[Congressional Record (Bound Edition), Volume 156 (2010), Part 11]
[Senate]
[Pages 16005-16006]
[From the U.S. Government Publishing Office, www.gpo.gov]




           PHYSICIAN FEE SCHEDULE: IMPACT ON THERAPY SERVICES

  Mr. BARRASSO. Mr. President, for the past 6 months I have come to the 
floor of the U.S. Senate to offer my doctor's ``second opinion'' about 
the health reform law. Day after day, week after week, we continue to 
see disturbing news reports uncovering the law's consequences--
consequences that restrict individual freedoms, erode patient access to 
medical care, and increase our Nation's debt and deficit.
  Specifically, I have listened closely as President Obama and 
congressional Democrats repeatedly try to convince the American people 
that the health care law does not cut Medicare. Having practiced 
medicine for well over two decades, I can tell you that the Nation's 
Medicare patients and Medicare providers are not fooled. They know the 
Democrat's health care law cuts over $500 billion from the Medicare 
Program. They know the law does not use that money to make sure 
Medicare is strong and solvent for generations to come. They know the 
law raids Medicare and uses the money to start a brand new entitlement 
program for the nonelderly.
  America's seniors, and the medical professionals who treat them, 
understand that if we take over $500 billion away from Medicare then 
patients will lose benefits. They understand that if we take over $500 
billion away from Medicare, then the quality of care will go down. They 
understand it will be increasingly difficult to see a doctor--
especially in rural and frontier States like Wyoming. And they 
understand the local community hospitals, home health agencies, nursing 
homes, and skilled nursing facilities will struggle to keep their doors 
open.
  Over the August work period, I traveled all across the State of 
Wyoming--talking to folks at town meetings, parades, picnics, fairs, 
and rodeos. Everyone agrees Medicare is going broke--and that the new 
health care law does nothing to fix the problem. In fact, it only 
serves to make a bad situation worse.
  I want to share with the Senate a guest editorial printed in the 
Casper Journal. Written by Kathy Blair, a board certified orthopedic 
physical therapist, the article explains how proposed Medicare 
reimbursement cuts to physical and occupational therapists will limit 
patient access to medical care.
  On Friday, June 25, 2010, the Obama administration released its 
proposed 2011 Physician Fee Schedule rule and regulation. The draft 
rule sets Medicare payments for individual physician services. As 
Kathy's editorial explains, the new health care law requires the 
Administration to institute a so-called Multiple Procedure Payment 
Reduction--MPPR. Originally designed to impact payment for multiple 
surgeries performed simultaneously, the administration now plans to 
apply the MPPR policy to physical and occupational therapy services. 
This move is expected to cut Medicare physical and occupational therapy 
payments next year by 12 percent.
  I thank Kathy Blair for bringing this important matter to the 
Senate's attention and ask unanimous consent to have her editorial 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

              [From the Casper Journal, Aug. 18-24, 2010]

     Proposed Medicare Policy May Reduce Physical Therapy Services

                          (By Dr. Kathy Blair)

       On June 25, 2010, the Centers for Medicare and Medicaid 
     Services (CMS) issued a proposed rule that updates 2011 
     payment rates for physician services, outpatient physical 
     therapy services and other services. In the rule, CMS 
     proposes to implement a multiple procedure payment reduction 
     (MPPR) policy that would result in significant reductions in 
     payment for outpatient therapy services, regardless of the 
     setting in which the services are delivered. It will apply to 
     physician offices, outpatient private practice settings and 
     outpatient services in hospitals, as well as some home health 
     and skilled nursing services (Part B).
       Estimates indicate that these changes will result in a 12- 
     to 13-percent decrease in payment for outpatient physical 
     therapy services in 2011. These cuts, along with the 
     sustainable growth rate (SCR) cuts and therapy cap, would 
     combine to reduce reimbursement by as much as 35 percent in 
     2011.
       Physical therapists may have to elect not to see Medicare 
     beneficiaries or close their doors as a result of such 
     significant reductions in reimbursement. It will clearly have 
     an impact on the ability of Medicare beneficiaries to gain 
     access to needed therapy services.

[[Page 16006]]

       Access to necessary therapy services has the potential to 
     decrease costs associated with the management of conditions 
     typically seen by physical therapists under the Medicare 
     program. Therapy services are important to keep Medicare 
     beneficiaries healthy and functioning in their homes or the 
     facilities in which they reside.
       Additionally, individuals considering a career in physical 
     therapy may reconsider their choice. The inability to serve 
     the rehabilitation needs of seniors and individuals with 
     disabilities due to unsustainable payment cuts would limit 
     access today and has the potential to worsen health care 
     workforce issues in the future.
       CMS needs to hear from you to understand the implications 
     the MPPR policy will have on physical therapy practices and 
     the healthcare of all Medicare recipients. Comments must be 
     received by an Aug. 24 deadline and can be submitted 
     electronically at http://www.regulations.gov/search/Regs/home
.&fnl;html #submitComment?R=0900006480b182c9.
       For contact information about mailing letters to comment, 
     call Wind City Physical Therapy at 235-3910. Please allow 
     adequate time for letter delivery before the comment period 
     ends.

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