Re: Advocating for Repeal of $1500 Cap

[Guest guest]

Here is a Email address list for the Legislators by state who have email.

Let's go get 'em . Keep up the good job.

A. Stieglitz, MS,PT,ATC

Integrated Rehabilitation Services, LLC

148 East Avenue, Suite 2M

Norwalk, CT 06851

Fax:

E-Mail: rstieglitz@...

Alabama

Sen. Jeff Sessions senator@...

Sen. Shelby senator@...

Rep. Spencer Bachus sbachus@...

Rep. Sonny Callahan callahan@...

Rep. Bud Cramer budmail@...

Rep. Terry Everett everett@...

----------------------------------------------------------------------------

----

Alaska

Sen Ted s senator_stevens@...

Sen. Murkowski email@...

----------------------------------------------------------------------------

----

Arizona

Sen. Jon Kyl info@...

Sen. McCain senator_mccain@...

Rep. J. D. Hayworth hayworth@...

Rep. Jim Kolbe jimkolbe@...

Rep. Ed Pastor edpastor@...

----------------------------------------------------------------------------

----

Arkansas

Sen. Dale Bumpers senator@...

Sen. Tim Hutchinson senator hutchinson@...

Rep. Jay Dickey jdickey@...

Rep. Tim Hutchinson timhutch@...

----------------------------------------------------------------------------

----

California

Sen. Barbara Boxer senator@...

Sen. Dianne Feinstein senator@...

Rep. Bilbray bilbray@...

Rep. Brown talk2geb@...

Rep. Tom campbell@...

Rep. chriscox@...

Rep. Dreier cyberrep@...

Rep. Eshoo annagram@...

Rep. Sam Farr samfarr@...

Rep. Vic Fazio dcaucus@...

Rep. Jane Harman jharman@...

Rep. Tom Lantos talk2tom@...

Rep. Jerry khuiskes@...

Rep. Zoe Lofgren zoegram@...

Rep. McKeon tellbuck@...

Rep. gmiller@...

Rep. Ron Packard rpackard@...

Rep. Pelosi sfnancy@...

Rep. Radanovich george@...

Rep. Riggs repriggs@...

Rep. Fortney 'Pete' Stark petemail@...

Rep. Lynn C. Woolsey woolsey@...

----------------------------------------------------------------------------

----

Colorado

Sen. Wayne Allard

Sen. Ben Nighthorse data@...

Rep. Dan Schaefer schaefer@...

Rep. Skaggs skaggs@...

----------------------------------------------------------------------------

----

Connecticut

Sen. Dodd. sen_dodd@...

Sen. ph Lieberman. senator_lieberman@...

Rep. Sam Gejdenson bozrah@...

Rep. Shays cshays@...

----------------------------------------------------------------------------

----

Delaware

Sen. ph Biden senator@...

Sen. Roth

Rep. Castle delaware@...

----------------------------------------------------------------------------

----

Florida

Sen. Bob Graham bob_graham@...

Sen. Connie Mack senator_mack@...

Rep. Bilirakis truerep@...

Rep. Canady canady@...

Rep. Deutsch pdeutsch@...

Rep. Alcee Hastings hastings@...

Rep. Mica mica@...

Rep. Dan miller13@...

Rep. Cliff Stearns cstearns@...

Rep. Thurman kthurman@...

Rep. Dave Weldon fla-15@...

----------------------------------------------------------------------------

----

Georgia

Sen. Max Cleland senator_max_cleland@...

Sen. Coverdell senator_coverdell@...

Rep. Saxby Chambliss saxby@...

Rep. Mac rep3mac@...

Rep. Newt Gingrich georgia6@...

Rep. Linder jlinder@...

Rep. Charlie Norwood ga10@...

----------------------------------------------------------------------------

----

Hawaii

Sen. Akaka

Sen. Inouye senator@...

Rep. Neil Abercrombie neil@...

----------------------------------------------------------------------------

----

Idaho

Sen. Larry Craig larry_craig@...

Sen. Dirk Kempthorne dirk_kempthorne@...

Rep. Helen Chenoweth askhelen@...

----------------------------------------------------------------------------

----

Illinois

Sen. Durbin

Sen. Carol Moseley-Braun senator@...

Rep. Jerry Costello jfcil12@...

Rep. Fawell hfawell@...

Rep. Gutierrez luisg@...

Rep. Dennis Hastert dhastert@...

Rep. Ray LaHood lahood18@...

Rep. Bobby Rush brush@...

Rep. Jerry Weller jweller@...

----------------------------------------------------------------------------

----

Indiana

Sen. Dan Coats

Sen. Lugar lugar@...

Rep. Lee Hamilton hamilton@...

Rep. Hostettler johnhost@...

Rep. McIntosh mcintosh@...

Rep. Tim Roemer troemer@...

Rep. Mark Souder souder@...

----------------------------------------------------------------------------

----

Iowa

Sen. Grassley chuck_grassley@...

Sen. Tom Harkin tom_harkin@...

Rep. Jim Nussle nussleia@...

----------------------------------------------------------------------------

----

Kansas

Sen. Sam Brownback sam_brownback@...

Sen. Pat

Rep. Todd Tiahrt tiahrt@...

----------------------------------------------------------------------------

----

Kentucky

Sen. Wendell Ford wendell_ford@...

Sen. Mitch McConnell senator@...

Rep. Jim Bunning bunning4@...

Rep. Ed Whitfield edky01@...

----------------------------------------------------------------------------

----

Louisiana

Sen. Breaux senator@...

Sen. Landrieu senator@...

Rep. Jim McCrery mccrery@...

----------------------------------------------------------------------------

----

Maine

Sen. Olympia Snowe olympia@...

Sen. senator@...

Rep. Baldacci baldacci@...

----------------------------------------------------------------------------

----

land

Sen. Barbara Mikulski. senator@...

Sen. Sarbanes senator@...

Rep. Ben Cardin cardin@...

Rep. Ehrlich, Jr. ehrlich@...

Rep. Albert Wynn alwynn@...

----------------------------------------------------------------------------

----

Massachusetts

Sen Kennedy senator@...

Sen. Kerry john_kerry@...

Rep. Meehan mtmeehan@...

Rep. Joe Moakley jmoakley@...

Rep. Olver olver@...

----------------------------------------------------------------------------

----

Michigan

Sen. Spencer Abraham michigan@...

Sen. Carl Levin senator@...

Rep. Dave Camp davecamp@...

Rep. Conyers, Jr. jconyers@...

Rep. Vernon Ehlers congehlr@...

Rep. Hoekstra tellhoek@...

Rep. Lynn Rivers lrivers@...

Rep. Nick repsmith@...

Rep. Bart Stupak stupak@...

Rep. Fred Upton talk2fsu@...

----------------------------------------------------------------------------

----

Minnesota

Sen. Rod Grams mail_grams@...

Sen. Wellstone senator@...

Rep. Gil Gutknecht gil@...

Rep. Bill Luther tellbill@...

Rep. Minge dminge@...

Rep. Oberstar oberstar@...

Rep. Collin tocollin@...

Rep. Jim Ramstad mn03@...

Rep. Sabo msabo@...

Rep. Bruce Vento vento@...

----------------------------------------------------------------------------

----

Mississippi

Sen. Thad Cochran senator@...

Sen. Trent Lott sentorlott@...

Rep. Bennie ms2nd@...

Rep. Wicker rwicker@...

----------------------------------------------------------------------------

----

Missouri

Sen. Ashcroft john_ashcroft@...

Sen. Bond kit_bond@...

Rep. Jo Ann Emerson jemerson@...

Rep. Gephardt demldr@...

Rep. Talent talentmo@...

----------------------------------------------------------------------------

----

Montana

Sen. Max Baucus max@...

Sen Conrad Burns conrad_burns@...

----------------------------------------------------------------------------

----

Nebraska

Sen. Hagel chuck_hagel@...

Sen. Bob Kerrey bob@...

Rep. Jon Cristensen talk2jon@...

----------------------------------------------------------------------------

----

Nevada

Sen. Harry Reid senator_reid@...

Sen. senator@...

Rep. Ensign ensign@...

----------------------------------------------------------------------------

----

New Hampshire

Sen. Judd Gregg mailbox@...

Sen. Bob opinion@...

Rep. Bass cbass@...

----------------------------------------------------------------------------

----

New Jersey

Sen. Lautenberg frank_lautenberg@...

Sen. Toricelli senator_torric

Rep. s randrews@...

Rep. Bob s franksnj@...

Rep. Rodney Frelinghuysen njeleven@...

----------------------------------------------------------------------------

----

New Mexico

Sen. Jeff Bingaman senator_bingaman@...

Sen. Pete Domenici senator_domenici@...

----------------------------------------------------------------------------

----

New York

Sen. Moynihan senator@...

Sen. Alfonse D'Amato senator_al@...

Rep. Sherwood Boehlert boehlert@...

Rep. Eliot Engel engeline@...

Rep. Forbes mpforbes@...

Rep. Maurice Hinchey hinchey@...

Rep. Sue dearsue@...

Rep. King peteking@...

Rep. Rick Lazio lazio@...

Rep. Nita Lowey nitamail@...

Rep. Carolyn Maloney cmaloney@...

Rep. Manton tmanton@...

Rep. McNulty mmcnulty@...

Rep. Molinari molinari@...

Rep. Jerrold Nadler nadler@...

Rep. Bill Paxon bpaxon@...

Rep. Rangel rangel@...

Rep. Serrano jserrano@...

Rep. Jim Walsh jwalsh@...

----------------------------------------------------------------------------

----

North Carolina

Sen Lauch Faircloth senator@...

Sen. Helms jesse_helms@...

Rep. Cass Ballenger cassmail@...

Rep. Burr mail2nc5@...

Rep. Sue Myrick myrick@...

Rep. chtaylor@...

Rep. Mel Watt melmail@...

----------------------------------------------------------------------------

----

North Dakota

Sen. Kent Conrad senator@...

Sen. Byron Dorgan senator@...

Rep. Earl Pomeroy epomeroy@...

----------------------------------------------------------------------------

----

Ohio

Sen. Mike DeWine senator_dewine@...

Sen. Glenn senator_glenn@...

Rep. Sherrod Brown sherrod@...

Rep. Kasich budget@...

Rep. Oxley oxley@...

Rep. Rob Portman portmail@...

Rep. Deborah Pryce pryce15@...

Rep. Traficant telljim@...

----------------------------------------------------------------------------

----

Oklahoma

Sen. Inhofe

Sen. Don Nickles senator@...

Rep. Ernest J. Istook, Jr. istook@...

----------------------------------------------------------------------------

----

Oregon

Sen. Gordon oregon@...

Sen. Ron Wyden senator@...

Rep. DeFazio pdefazio@...

Rep. Furse furseor1@...

----------------------------------------------------------------------------

----

Pennsylvania

Sen. Rick Santorum senator@...

Sen Arlen Specter senator_specter@...

Rep. Jon Fox jonfox@...

Rep. Kanjorski kanjo@...

Rep. McHale mchale@...

Rep. Murtha murtha@...

Rep. Curt Weldon curtpa7@...

----------------------------------------------------------------------------

----

Rhode Island

Sen. Chafee senator_chafee@...

Sen. Jack

----------------------------------------------------------------------------

----

South Carolina

Sen. Ernest Hollings senator@...

Sen. Strom Thurmond senator@...

Rep. E. Clyburn jclyburn@...

Rep. Bob Inglis binglis@...

Rep. Mark Sanford sanford@...

Rep. Spratt jspratt@...

----------------------------------------------------------------------------

----

South Dakota

Sen. Tom Daschle tom_daschle@...

Sen. Tim tim@...

----------------------------------------------------------------------------

----

Tennessee

Sen. Bill Frist senator_frist@...

Sen Fred senator_thompson@...

Rep. Bob Clement clement@...

Rep. J.J. Duncan jjduncan@...

Rep. Harold Ford hford@...

Rep. Bart Gordon bart@...

----------------------------------------------------------------------------

----

Texas

Sen. Phil Gramm

Sen. Kay Hutchison senator@...

Rep. Joe Barton barton06@...

Rep. Lloyd Doggett doggett@...

Rep. Frost frost@...

Rep. Henry bnkgdems@...

Rep. Gene Green ggreen@...

Rep. Sam samtx03@...

----------------------------------------------------------------------------

----

Utah

Sen. senator@...

Sen. Orrin Hatch senator_hatch@...

----------------------------------------------------------------------------

----

Vermont

Sen. Jim Jeffords vermont@...

Sen. Leahy senator_leahy@...

Rep. Bernie bsanders@...

----------------------------------------------------------------------------

----

Virginia

Sen. Robb senator@...

Sen. Warner senator@...

Rep. Rick Boucher ninthnet@...

Rep. tomdavis@...

Rep. Bob Goodlatte talk2bob@...

Rep. Jim Moran repmoran@...

Rep. Owen Pickett opickett@...

----------------------------------------------------------------------------

----

Washington

Sen. Slade Gorton senator_gorton@...

Sen. Patty Murray senator_murray@...

Rep. Dunn dunnwa08@...

Rep. Nethercutt grnwa05@...

Rep. asklinda@...

Rep. Rick White repwhite@...

----------------------------------------------------------------------------

----

West Virginia

Sen. Byrd senator_byrd@...

Sen. Rockefeller III senator@...

Rep. Nick Rahall nrahall@...

Rep. Bob Wise bobwise@...

----------------------------------------------------------------------------

----

Wisconsin

Sen. Feingold senator@...

Sen. Herb Kohl senator_kohl@...

Rep. Barrett telltom@...

Rep. Jerry Kleczka jerry4wi@...

Rep. Klug badger02@...

Rep. Mark Neumann mneumann@...

Rep. Tom Petri tompetri@...

Rep. Sensenbrenner sensen09@...

----------------------------------------------------------------------------

----

Wyoming

Sen. Craig craig@...

Sen. Mike Enzi senator@...

----------------------------------------------------------------------------

----

----

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[Guest guest]

Excellent Post Rich - Thanks

At 02:12 PM 6/19/98 -0400, you wrote:

>Here is a Email address list for the Legislators by state who have email.

>Let's go get 'em . Keep up the good job.

>

> A. Stieglitz, MS,PT,ATC

>Integrated Rehabilitation Services, LLC

>148 East Avenue, Suite 2M

>Norwalk, CT 06851

>

>Fax:

>E-Mail: rstieglitz@...

>

>Alabama

>Sen. Jeff Sessions senator@...

>Sen. Shelby senator@...

>Rep. Spencer Bachus sbachus@...

>Rep. Sonny Callahan callahan@...

>Rep. Bud Cramer budmail@...

>Rep. Terry Everett everett@...

>----------------------------------------------------------------------------

>----

>

>Alaska

>Sen Ted s senator_stevens@...

>Sen. Murkowski email@...

>

>----------------------------------------------------------------------------

>----

>

>Arizona

>Sen. Jon Kyl info@...

>Sen. McCain senator_mccain@...

>Rep. J. D. Hayworth hayworth@...

>Rep. Jim Kolbe jimkolbe@...

>Rep. Ed Pastor edpastor@...

>----------------------------------------------------------------------------

>----

>

>Arkansas

>Sen. Dale Bumpers senator@...

>Sen. Tim Hutchinson senator hutchinson@...

>Rep. Jay Dickey jdickey@...

>Rep. Tim Hutchinson timhutch@...

>----------------------------------------------------------------------------

>----

>

>California

>Sen. Barbara Boxer senator@...

>Sen. Dianne Feinstein senator@...

>Rep. Bilbray bilbray@...

>Rep. Brown talk2geb@...

>Rep. Tom campbell@...

>Rep. chriscox@...

>Rep. Dreier cyberrep@...

>Rep. Eshoo annagram@...

>Rep. Sam Farr samfarr@...

>Rep. Vic Fazio dcaucus@...

>Rep. Jane Harman jharman@...

>Rep. Tom Lantos talk2tom@...

>Rep. Jerry khuiskes@...

>Rep. Zoe Lofgren zoegram@...

>Rep. McKeon tellbuck@...

>Rep. gmiller@...

>Rep. Ron Packard rpackard@...

>Rep. Pelosi sfnancy@...

>Rep. Radanovich george@...

>Rep. Riggs repriggs@...

>Rep. Fortney 'Pete' Stark petemail@...

>Rep. Lynn C. Woolsey woolsey@...

>----------------------------------------------------------------------------

>----

>

>Colorado

>Sen. Wayne Allard

>Sen. Ben Nighthorse data@...

>Rep. Dan Schaefer schaefer@...

>Rep. Skaggs skaggs@...

>----------------------------------------------------------------------------

>----

>

>Connecticut

>Sen. Dodd. sen_dodd@...

>Sen. ph Lieberman. senator_lieberman@...

>Rep. Sam Gejdenson bozrah@...

>Rep. Shays cshays@...

>----------------------------------------------------------------------------

>----

>

>Delaware

>Sen. ph Biden senator@...

>Sen. Roth

>Rep. Castle delaware@...

>----------------------------------------------------------------------------

>----

>

>Florida

>Sen. Bob Graham bob_graham@...

>Sen. Connie Mack senator_mack@...

>Rep. Bilirakis truerep@...

>Rep. Canady canady@...

>Rep. Deutsch pdeutsch@...

>Rep. Alcee Hastings hastings@...

>Rep. Mica mica@...

>Rep. Dan miller13@...

>Rep. Cliff Stearns cstearns@...

>Rep. Thurman kthurman@...

>Rep. Dave Weldon fla-15@...

>----------------------------------------------------------------------------

>----

>

>Georgia

>Sen. Max Cleland senator_max_cleland@...

>Sen. Coverdell senator_coverdell@...

>Rep. Saxby Chambliss saxby@...

>Rep. Mac rep3mac@...

>Rep. Newt Gingrich georgia6@...

>Rep. Linder jlinder@...

>Rep. Charlie Norwood ga10@...

>----------------------------------------------------------------------------

>----

>

>Hawaii

>Sen. Akaka

>Sen. Inouye senator@...

>Rep. Neil Abercrombie neil@...

>----------------------------------------------------------------------------

>----

>

>Idaho

>Sen. Larry Craig larry_craig@...

>Sen. Dirk Kempthorne dirk_kempthorne@...

>Rep. Helen Chenoweth askhelen@...

>----------------------------------------------------------------------------

>----

>

>Illinois

>Sen. Durbin

>Sen. Carol Moseley-Braun senator@...

>Rep. Jerry Costello jfcil12@...

>Rep. Fawell hfawell@...

>Rep. Gutierrez luisg@...

>Rep. Dennis Hastert dhastert@...

>Rep. Ray LaHood lahood18@...

>Rep. Bobby Rush brush@...

>Rep. Jerry Weller jweller@...

>----------------------------------------------------------------------------

>----

>

>Indiana

>Sen. Dan Coats

>Sen. Lugar lugar@...

>Rep. Lee Hamilton hamilton@...

>Rep. Hostettler johnhost@...

>Rep. McIntosh mcintosh@...

>Rep. Tim Roemer troemer@...

>Rep. Mark Souder souder@...

>----------------------------------------------------------------------------

>----

>

>Iowa

>Sen. Grassley chuck_grassley@...

>Sen. Tom Harkin tom_harkin@...

>Rep. Jim Nussle nussleia@...

>----------------------------------------------------------------------------

>----

>

>Kansas

>Sen. Sam Brownback sam_brownback@...

>Sen. Pat

>Rep. Todd Tiahrt tiahrt@...

>----------------------------------------------------------------------------

>----

>

>Kentucky

>Sen. Wendell Ford wendell_ford@...

>Sen. Mitch McConnell senator@...

>Rep. Jim Bunning bunning4@...

>Rep. Ed Whitfield edky01@...

>----------------------------------------------------------------------------

>----

>

>Louisiana

>Sen. Breaux senator@...

>Sen. Landrieu senator@...

>Rep. Jim McCrery mccrery@...

>----------------------------------------------------------------------------

>----

>

>Maine

>Sen. Olympia Snowe olympia@...

>Sen. senator@...

>Rep. Baldacci baldacci@...

>----------------------------------------------------------------------------

>----

>

>land

>Sen. Barbara Mikulski. senator@...

>Sen. Sarbanes senator@...

>Rep. Ben Cardin cardin@...

>Rep. Ehrlich, Jr. ehrlich@...

>Rep. Albert Wynn alwynn@...

>----------------------------------------------------------------------------

>----

>

>Massachusetts

>Sen Kennedy senator@...

>Sen. Kerry john_kerry@...

>Rep. Meehan mtmeehan@...

>Rep. Joe Moakley jmoakley@...

>Rep. Olver olver@...

>----------------------------------------------------------------------------

>----

>

>Michigan

>Sen. Spencer Abraham michigan@...

>Sen. Carl Levin senator@...

>Rep. Dave Camp davecamp@...

>Rep. Conyers, Jr. jconyers@...

>Rep. Vernon Ehlers congehlr@...

>Rep. Hoekstra tellhoek@...

>Rep. Lynn Rivers lrivers@...

>Rep. Nick repsmith@...

>Rep. Bart Stupak stupak@...

>Rep. Fred Upton talk2fsu@...

>----------------------------------------------------------------------------

>----

>

>Minnesota

>Sen. Rod Grams mail_grams@...

>Sen. Wellstone senator@...

>Rep. Gil Gutknecht gil@...

>Rep. Bill Luther tellbill@...

>Rep. Minge dminge@...

>Rep. Oberstar oberstar@...

>Rep. Collin tocollin@...

>Rep. Jim Ramstad mn03@...

>Rep. Sabo msabo@...

>Rep. Bruce Vento vento@...

>----------------------------------------------------------------------------

>----

>

>Mississippi

>Sen. Thad Cochran senator@...

>Sen. Trent Lott sentorlott@...

>Rep. Bennie ms2nd@...

>Rep. Wicker rwicker@...

>----------------------------------------------------------------------------

>----

>

>Missouri

>Sen. Ashcroft john_ashcroft@...

>Sen. Bond kit_bond@...

>Rep. Jo Ann Emerson jemerson@...

>Rep. Gephardt demldr@...

>Rep. Talent talentmo@...

>----------------------------------------------------------------------------

>----

>

>Montana

>Sen. Max Baucus max@...

>Sen Conrad Burns conrad_burns@...

>----------------------------------------------------------------------------

>----

>

>Nebraska

>Sen. Hagel chuck_hagel@...

>Sen. Bob Kerrey bob@...

>Rep. Jon Cristensen talk2jon@...

>----------------------------------------------------------------------------

>----

>

>Nevada

>Sen. Harry Reid senator_reid@...

>Sen. senator@...

>Rep. Ensign ensign@...

>----------------------------------------------------------------------------

>----

>

>New Hampshire

>Sen. Judd Gregg mailbox@...

>Sen. Bob opinion@...

>Rep. Bass cbass@...

>----------------------------------------------------------------------------

>----

>

>New Jersey

>Sen. Lautenberg frank_lautenberg@...

>Sen. Toricelli senator_torric

>Rep. s randrews@...

>Rep. Bob s franksnj@...

>Rep. Rodney Frelinghuysen njeleven@...

>----------------------------------------------------------------------------

>----

>

>New Mexico

>Sen. Jeff Bingaman senator_bingaman@...

>Sen. Pete Domenici senator_domenici@...

>----------------------------------------------------------------------------

>----

>

>New York

>Sen. Moynihan senator@...

>Sen. Alfonse D'Amato senator_al@...

>Rep. Sherwood Boehlert boehlert@...

>Rep. Eliot Engel engeline@...

>Rep. Forbes mpforbes@...

>Rep. Maurice Hinchey hinchey@...

>Rep. Sue dearsue@...

>Rep. King peteking@...

>Rep. Rick Lazio lazio@...

>Rep. Nita Lowey nitamail@...

>Rep. Carolyn Maloney cmaloney@...

>Rep. Manton tmanton@...

>Rep. McNulty mmcnulty@...

>Rep. Molinari molinari@...

>Rep. Jerrold Nadler nadler@...

>Rep. Bill Paxon bpaxon@...

>Rep. Rangel rangel@...

>Rep. Serrano jserrano@...

>Rep. Jim Walsh jwalsh@...

>----------------------------------------------------------------------------

>----

>

>North Carolina

>Sen Lauch Faircloth senator@...

>Sen. Helms jesse_helms@...

>Rep. Cass Ballenger cassmail@...

>Rep. Burr mail2nc5@...

>Rep. Sue Myrick myrick@...

>Rep. chtaylor@...

>Rep. Mel Watt melmail@...

>----------------------------------------------------------------------------

>----

>

>North Dakota

>Sen. Kent Conrad senator@...

>Sen. Byron Dorgan senator@...

>Rep. Earl Pomeroy epomeroy@...

>----------------------------------------------------------------------------

>----

>

>Ohio

>Sen. Mike DeWine senator_dewine@...

>Sen. Glenn senator_glenn@...

>Rep. Sherrod Brown sherrod@...

>Rep. Kasich budget@...

>Rep. Oxley oxley@...

>Rep. Rob Portman portmail@...

>Rep. Deborah Pryce pryce15@...

>Rep. Traficant telljim@...

>----------------------------------------------------------------------------

>----

>

>Oklahoma

>Sen. Inhofe

>Sen. Don Nickles senator@...

>Rep. Ernest J. Istook, Jr. istook@...

>----------------------------------------------------------------------------

>----

>

>Oregon

>Sen. Gordon oregon@...

>Sen. Ron Wyden senator@...

>Rep. DeFazio pdefazio@...

>Rep. Furse furseor1@...

>----------------------------------------------------------------------------

>----

>

>Pennsylvania

>Sen. Rick Santorum senator@...

>Sen Arlen Specter senator_specter@...

>Rep. Jon Fox jonfox@...

>Rep. Kanjorski kanjo@...

>Rep. McHale mchale@...

>Rep. Murtha murtha@...

>Rep. Curt Weldon curtpa7@...

>----------------------------------------------------------------------------

>----

>

>Rhode Island

>Sen. Chafee senator_chafee@...

>Sen. Jack

>----------------------------------------------------------------------------

>----

>

>South Carolina

>Sen. Ernest Hollings senator@...

>Sen. Strom Thurmond senator@...

>Rep. E. Clyburn jclyburn@...

>Rep. Bob Inglis binglis@...

>Rep. Mark Sanford sanford@...

>Rep. Spratt jspratt@...

>----------------------------------------------------------------------------

>----

>

>South Dakota

>Sen. Tom Daschle tom_daschle@...

>Sen. Tim tim@...

>----------------------------------------------------------------------------

>----

>

>Tennessee

>Sen. Bill Frist senator_frist@...

>Sen Fred senator_thompson@...

>Rep. Bob Clement clement@...

>Rep. J.J. Duncan jjduncan@...

>Rep. Harold Ford hford@...

>Rep. Bart Gordon bart@...

>----------------------------------------------------------------------------

>----

>

>Texas

>Sen. Phil Gramm

>Sen. Kay Hutchison senator@...

>Rep. Joe Barton barton06@...

>Rep. Lloyd Doggett doggett@...

>Rep. Frost frost@...

>Rep. Henry bnkgdems@...

>Rep. Gene Green ggreen@...

>Rep. Sam samtx03@...

>----------------------------------------------------------------------------

>----

>

>Utah

>Sen. senator@...

>Sen. Orrin Hatch senator_hatch@...

>----------------------------------------------------------------------------

>----

>

>Vermont

>Sen. Jim Jeffords vermont@...

>Sen. Leahy senator_leahy@...

>Rep. Bernie bsanders@...

>----------------------------------------------------------------------------

>----

>

>Virginia

>Sen. Robb senator@...

>Sen. Warner senator@...

>Rep. Rick Boucher ninthnet@...

>Rep. tomdavis@...

>Rep. Bob Goodlatte talk2bob@...

>Rep. Jim Moran repmoran@...

>Rep. Owen Pickett opickett@...

>----------------------------------------------------------------------------

>----

>

>Washington

>Sen. Slade Gorton senator_gorton@...

>Sen. Patty Murray senator_murray@...

>Rep. Dunn dunnwa08@...

>Rep. Nethercutt grnwa05@...

>Rep. asklinda@...

>Rep. Rick White repwhite@...

>----------------------------------------------------------------------------

>----

>

>West Virginia

>Sen. Byrd senator_byrd@...

>Sen. Rockefeller III senator@...

>Rep. Nick Rahall nrahall@...

>Rep. Bob Wise bobwise@...

>----------------------------------------------------------------------------

>----

>

>Wisconsin

>Sen. Feingold senator@...

>Sen. Herb Kohl senator_kohl@...

>Rep. Barrett telltom@...

>Rep. Jerry Kleczka jerry4wi@...

>Rep. Klug badger02@...

>Rep. Mark Neumann mneumann@...

>Rep. Tom Petri tompetri@...

>Rep. Sensenbrenner sensen09@...

>----------------------------------------------------------------------------

>----

>

>Wyoming

>Sen. Craig craig@...

>Sen. Mike Enzi senator@...

>----------------------------------------------------------------------------

>----

>

>

>

>

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R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

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[Guest guest]

I am seeking information about the proposed transfer/discharge rule for

10 DRGs that will take effect in the near future.

I am trying to find out the number of days that are being

allowed/recommended on the inpatient stay for the 10 DRGs targeted:

Stroke (14)

Amputation (113)

Total joints (209-210-211-236)

Skin Grafts (263-264)

Psych (429)

Tracheostomy(483)

It is my understanding that the above DRGs' reimbursement will be

penalized if they are discharged before the recommended # of days.

Please help clarify this rule and give me any other information that could

be helpful to my understanding of how this rule will affect: 1) my

inpatient volumes and census, and 2) my subacute/long term care

volumes and discharges.

Thanks in advance for any info.

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[Guest guest]

You can download the actual regs at <http://www.thefocusgroup.net/news.htm>

At 09:51 AM 6/22/98 -0500, you wrote:

>I am seeking information about the proposed transfer/discharge rule for

>10 DRGs that will take effect in the near future.

>I am trying to find out the number of days that are being

>allowed/recommended on the inpatient stay for the 10 DRGs targeted:

>

>Stroke (14)

>Amputation (113)

>Total joints (209-210-211-236)

>Skin Grafts (263-264)

>Psych (429)

>Tracheostomy(483)

>

>It is my understanding that the above DRGs' reimbursement will be

>penalized if they are discharged before the recommended # of days.

>

>Please help clarify this rule and give me any other information that could

>be helpful to my understanding of how this rule will affect: 1) my

>inpatient volumes and census, and 2) my subacute/long term care

>volumes and discharges.

>

>Thanks in advance for any info.

>

>

>

>

>

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>Read this list on the Web at http://www.FindMail.com/list/ptmanager/

>To unsubscribe, email to ptmanager-unsubscribe@...

>To subscribe, email to ptmanager-subscribe@...

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R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

----

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[Guest guest]

Tina -

I hope this comes through OK.

Discharge Definition When Transferring to PostAcute Care

Effective on or after October 1, 1998, cases that fall within a group

of 10 diagnostic related groups (DRGs) would be treated in a similar

manner to hospital to hospital transfers for payment purposes. The

Secretary would determine whether the full transfer policy or a blended

payment rate would apply, based on whether a substantial portion of the

costs of care are incurred in the initial days of the inpatient hospital

stay. Medicare payment would not exceed an amount equal to the sum of the

following: 50% of the transfer amount and 50% of the total DRG amount.

The transfer policy would apply to patients transferred from a PPS

hospital to a PPSexempt facility, a SNF, and discharges with subsequent

home health care (as defined byt he Secretary). The Secretary would be

authorized to extend this transfer policy to other DRGs and other

settings beginning in FY 2001.

UPDATE: A final rule was published by HCFA on May 12, 1998 (42 CFR

Parts 410, et al. Medicare Program: Changes to the Hospital Inpatient

Prospective Payment Systems and Fiscal Year 1998 Rates. CFR Pages 26317 -

26360) Available for download from Federal Register or at author’s

website at

<http://www.thefocusgroup.net/news.htm>

Other (non rehabilitation)

Hospital Provisions In BBA

There are many additional provisions of the BBA that affect hospitals

generally, but not rehabilitation specifically. These provisions

will indirectly affect rehabilitation departments as they affect the

overall financial stability of the hospital organization.

PPS Hospital Payment Update. The Act provides a 0 percent update

in FY 1998 for all hospitals in all areas; market basket (MB) increase

minus 1.9 percentage points for FY 1999; MB minus 1.8 percentage points

in FY 2000; and MB minus 1.1 percentage points for FY 2001 and FY 2002..

BBA would effectively reduce the update factor to an average increase of

about 1.3 percent per year -- a 57% reduction. ($17.1 billion savings

over five years).

Capital Payment to PPS Hospitals. The legislation calls for a

permanent reduction of 17.8 percent in capital payments to PPS hospitals.

The provision does not include a special capital subsidy for property

taxes of selected urban hospitals. ($5.3 billion in cuts over five

years.)

Disproportionate Share Hospital Payments. DSH payments are reduced

1 percent in FY 1998; 2 percent in FY 1999; 3 percent in FY 2000; 4

percent in FY 2001; and 5 percent in FY 2002. ($600 million over five

years). The Secretary of the Department of Health and Human Services

(HHS) must report to Congress within one year with a recommendation to

revise the DSH formula to provide a single qualifying threshold for all

hospitals.

Reduction in Independent Medical Evaluation Adjustment. The IME

adjustment is reduced from 7.7 percent to 7.0 percent in FY 1998; 6.5

percent in FY 1999; 6.0 percent in FY 2000; and 5.57 percent in FY 2001

and thereafter. ($5.6 billion in savings over five years.)

Limit on Number of Residents and Interns. The number of interns

and residents will be frozen at the level reported on a hospital's cost

report for the period ending December 31, 1996. Beginning FY 1998,

subject to this limit, the total number of FTE residents for determining

a hospital's Graduate Medical Education payments will equal the average

of the actual FTE resident count for the cost reporting period and the

preceding two cost reporting periods, i.e., a 3-year rolling average.

($700 million in savings.)

Hospital Bad Debt. Payments for bad debts will be reduced by 25%

in FY 1998; 40% in FY 1999 and 45% in FY 2000 and thereafter. ($500

million in cuts over five years)

Prospective Payment for Hospital Outpatient Services. A PPS for

hospital outpatient services, i.e., ambulatory surgery, radiology and

other diagnostic services, will be implemented in FY 1999. In the

interim, the formula driven overpayment error will be eliminated in FY

1998. Rehabilitation outpatient services are explicitly excluded from

this provision.

Tax-Exempt Bonds. The budget agreement repeals the $150 million

cap on tax-exempt bonds that hospitals can have outstanding for non-acute

capital expenditures after date of enactment of the new law.

Managed Care Payments. Area payment will be the higher of: 1)

After a six-year transition period starting in FY 1998, a payment rate

based on a blend of 50% area and 50% national rates; 2) a minimum amount

($367 in FY 1998); or 3) a minimum increase of 2%. Only graduate medical

education payments (not DSH) will be carved out over a five-year period

and paid directly to eligible facilities and plans. The payment rates

will be adjusted for input price variations. There is no discounted

payment for new enrollees; the same rate would apply to all enrollees.

Update based on national per-capita increase less .8% in FY 1998 and .5%

in FY 1999 through FY 2002. ($22.5 billion in reduced payments to health

plans over the five-year period.)

Rural Hospitals. The legislation reinstates the Medicare-dependent

hospital program, which expired in 1995, and extends it through fiscal

year 2001. Medicare will cover telemedicine consultations in underserved

areas. Rural health clinics based in hospitals with fewer than 50 beds

are exempt from new limits on cost reimbursements. Limits that previously

applied only to independent clinics are extended to hospital-based

clinics in larger hospitals.

The agreement replaces the Essential Access Community Hospital

demonstration program with a new limited-service hospital program

available in any state. The measure offers cost reimbursement and reduced

staffing requirements for rural hospitals that maintain no more than 15

acute care beds, provide 24-hour emergency room services, are more than

35 miles from the nearest facility, and keep inpatients up to 96 hours.

The state can waive the mileage requirement.

Preventive Benefits. BBA includes a $4 billion package of

preventive benefits, including mammography, pap smears, diabetes

self-management, and prostate and colorectal cancer screening. The

deductible for mammography services would be waived, but not the

copayment.

Medicaid

BBA includes some of the most sweeping changes to the Medicaid

program in years, giving states new flexibility to take advantage of

managed care and cut their costs in other ways.

But the budget plan would cut federal Medicaid costs by $14.6 billion

over five years, despite the dramatic drop in spending over the past two

years. For the first time, it puts a flat cap on states’ disproportionate

share hospital (DSH) funds, cutting DSH spending by $10.4 billion --

about half of the originally proposed reduction.

The final Medicaid language includes specific, state-by-state DSH funding

levels, writing into law the lesser of the House and Senate DSH cuts for

each state, which are based on fiscal year 1995 DSH allocations. Florida,

for example, will receive $955 billion over the 1998-2002

period.

The cuts were adjusted to make sure no state loses more than 3.5 percent

of its total Medicaid funding from fiscal year 1995, a concession to

Texas and 12 other high-DSH states.

After 2002, states will continue to receive the DSH funding levels they

were given in 2002, adjusted for inflation as measured by the consumer

price index.

The legislation includes a targeting provision requiring states to devise

a mechanism to give first priority on DSH funds to hospitals with the

highest number of Medicaid and uninsured patients, particularly

children's hospitals.

State Flexibility Measures: The agreement includes the repeal of the

Boren amendment, which requires states to reimburse hospitals and nursing

homes at " reasonable and adequate rates " for Medicaid services,

and replaces it with a requirement that states must have a public process

for setting payment rates. Reimbursement rates for hospitals would have

to make some accommodation for those that serve the highest numbers of

low-income patients.

The budget plan also gives authority for the states to require, with

limited exceptions, enrollment in managed care plans without a federal

waiver; repeal of the 75/25 enrollment rule for Medicaid managed care

plans; and phases out 100 percent cost reimbursement for Federally

Qualified Health Centers (FQHCs) and rural health clinics.

Emergency Room Coverage

A prudent layperson standard will apply to emergency services

coverage for Medicare+Choice and Medicaid managed care health plans.

Impact of Acute Care Changes on the balance of the rehabilitation

continuum.

There are a significant number of changes that will affect hospitals

that do not involve rehabilitation services. Of those changes that

do affect rehabilitation, there are currently many more questions than

there are answers. Of paramount importance will be the 10 DRGs

included in the redefinition of discharge/transfer for patients sent into

post acute rehabilitation programs.

The future expansion of this policy will be evaluated soon after

implementation of the first stage. An additional consideration will

be what the hospital will do if there are patients who can be discharged

to post acute settings prior to the expected DRG LOS.

There has been much discussion in the industry about the philosophical

concept of “warehousing” patients until the expected LOS to allow full

DRG payment. In this concept, the patient will receive minimally needed

services (including rehab therapies - or not) during the additional days

of the LOS from the time of possible discharge until the end of the

anticipated LOS. Sophisticated financial modeling is being used to

identify the specific situations when this is fiscally attractive.

Ethical and regulatory discussions will need to identify if warehousing

will be a valid option for hospitals.

The transition to a fee schedule for outpatient rehabilitation services

as of January 1, 1999 will have a tremendous impact on the delivery of

rehabilitation services to outpatients in programs provided by

hospitals. Although hospital outpatient programs will not be

included in the $1500 cap, the implementation of a fee schedule will be a

major change. Of course, the extent of the impact on the programs

will depend on the specifics of the fee schedule. These details are not

yet known. It is anticipated that the basis for the fee schedule

will be a RBRVS system similar to that in place for PTIP and OTIP

settings.

An additional issue for hospital outpatient rehabilitation services will

be the amount of increased demand that will be realized due to shifts of

Medicare patients in the aftermath of the Balanced Budget Act. This

increase in patient demand will include the most complex and costly

patients. These patients will not be able to receive an adequate

intensity of care in non-hospital settings without confronting the $1500

annual cap. Hospital rehabilitation programs will need to prepare

for this increase in demand and intensity of service demand.

R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

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[Guest guest]

Tina

My original post did not get through well so I've posted the full article

in Adobe format at <www.theFOCUSgroup.net/news.htm>

If you need Adobe Acrobat Reader, try <www.adobe.com>

Comments are welcome.

R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

----

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