Subject: HB 1113 Athletic Training Bill :

The athletic training bill was tabled to the 36th legislative day. Given the session is only 35 days, this means that the bill was effectively dead.
For the sake of the public record, we (the SDPTA and the SDOTA) tried everything we could to work something out with the athletic trainers so that their practice act would be upgraded and modernized but remain within their established scope of practice. It became very clear in every interchange that their agenda is indeed an expansion of their scope of practice with their top priority being 3rd party reimbursement. We had prepared two amendments, both of which would have benefited most or perhaps all athletic trainers in the state, but neither of these amendments allowed for an expansion of scope or 3rd party billing. Apparently, due to those exceptions, those representing the athletic trainers rejected our attempts to help them modernize their practice act and instead, chose to go back before the HHS committee and fight for their original language. Their unwillingness to compromise in the legislative process caused the bill to die in committee.
An interesting development was the number of communications that took place between our members and various athletic trainers around the state who either didn’t even know that this bill was in the legislature or didn’t support what was in the original bill. It would have been nice if we would have had a way to communicate with the other athletic trainers in the state in order to inform them as to how they would have benefited from our amendments. It is important for them to know that their representatives rejected legislation that would have been an improvement over the existing statute.
It is now very important that those of you who contacted legislators, re-connect with them again to thank them for their support. We can’t ask for something on one end and not thank them on the other when they come through and support us. It would be my expectation that this bill will be back next year in one form or another as I would think that the trainers will not quit on this one attempt.

This creates two major action points for us:
1.) We need to stay in close communication with the legislators in our respective districts all year long so that there is a relationship that exists when we talk to them. 2.) This would be an ideal time to donate money to the SDPT- PAC as every one of these committee members is up for re-election next fall and we need to be able to donate to their campaigns. We need to begin to cement our presence in Pierre as a legislative force to contend with. There is no substitute for a strong grass-roots effort which you all came through with beyond expectation. Now if we can add a few dollars on top of our grass-roots machine, we will truly strengthen our position in Pierre for the future.
Thank you all for your tremendous support and response – I can’t tell you how much easier it is to do my job when you all do yours like that!!! If I don’t see you on Sunday or Monday, I’ll look forward to seeing you in April in Chamberlain!……………………………Phil Moe, SDPTA Legislative Chair

Breaking News: Therapy Cap Enforcement Delayed: July 1, 2003

The Centers for Medicare & Medicaid Services (CMS) agreed late yesterday to further delay implementation of the $1,590 cap on Medicare rehabilitation services until Sept. 1, 2003. The agency entered into an agreement with three organizations representing Medicare beneficiaries who filed suit last week in the US District Court in Washington, DC, to seek a temporary restraining order preventing the enforcement of the therapy cap. In agreeing to the 60-day delay, CMS committed to begin modifying Medicare beneficiaries through Medicare Summary Notices and the CMS website that the therapy caps will be enforced beginning September 1st. CMS will continue to negotiate with the plaintiffs on other counts in the lawsuit on administration and billing issues.

The delay comes less than a week after APTA President Ben F. Massey, Jr, PT, MA, wrote to CMS Administrator Thomas A Scully.

CMS is drafting a policy statement that will be posted on its website as soon as possible. APTA also will provide updates in the $1,590 Medicare Therapy Cap Resource Center on its website at

Federal Government Affairs Forum

At the end of April, Karen Gallagher and Phil Moe attended the forum in Washington, DC. It was the highest attended forum to date with over 150 attendees from 49 states. APTA funds a Key Contact and the Federal Affairs Liaison from each state. There were several major issues addressed this year. Below is a summary. More information can be found on the APTA website under Government Affairs.

Direct Access under Medicare
The most exciting undertaking by APTA in recent years is the introduction of legislation in Congress to allow direct access to physical therapy for Medicare beneficiaries. We stood outside the US Capitol at the press conference on April 30th, announcing the introduction of this bill in the Senate.

All members received a flyer with information on this legislation with their most recent journals. Please review this information, then go to the APTA website and use the website to contact the SD delegation to express your support of this bill. Specifically asking Senator Johnson and Representative Thune to co-sponsor this legislation. In his role as majority leader, Senator Daschle would not likely sign on as a co-sponsor, but asking his support is appropriate.

APTA has challenged each state’s liaison to obtain three support letters from physicians and three support letters from patients in the state. Please contact Karen Gallagher, if you know of any patients or physicians who would be willing to help with this. We can supply a draft letter.

Repeal of $1500 Cap
We haven’t heard too much about the cap recently, but it is still out there. The moratorium expires on December 31, 2002, thus, without congressional action, we will be back under the therapy caps 1-1-03. There are bills in Congress to repeal the cap, however, it is a challenge, as the federal government is under budget deficits again and anything determined to “cost” the system would be hard to pass.

Data from an independent study shows that 13% of Medicare beneficiaries would exceed the cap annually. Another interesting statistic is that the breakdown for expenditures for therapy is 70% PT, 20% OT and 10% Speech. Yet the cap is for $1500 annually for PT and Speech combined.

One major change has occurred in the reimbursement of Part B outpatient therapy, which is the fee schedule. When the Balanced Budget Amendment of 1997 was passed, which initially imposed the caps, there was not a fee schedule in place.

Senator Johnson has signed on as a co-sponsor to the Senate bill in March. Representative Thune agreed to co-sponsor the House bill after our visit on April 30th and now is an official co-sponsor as well. Please write and thank both for their support of this legislation. Also, our chapter is challenged to obtain three letters of support from patients regarding the $1500 cap. Please contact Karen Gallagher if you can help with this.

Fee Schedule Reductions

Legislation has been introduced to update the physician fee schedule payment system. As it currently exists, there are across-the-board cuts each year totally 19% reduction in three years if the formula is not changed. Over 85 provider groups (including APTA) support passage of the legislation to stop these reductions.

These were the main issues discussed. We did have updates on IDEA, CMS Reform, Home Health and wound care, PTA supervision in the Private Practice Setting, HIPPA and Manipulation related to Medicare. Please check out the APTA website for more information or contact either of us.