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"We're at a critical crossroads. The profession needs your voice and we need it now."

That's how Laura Keivel, APTA's grassroots and political affairs specialist, describes the advocacy challenge facing the physical therapy profession now that CMS has issued a proposed payment rule for 2021 that includes a severe cut to PTs and a host of other disciplines. If adopted as is, the rule would lead to an estimated 9% decrease in payment for codes commonly used in physical therapy.

"As we've stated before, the cuts being proposed are unconscionable," says Justin Elliott, APTA vice president of government affairs. "They were ill-advised a year ago, but now, in light of a public health crisis that's affecting millions and putting many health care providers at serious physical and financial risk, they're not just a bad idea — they're irresponsible and cruel. APTA and a coalition of other impacted health care provider groups are calling on Congress to step in."

The call for congressional action on a CMS fee schedule isn't typical. In a normal year, the release of the proposed physician fee schedule rule from CMS is a time for APTA and its members to focus on comments to the agency itself to make the case for changes or support elements of what is proposed. But this year is different: This time around, CMS implies legal restrictions are forcing its hand — restrictions that only Congress can change.

That's why APTA and a long list of other organizations are turning up the heat on lawmakers to help fix a potentially devastating provision in a regulatory rule.

How To Take Action

To help lawmakers understand the need for immediate action, APTA is asking all PTs and PTAs — both members and nonmembers — as well as patients and other stakeholders, to contact their legislators on Capitol Hill and press for action on the proposed cuts.

Getting involved is easy: Visit our Medicare Physician Fee Schedule Advocacy webpage and follow the instructions via the APTA Action Center. We've developed one statement template for PTs and PTAs, and a separate one for the public. Share the public letter with colleagues, friends, family, and patients to encourage their participation in adding to the volume of letters going to Capitol Hill.

The effort is already off to an impressive start — according to Keivel, by the morning of Monday, Aug. 10, nearly 15,000 emails to lawmakers had been sent through the APTA Action Center.

Ongoing Efforts and Recent Developments

In addition to our call for contacting lawmakers and CMS, we've launched a series of social media posts that can help you share the advocacy message easily among your own networks. We're also working with a broad coalition of other organizations to magnify the message that the proposed cuts simply cannot happen.

Our work with other groups began well before CMS issued its proposed rule, and have gained traction in Congress: In February, 99 members of the U.S. House of Representatives signed on to a letter challenging CMS' reasoning behind the planned cuts, and in May, a letter to House leaders signed by 46 representatives characterized the cuts as "reckless" and called for waivers of budget neutrality requirements.

And now the latest: On August 11, 92 bipartisan members of the House of Representatives joined Rep. Bobby Rush, D-Ill., in a congressional sign-on letter calling for House leaders to include waivers for budget neutrality around E/M codes "in any upcoming relevant legislation moving through the House." The group also presses for CMS to report to Congress on the impacts of both the COVID-19 health emergency and the proposed payment cuts.

The letter states that "If these cuts go into effect, they will be devastating for providers and will ultimately result in decreased access to care for patients. Our healthcare system is already under tremendous financial strain, as it continues to grapple with both the economic and health consequences of the coronavirus. Now is not the time to implement these reckless cuts."

"The broad bipartisan support demonstrates that Congress must act, and must act now," said Elliott. "We are grateful for Representative Rush's leadership and appreciate the support of the 92 bipartisan members of the House who have joined him in calling for Congress to intervene."

Keivel believes the attention from lawmakers is a direct result of the ways APTA's advocacy efforts have been reinforced by the grassroots work of members, nonmembers, patients, and other stakeholders — and that individual involvement will be key in bringing about change.

"The engagement of the physical therapy community on this issue has been inspiring, but we need to turn up the volume," Keivel said. "We need to seize every opportunity to connect with lawmakers as soon and as often as possible so that they fully understand the magnitude of the damage that could happen if this rule is finalized as proposed."

CMS Needs Your Perspective, Too

Even though CMS claims the cuts are necessary to comply with budget neutrality requirements, the agency needs to be made aware of the potentially disastrous effects the reductions could have on patient care and access. That's where APTA's regulatory action center comes into play.

Visit the Regulatory Action Center webpage to download a customizable letter that allows you to share your individual perspective while joining in a unified effort for change. There are separate template letters available; one for PTs and PTAs and one for patients. Deadline is October 5.

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