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Rep. Greg Walden hears about importance of physical therapy during stop at APEX facility.

HOLLY GILL/MADRAS PIONEER - Rep. Greg Walden, second from left, listens to opinions about the cap on Medicare paryments for rehabilitative therapies.For more than two decades, a cap on Medicare payments for rehabilitative therapies had caused problems for people over 65 seeking physical therapy after a stroke or a broken bone.

Congress got around the cap — which was $2,010 earlier this year — by regularly passing bills to allow an automatic exception for patients for whom the treatment was a medical necessity. The last "exception" bill expired at the end of 2017, but the federal budget, passed in February, included a repeal of the cap, long championed by U.S. Rep. Greg Walden. Walden visited Apex Physical Therapy in Madras last week, to discuss the repeal with Apex owner and physical therapist Brock Monger, the owner of Vantage Clinical Solutions, of Bend, Tannus Quatre, also a physical therapist, and staff members at Apex.

"Medicare had an arbitrary cap," Walden explained. "Seniors were starting to hit the cap, and not being able to get the care they needed. Now, it's gone for good."

"Every year, it added to the cost we were shoving down the road," he said. "It put everybody through a lot of anxiety."

Quatre, who serves as the liaison for the American Physical Therapy Association, said he has been traveling to Washington, D.C., for years, lobbying for the repeal of the therapy cap, which has been in place since 1996.

"I've been working, literally for 20 years to get that repealed," he said.

The group also discussed the benefits of physical therapy in preventing reliance on pain medications.

Terry Black, of Metolius, a retired farmer, said that after an injury at the beginning of the year, he was taking high doses of medication for the pain.

"I laid in bed and felt sorry for myself," he said. "Meanwhile, my place and animals went downhill."

In February, he started physical therapy, which was very difficult, at first, but then, "each station got a little easier and easier. The clincher was doing exercise at home."

"Through Brock, I've been able to get back; I'm even stacking hay," he said. "This has been a lifesaver to me. I recommend it to anyone; go to physical therapy and get of the pain meds."

Walden suggested that alternatives to medication — from acupuncture to physical therapy — should be "as valuable as pain meds."

HOLLY GILL/MADRAS PIONEER - Apex owner Brock Monger, left, shows the congresssman correct form for lifting a weight.Black, 70, a U.S. Marine, who served in Vietnam, said that the Veterans Administration "finally came through" and allowed him to seek physical therapy.

Quatre pointed out that physical therapists are often instrumental in getting patients off pain medication. "We look at what's happening," he said, which helps the patient "not mask it with pain pills."

Monger said that while physical therapists "try to stay in our lane," they're often the first to notice dependency on opioids.

"We want to be part of the conversation (on opioids)," Quatre added.

The small group also discussed the shortage of physical therapists, and the high cost of becoming physical therapists. "It costs over $150,000 for a physical therapist to become a doctor of physical therapy today," said Quatre, who asked for Walden's support for removing a cap on the number of federal loans for physical therapy students. "We need physical therapists."

Walden spent about an hour and a half visiting with the physical therapists, including a short workout, and said he will continue to work to strengthen access to physical therapy.

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