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The Sequestration…

Effective March 1st, across the board spending cuts have been implemented because Congressional leaders and the President are unable to resolve fiscal political disagreements. So what does this mean for Occupational, Physical and Speech Therapy providers? While the actual effects remain to be seen, OTs, PTs and Speech therapists are best served by being informed. Here’s what we know.

The good news? Medicaid and the Dept. of Veterans Affairs are exempt from sequestration. In addition, federal agencies will have some discretion in how to apply their cuts so the full effect may not be known for a time.

The APTA reports that physical therapy will see impacts on rehabilitation research, education and Medicare payments.  They report expected cuts of 5-7% for NIH funding, 5-8% cuts in the Dept. of Education and 2% cuts in Medicare payments. Even a 2% cut (according to AOTA) will create cash flow problems for employers-thus directly impacting the practitioner. All Medicare settings: hospitals, rehab centers, SNFs, acute care facilities, and home health will likely feel these cuts.

The sequestration is only one issue facing therapy providers. There is still the Medicare “Doc fix,” outpatient providers reporting functional data when billing Medicare, the Multiple Procedure Payment Reduction (MMPPR), and the therapy cap exceptions process which must be addressed. While Congressional leaders have suggested they will address many of these issues, they plan to do so as part of the larger economic package-which clearly is going nowhere these days.

And what about school therapists? ASHA (the American Speech, Language and Hearing Association) reported on a memo sent to state education chiefs and superintendents, the U.S. Dept of Education has said sequestration requirements would be implemented from funds available in July for the 2013-2014 school year and not from the current 2012 advance appropriations. The Dept. does not believe the sequestration will affect funding for this current school year.  For the school therapist who is winding down the current year, this probably is irrelevant. After all, the school year is all but over. The issue is next year. The Budget Control Act (BCA) right now has all federal education programs set to be cut next year unless the Congress and the President act.  Besides indirect effects (think professional development opportunities), the Individuals with Disabilities Act (IDA) will face a $972.5 million cut for next school year… this is a $243 million cut to related (including therapy) services.

So what’s a therapist to do? First of all, stay informed.  The AOTA, APTA, and ASHA all have up to date information available to the public on their perspective websites. State professional and educational organizations also have information on line. Secondly, as therapy providers, one of the best things we can do is continue to provide quality services to our clients and demonstrate the value of occupational, physical, and speech therapy. Finally, be heard. Reach out to your Congressmen and women and let your voice be heard. If you aren’t sure who your congressional reps are you can go to:

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