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August/September 2002

Erik Weihenmayer

Athlete With Disability Wins ESPY Award

ESPN honored an athlete with a disability for the first time at its 10th annual ESPY award ceremony, held in July in Hollywood, Calif.

Blind mountain climber Erik Weihenmayer, who climbed Mt Everest last summer, won the ESPY award for top athlete with a disability. Also nominated for the award were Paralympic gold medalist skier Sarah Will and rugby wheelchair star Steve Pate.

The award was presented along with 10 other awards for top athletes in traditional sports such as basketball and baseball. The new disability category was created with the help of Steve Raymond, an ESPN marketing executive who has worked with the Paralympic disabled ski team. After receiving approval from ESPN for the category, Raymond put together a committee to make the nominations for the award. The committee included Randy Snow, a Paralympian wheelchair basketball player, and Charlie Huebner, managing director of US Paralympics.

One of the disability sports organizations that sent nominee considerations to the committee was the Center for Study of Sport in Society, a program of Northeastern University in Boston.

Eli Wolf, director of the center’s disability sport research initiative, was hopeful that the new award will bring more visibility and credibility to athletes with disabilities. “It’s exciting that these athletes will be on the same stage as the most high profile athletes in the world,” he said.

The ESPY Awards were launched by ESPN in 1993 and are given for excellence in sports performance; 34 awards were given out at this year’s event.

APTA Urges Congress to Adopt Direct Access

The American Physical Therapy Association (APTA) is stepping up efforts to convince Congress to pass a direct access law for Medicare beneficiaries.

A bill introduced in late April by Senators Blanche Lincoln (D-Ark) and Arlen Specter (R-Pa) is part of HR 3363, the House’s Medicare Patient Access to Physical Therapists Act, which would give Medicare recipients direct access to physical therapists.

Since the bill was introduced, APTA representatives have been meeting with Congress members to try to get cosponsors on the legislation. Although an increasing number of states have direct access laws, those laws differ slightly and do not always have the impact that therapists are seeking.

For example, many direct access laws are permissive, as opposed to mandatory, which means that patients are permitted to see therapists without a doctor’s referral; however, a payor can still require a referral.

In addition, it is possible to have a state direct access law but also have a state practice act that forbids therapists from seeing Medicare patients without a referral. In other words, therapists in that state can see privately insured patients without a referral, but not Medicare patients.

However, if passed, the bill would eliminate the Medicare loophole for preexisting direct access states, and ensure direct access for Medicare recipients in states that have such laws on the books.

Still, Justin Moore, a government affairs representative for APTA, says, “We are very hopeful about this. We are working to overcome some resistance from Congress.” He says that is happening because some legislators believe Medicare as a whole should be overhauled, as opposed to minor changes such as the PT bill.

Moore says APTA’s work on getting the bill passed will be long-term, calling it a “3-5 year process, realistically.” He also notes that, according to APTA, direct access would actually save the government money. If patients have direct access, he says, they will not have to be hospitalized as often. In addition, when patients receive quicker care, overall costs tend to be lower.

But some health care providers, such as orthopedic surgeons, oppose the bill because of fears that direct access would harm patient safety.

Therapy Cap Gets 2-Year Moratorium Extension

The $1,500 therapy cap, which rehabilitation organizations have long been hoping would be killed off completely, received a 2-year extension to its mora-torium as part of the Medicare Modernization and Prescription Drug Act of 2002 (HR 4954), which passed the House on June 28. This marks the third time in the past few years that Congress has proposed a moratorium on the outpatient therapy cap.

The current moratorium was placed into this massive Medicare reform bill, which is currently being debated in the Senate. And although it appears to be good news for therapists, organizations such as APTA were trying to convince Congress to kill the cap altogether, rather than postponing it once again.

The therapy cap, which had previously been placed on a 1-year moratorium on two separate occasions, had been scheduled to go back into effect beginning on January 1, 2003. The bill also requests that the Department of Health and Human Services finally complete its overdue report on alternatives to the cap, and that the General Accounting Office undertake a study on the effects of direct access to physical therapists.

Associations Hope to Change 75% Rule

Several prominent rehabilitation providers have sent a letter to the Centers for Medicare & Medicaid Services (CMS), requesting that the 75% rule be revamped.

The rule, which is used to determine whether a facility is an inpatient rehab facility, mandates that 75% of an inpatient facility’s annual Medicare population must be patients whose diagnoses fall into one of 10 categories.

However, the letter, authored by five associations including the American Medical Rehabilitation Providers Association and the American Academy of Physical Medicine and Rehabilitation, notes that the current categories were decided in 1984.

The associations argue that because such facilities are seeing more patients for cancer rehab, cardiac rehab, and pain management, the rule’s requirements need updating. The letter suggests replacing the current list with the 20 rehabilitation impairment categories used in the prospective payment system.

The letter was signed by the associations on April 17.

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