Proposed Medicare Physician Fee Schedule Rule
On July 13, the Centers for Medicare and Medicaid Services (CMS) released their proposed rule for 2001 Medicare payments. CMS has proposed an arbitrary cut to therapy services that would, if implemented as written, reduce therapy payments by an estimated 10% to 15%. The cuts, known as Multiple Procedure Payment Reductions (MPPR), target the formula through which therapy payments are valued and reduce payments for the billing of multiple codes. The proposal also fails to separate the payment for each discipline (OT, PT, and SLP) and reduces payments to OT when billed the same day as PT or SLP and vice versa. AOTA is working with a broad coalition of stakeholders to oppose the rule and has already conducted a series of meetings with key policymakers at federal agencies and on Capitol Hill. Letters have also been sent by a strong bi-partisan group in both the House and Senate urging CMS to reconsider their proposed cuts.
AOTA is making this a top priority over the next few months because of the potential impact on Medicare services as well as the problem of other insurance plans adopting similar cuts if implemented by Medicare. Additional information, including a sample letter for you to submit your own comments to CMS opposing the proposed rule is available.
Health Care Reform
As the regulatory and implementation process of health reform begins to take center stage, AOTA continues to work with Congress and is expanding its advocacy and influence to federal agencies and regulatory bodies.
AOTA continues to work with Congress to ensure the victories achieved legislatively are not diminished in the implementation process. AOTA has provided comments to the National Association of Insurance Commissioners (NAIC) in regard to that group’s work advising Congress regarding the design and scope of health insurance plans under the new health reform exchanges. AOTA’s comments focused on the definition of qualified providers to ensure access to occupational therapists and occupational therapy assistants. AOTA also worked with the Consortium for Citizens with Disabilities (CCD) to provide comments on the importance of habilitation services and recommending a broad definition of habilitation for the purpose of coverage under the new plans. This advocacy is intended to take full advantage of the victory AOTA won with the specific inclusion of rehabilitation and habilitation services as a required category of benefits under the exchange plans.
The Centers for Medicare and Medicaid Services (CMS) requested comment on three proposed alternatives to the therapy cap in the proposed 2011 Medicare Physician Fee Schedule Rule. For additional information on the proposed 2011 Fee Schedule, please read an analysis from AOTA’s Regulatory and Reimbursement Policy Division.
AOTA is working with members to coordinate a response to the proposals and to protect the interests of occupational therapy and the Medicare beneficiaries who need our services. The request for comments is related to the project committees charged by Congress and CMS to identify possible alternatives to the therapy cap.
The Medicare Part B outpatient therapy cap exceptions process is currently in place throughout the remainder of 2010. AOTA continues to work toward full repeal of the therapy cap and will be working in coalition with other consumer and provider organizations to urge Congressional action before 2011.
It is likely that Congress will only move to address the Cap during a lame duck session after the mid-term elections in November. Stay informed at AOTA’s Legislative Action Center.
FY 2011 Appropriations
The Senate Committee on Appropriations has approved the fiscal year 2011 Senate Labor, Health and Human Services, Education and Related Agencies Appropriations bill (S.3686), providing $169.6 billion in discretionary funding for a range of programs. Specifically included in the proposal is a $2.7-million increase for the National Institute for Disability and Rehabilitation Research (NIDRR), an increase of $250 million to target fraud waste and abuse in Medicare, $8.2 billion for Head Start programs ($990.3 million increase from FY 2010), $57.9 million (an increase of $20 million) for public health workforce training, including occupational therapy, as well as additional funding for critical health care and education programs. To read a summary of this legislation or to view the bill in its entirety, please visit the Senate Committee on Appropriations’ Web site.
AOTA Capitol Hill Day
AOTA’s Capitol Hill Day is scheduled for Monday, September 20, 2010. Last year more than 320 AOTA members came to Washington to advocate for occupational therapy. This year we will be in the middle of a contentious mid-term election with many important issues facing Congress. The Medicare Therapy Cap, the Reauthorization of the Elementary and Secondary Education Act, Medicare fee schedule changes, health reform implementation, development of final rules related to mental health parity, federal autism research and services legislation, rehabilitation research, and supplemental Department of Veterans Affairs and Department of Defense initiatives will all be issues before Congress with significant implications for occupational therapy.
Come join your colleagues to be a voice for your profession. Bring a colleague and share an empowering experience in the nation’s capital. This year, Ergo Solutions, a large rehabilitation agency in Washington, D.C., is sponsoring a wrap-up reception at Tortilla Coast from 5 to 7 p.m., so please plan to stay and socialize with your colleagues after Hill Day. The event will be held at, Tortilla Coast - Capitol Hill 400 First Street SE.
American Occupational Therapy Political Action Committee (AOTPAC)
AOTPAC is halfway to its fundraising goal of $250,000. There are still many primary races and the general elections yet to come. Our friends in Congress and challengers identified as possible new friends are seeking our support during this contentious election year. Your contributions will help us support our friends and build new relationships as we approach the new Congress in 2011.
AOTPAC is seeking a new director for its Region I board position. Applicants must live in the region and meet other qualifications. For more information, read the announcement on the AOTA Web site.