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In the film Mr. Smith goes to Washington, a young Jimmy Stewart fights entrenched establishment forces through a heroic filibuster and wins the day.  Needless to say, the end of Mr. Lantz goes to Washington is not so stirring.  However, my time spent with hundreds of honorable therapists fighting for common sense regulations and patient access was both rewarding and enlightening.

 

Having been to DC. before on behalf of the AOTA and APTA, this trip was different in the overall sense of optimism that far exceeded previous trips to the hill.  For one thing, the event was taking place in April, with the cherry blossoms vibrantly in bloom… a stark contrast to our Hill Day of 2011 which took place in a virtual July inferno.  The Federal Advocacy Forum was headquartered at the Liasion Hotel, a stylish and intimate spot, seconds away from the Capitol steps.

 

On Sunday and Monday we were treated to various guest speakers- ranging from Mike Allen, a veteran DC journalist at Poltico, who regaled everyone with all the buzzy gossip surrounding the current political environment-to Neera Tanden, former health care advisor in both the Clinton and Obama administrations, who updated us on the progress and setbacks of the Affordable Care Act.  We also broke out into our state delegations to game plan for our Tuesday Hill visits.

 

Being from Charleston, I joined my SC compadres in hatching our plan of attack.  Although we were small in number(3),  we were large in spirit. The final event before the big day was the PAC event at the Dubliner Pub, a boisterous event closed down by the beer-loving Wisconsin contingent.  Tuesday morning came early, and with shocking news of the Boston Marathon bombing in the background it was anticipated that security would likely be more onerous than usual.  In addition, Congress was engulfed in gun-control and immigration debates that made it a challenge to see actual politicians.  Luckily the day was a balmy 75 degrees, and strolling through the Neoclassical and Georgian architecture built long ago is never a chore.  On the day, we were able to spend productive time with 7 SC politicians, including high-level aids of Senator Tim Scott and Senator Lindsay Graham.  Aaaah you say, but what were you talking about and why should I care?  Well, unless you have nothing to do with therapy or you’ve been out captaining a sailboat in the America’s Cup, I think its safe to say your familiar with the Therapy Caps….if not, please check out the history here.

 

At the risk of getting too wonky, let me fill you in on some meaningful movement on this issue.  When the therapy cap was created in 1997, CMS was enlisted to come up with an alternative payment formula for outpatient therapy.  Unfortunately, this was never accomplished, and year, after year, after year, we all sweat out a 1 year extension on the exceptions process. The last 2 years we have been tied to what’s commonly known as the “Doc Fix” which is a way around the  flawed formula of SGR(sustainable growth rate), calling for up to a 27% reduction in physician fees due to health care costs outgrowing the rate of inflation.

 

Despite bi-partisan support to find a permanent fix in regards to the therapy caps, budgetary pressures on CBO scores have made this an uphill climb, since yearly extensions are scored as revenue neutral.  Have I lost you yet?  I promise to bring it back to more digestible dialogue soon.  This year, the CBO scored a permanent fix to the SGR, including the therapy cap, at almost half what it has been in the past.  Why you ask?  Please don’t……..no one could give me a good answer, but hey…….we will take it. The promising news is that both parties recognize the arbitrary and flawed nature of the SGR and everyone wants to get rid of it.

 

Hearings are scheduled for Summer, and there is genuine optimism that a permanent fix is in the works.  In addition, CMS notes that we are entering a critical time in regards to therapy access.  It is estimated that by 2020 we will have a shortage of over 40k therapists to deal with our aging population.  At Advanced Medical, we do our part to get quality therapists into underserved and rural communities, and stand ready to deal with the increased demand.  An alternative payment plan in the works from the APTA, along with a delay of the MPPR cuts(more later) has us all feeling groovy.
Going back to our day on the Hill, despite fighting with the Golf Lobby, Beer Wholesalers lobby,(did they plan to come together) and other various groups, we managed to make tangible progress on our journey.  Without a doubt, the cliche on our political parties held somewhat true- R’s responded to our cries of overregulation and D’s responded to our calls for greater access. More importantly, the bi-partisan support for therapy cap repeal and a permanent fix to the SGR was overwhelming.  Close to 400 therapists took part in the visits, and I was incredibly impressed with the caliber of people I was fortunate to lobby with.  It was no surprise to read about the therapists who jumped into action in Boston(http://www.apta.org/PTinMotion/NewsNow/2013/4/17/APTAMembersAssistinBoston/)  as we see up close the work that the therapy profession does in schools, with veterans, and seniors on a daily basis.  Please grab a megaphone and join the cause-we are close….

Until next time.