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Congress is back in session, and while other issues may grab front-page headlines, the next few months also could prove significant for the physical therapy profession—sometimes thanks to the ripple effects of big-ticket legislation, and at other times when lawmakers turn their attention to more physical therapy-specific bills.

PT in Motion News asked Ken Sprague, APTA's senior congressional affairs specialist, about the legislative issues that should be on the radar of physical therapists (PTs), physical therapist assistants (PTAs), students, and their supporters. Here's Sprague’s list of the top 5 issues to track over the coming weeks:

1. Repeal of the Medicare Therapy Cap
Congress is arguably closer than it's ever been to coming up with partial or full repeal of the Medicare therapy cap. A bill in the US House of Representatives to end the cap has strong bipartisan support, with 177 cosponsors as of late July.

Sprague’s take: "Watch for movement with this legislation through 1 of the several September must-pass legislative packages, such as the Children's Health Insurance Program (CHIP) reauthorization or the various Medicare extenders that will require congressional action. APTA continues to work with committee staff in the House and Senate to develop amendment language and garner even more support for the bill."

Tip: Coming September 12 and 13, take part in a Flash Action Strategy, an effort led by student members of APTA that will invite PTs and PTAs to participate in a high-intensity, short-duration advocacy effort around repeal of the therapy cap (#FAS2017 and #StopTheCap). Also, be sure to check out a video of APTA CEO Justin Moore, PT, DPT, testifying before a House subcommittee on repeal of the cap.

2. Inclusion of PTAs in TRICARE
TRICARE, a major part of the US Department of Defense health care system, says that physical therapist assistants (PTAs) aren't payable under the program—but that may be changing. In June, a House committee directed the US Secretary of Defense to look at ways to bring PTAs, occupational therapy assistants, and other support personnel into the TRICARE payment system.

Sprague’s take: "APTA continues to work with the Senate to advance this initiative by way of the National Defense Authorization Act. That act hasn't passed in the Senate, so we're working with members of the Armed Services Committee to make it happen."

3. Protection for PTs traveling with sports teams
Known as the Sports Medicine Licensure Clarity Act, this legislation would provide added legal protections for sports medicine professionals—including PTs—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. The bill already easily passed in the House, and now it's in the Senate.

Sprague’s take: "APTA is continuing to gain additional cosponsors for this bill in the Senate, so we hope to see advancement—hopefully we could see a committee hearing or markup on this before the end of the year."

4. Appropriations challenges
One of the biggest challenges Congress is facing is whether and how it will keep the federal government open, which means passing appropriations bills that pay for many of the agencies associated with physical therapy and other health care—the US Centers for Medicare and Medicaid Services, other agencies within the Department of Health and Human Services, the National Institutes of Health, and so on. The final shape of these appropriations was still very much up in the air by late August.

Sprague’s take: "APTA is tracking this issue closely because of the huge number of agencies that are affected by the appropriations process. While President Trump released an extremely skinny budget in May with many dramatic cuts across the board, Congress already has shown they likely will not implement those cuts through the appropriations process. We will probably see a short-term continuing resolution at some point in September to keep the government open and larger appropriations packages later in the fall."

5. Repealing and replacing the ACA
The Senate was unable to pass its plan for repealing and replacing the Affordable Care Act (ACA) before its August recess and seems increasingly unlikely to try again any time soon. In the absence of those efforts, bipartisan efforts are emerging aimed at stabilizing the insurance markets in the ACA's state exchanges.

Sprague’s take: "Legislators are looking at efforts such as legislating the cost-sharing reduction payments made by the federal government to offset the high cost of premiums and deductibles for individuals who purchase insurance through the exchanges. Other initiatives that likely will be discussed are the repeal of the employer mandate, revisiting the medical device tax, and other more bipartisan efforts. There's already movement in these areas, with meetings of the Senate Health, Education, Labor, and Pensions Committee already scheduled for the first 2 weeks of September."

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