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Congressional Testimony
April 5, 2000, Wednesday
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 1307 words
HEADLINE:
TESTIMONY April 05, 2000 AMERICAN PHYSICAL THERAPY ASSOCIATION
SENATE FINANCE MEDICAL PAYMENTS TO SCHOOLS
BODY:
Testimony of the American Physical Therapy
Association for a hearing of the Senate Finance Committee regarding Medicaid
Payments to Schools April 5, 2000 On behalf of the 70,000 member physical
therapists, physical therapist assistants, and students of physical therapy, the
American Physical Therapy Association (APTA) is pleased to submit this statement
for your consideration as you examine Medicaid payments to schools. APTA
appreciates having the opportunity to comment. The Individuals with
Disabilities Education Act (IDEA) requires that all children with
disabilities receive a free and appropriate public education, and "related
services" necessary to benefit from their educational program. As a designated
44 related service," physical therapy must be provided at no cost to the child
or family. The cost of providing special education and related services has
given rise to financial concerns for school districts. To finance and deliver
services, IDEA's authorizing legislation and regulations require that it
coordinate with other federal programs, such as Medicaid. However, the
interaction between the financial responsibilities of these two entities has not
been well defined, and efforts to coordinate Medicaid and IDEA have been
affected by the lack of clear and consistent federal guidelines. There is
confusion over proper billing procedures which is coupled with the lack of clear
and consistent federal guidance about services appropriately provided under
Medicaid. A further challenge involves third-party liability (TPL) under the
Medicaid statute. Third-party liability refers to the legal obligation of
certain health care payors (including private health insurance) to pay the
medical claims of Medicaid beneficiaries before Medicaid pays these claims.
Medicaid rules require that Medicaid pay only after TPL sources have met their
legal obligation to pay, whereas IDEA requires that parents not be charged for
services provided through an IEP. Of considerable concern is the possibility of
limitation, or loss, of lifetime insurability and benefits for these children.
In addition, the increasing number of states choosing to utilize a managed care
plan for Medicaid services creates a life- time cap where none had previously
existed. Physical therapists are integrally involved in the provision of
services for children with disabilities in educational environments. Physical
therapists trained in pediatrics provide essential early intervention and
school-based services for children with disabilities. Physical therapy helps
children overcome the mobility and other functional obstacles to learning and
daily living that most of us take for granted. Access to physical therapy in
their own schools and communities gives children with disabilities the
educational opportunities we all need in order to enhance our lives, to live
independently, to become gainfully employed, and to be positive contributors to
society. These are just some of the important achievements that the IDEA program
has made possible. APTA strongly supports IDEA and its goals of providing a free
appropriate public education to all children. Unfortunately, the challenges
faced by providers and schools who are charged with carrying out IDEA are
further exacerbated by the limited funding that is provided to the schools under
IDEA. Although Congress has taken steps to increase funding for IDEA in the past
few years, much work remains. Full funding of the Federal share of IDEA is
crucial to the program's success. APTA urges Congress to address the critical
need for fulfilling the Federal government's promise under IDEA. Fully funding
the Federal share of IDEA is the best way Congress can assure that children with
disabilities will receive the necessary services and to prevent the
inappropriate use of Medicaid funds. We urge you to continue your work toward
providing full Federal funding of IDEA. We also would ask you urge HCFA to
establish a panel of expert stakeholders, including related service providers,
to assist them in their development of guidelines and clarification regarding
the use of Medicaid dollars to serve children in the schools. This expert panel
could provide invaluable information to HCFA in their efforts to address the
issues that families, providers, and schools face each day in their efforts to
properly implement IDEA. Thank you again for allowing us to provide this
statement for the record. We look forward to working with you on this very
important issue.
LOAD-DATE: April 10, 2000, Monday
