Most likely, the first stroke-related priority Congress will move forward with is the Medicare therapy cap. Currently, stroke survivors on Medicare are capped at $1,920 for occupational therapy and $1,920 for physical and speech therapy combined. An exceptions process allows some patients to receive therapy beyond the caps, but it is set to expire on March 31, 2015. Congress now has two months to either permanently repeal the therapy caps or extend the exceptions process. In the coming weeks, legislation to repeal the therapy caps will be introduced in both chambers. At the same time, House members are crafting a “Doc Fix” bill, also known as Sustainable Growth Rate or SGR bill, which will reform Medicare’s reimbursements to physicians. In the past, changes to the Medicare therapy caps have been attached to SGR bill and would likely be included in the latest incarnation. National Stroke Association supports fully repealing the Medicare therapy caps to allow stroke survivors to receive the full outpatient therapy they need to successfully recover from a stroke.
The other stroke-related legislative priority to see traction in the 114th Congress is increased funding for medical research. During his State of the Union Address last week, President Obama announced a new Precision Medicine Initiative to more efficiently treat diseases through individualized care. Although no specifics were mentioned about the initiative, precision medicine builds on the success of the Human Genome Project to treat illnesses with drugs that target molecular subtypes of diseases and consider each patient’s genetic makeup. Precision medicine could result in more effective acute and rehabilitative treatments for stroke survivors. Members of the House of Representatives are currently drafting a series of medical research bills, including legislation with provisions supporting Precision Medicine research. National Stroke Association will support any new presidential initiatives, federal programs, or Congressional funding priorities that may generate new treatments for stroke survivors.
We sent out an action alert summarizing other legislative priorities for the 114th Congress and asking survivors to contact their legislators and keep the stroke community’s legislative priorities on the agenda. If you have not done so already, please join other stroke advocates and contact Congress today!
The U.S. healthcare system is affected by laws passed by both Congress and state legislatures. Thus, it’s important that the legislators who represent you at all levels of government understand the needs and challenges of stroke so they can make better decisions about policies that impact the stroke community.
To help you communicate about stroke-related issues with your state legislators, we developed the State Advocacy Action Center. What will you find when you visit the action center? You’ll find information specific to your state legislature, including:
Below, we’ve outlined legislative policy trends we’ve identified during the first few weeks of legislative sessions.
Telemedicine Improves Access and Care for Stroke Survivors
Telemedicine services can bring specialized stroke care to residents of your state that don’t currently have access to them. Having these services available can mean the difference between life and death for someone experiencing a stroke. Because every second counts when someone is having a stroke, these services can also lessen the impact of stroke on a survivor. This outcome improves the post-stroke quality of life for the survivor and his or her family. It also reduces the cost of their future care—for the survivor’s family and the healthcare system as a whole.
“Cap the Co-Pay” Protects Stroke Survivors from Increases in Out-of-pocket Expenses
This policy change will protect you from the financial burden of paying a higher-percentage of the cost of your medicine. Why is this important for the stroke community? Capping the highest co-payments for medications distributes pharmacy costs more fairly between enrollees and insurers. This is a win-win situation stroke survivor and eases the financial strain that is common during recovery.
Stroke Systems of Care: Getting Quality Care as Fast as Possible
Stroke Systems of Care legislation would decrease the time it takes to diagnose a stroke patient and transport him or her to an appropriate healthcare facility for treatment. Since every minute counts when someone is having a stroke, this can mean the difference between life and death. It can also reduce the impact of stroke, giving stroke survivors a chance at a better recovery.
Prescription Synchronization Makes Your Life Easier
Prescription Synchronization policy would require health plans to allow “medication synchronization” for people with chronic conditions. Since stroke is considered a chronic condition, the new policy would apply to stroke survivors. This means that health insurance plans will have to allow your healthcare providers to synchronize your medications, which means putting them on the same refill schedule. There are also provisions in the legislation that prevent you from paying higher copays or dispensing fees for those prescriptions.
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