After negotiated language from last weekend on a public plan option and a Medicare buy-in at age 55 fell apart, the Senate’s debate on the Patient Protection and Affordable Care Act (HR 3590) the week of December 14 returned to a compromise on the public plan option, such as state-based health care cooperatives, according to the American Physical Therapy Association (APTA), Alexandria, Va.
This action gained critical support for Senate Majority Leader Harry Reid (D-Nev) in his attempt to achieve the 60 votes needed to proceed toward passage of HR 3590.
As the week closed, most of the focus was again on Sen Ben Nelson (D-Neb) and his opposition to the current bill due to its lack of language prohibiting federal funding for abortion. Without Nelson’s support or the crossover of a Republican, such as Sen Olympia Snowe (R-Me), the Senate is unable to meet the 60 votes needed to proceed toward a vote on HR 3590. The Senate is expected to continue its debate through the weekend with a final vote desired by Christmas Day.
HR 3590 contains many critical provisions and public policy priorities for physical therapists. Without congressional action, the therapy cap exceptions process will expire on December 31. In addition, a 21.9% reduction in the conversion factor and rural payments are also scheduled to go into effect on January 1, 2010.
HR 3590 has a 1-year extension of the therapy cap exceptions process, a .5% update to the conversion factor (over the 21.9% reduction), and continuation of the 1.0 Geographic Practice Cost Index (GPCI) floor on rural provider payments.
In separate legislation, the House passed an extension of the 2009 conversion factor to avoid the 21.9% reduction from January 1, 2010, to February 28, 2010, until comprehensive health care reform is passed. The Senate is schedule to vote on the measure on December 19.
Unfortunately, the bill does not include an extension of the therapy cap exceptions process. The Patient Protection and Affordable Care Act (HR 3590) and the American’s Affordable Health Choices Act (HR 3962), the Senate’s and the House of Representatives’ health care reform proposals, both contain provisions to extend the caps exceptions process. As it is not expected that a health care reform bill will be signed into law before December 31, APTA is seeking legislation that could serve as a vehicle for extending the therapy cap exceptions process before the end of the year.