Congress Urged to Extend Therapy Cap

The American Physical Therapy Association (APTA), Alexandria, Virginia, said that in a letter to Congress today, more than 40 organizations representing patients, healthcare providers, and advocates joined APTA in urging members of Congress to extend the Medicare therapy cap exception process beyond 2006.

The current financial caps are set at $1,740 for physical therapy and speech language pathology combined, and $1,740 for occupational therapy.

Without action by Congress, the exceptions provision adopted as part of the Deficit Reduction Act of 2005 (allowing Medicare beneficiaries needing care above the capped amount to apply for exceptions) will expire on December 31, 2006. This could leave many senior citizens and people with disabilities who need physical therapy care the most facing a choice between forgoing necessary care or paying 100 percent out of pocket when their Medicare coverage runs out.

"The therapy cap discriminates against Medicare beneficiaries who are in the most need of physical therapist services," said APTA President R. Scott Ward, PT, PhD. "Data show that patients with stroke, hip fracture, Parkinson's disease, and other conditions that require extensive rehabilitation are most likely to be affected by the Medicare therapy caps." He added, "While legislation repealing the therapy caps would solve this problem once and for all, allowing the exceptions process to continue beyond 2006 will help protect Medicare beneficiaries from the effects of a therapy cap, even if it is a short-term solution. We urge the House and Senate leaders to act on the therapy caps this year."

Legislation to completely repeal the therapy caps, The Medicare Access to Rehabilitation Services Act of 2005 (HR 916/S 438), has strong bipartisan support in both the House and the Senate. Senators John Ensign (R-NV) and Blanche Lincoln (D-AR) introduced the Senate legislation and Representatives Phil English (R-PA), Ben Cardin (D-MD), Roy Blunt (R-MO), and Frank Pallone (D-NJ), introduced the House legislation.

The rehabilitation coalition includes: American Academy of Physical Medicine and Rehabilitation, American Academy of Neurology, Alzheimer's Association, American Association of Homes & Services for the Aging, American Association on Mental Retardation, American Dance Therapy Association, American Health Care Association, American Heart Association/American Stroke Association, American Medical Directors Association, American Medical Rehabilitation Providers Association, American Music Therapy Association, American Network of Community Options and Resources, American Nurses Association, American Occupational Therapy Association, American Physical Therapy Association, American Speech-Language and Hearing Association, American Therapeutic Recreation Association, Amputee Coalition of America, Arthritis Foundation, Brain Injury Association of America, Catholic Health Association of the United States, Center for Medicare Advocacy, Inc., Christopher Reeve Foundation, Easter Seals, HealthSouth, National Association for the Support of Long Term Care, National Association of Councils on Developmental Disabilities, National Association of Directors of Nursing Administration/LTC, Inc., National Association of Rehabilitation Providers and Agencies, National Association of Social Workers, National Association of State Head Injury Administrators, National Council for Community Behavioral Healthcare, National Disability Rights Network, National Multiple Sclerosis Society, National Rehabilitation Association, National Rural Health Association, National Stroke Association, Parkinson's Action Network, Power Mobility Coalition, The Arc of the United States, United Cerebral Palsy, and United Spinal Association.

Congress Urged to Extend Therapy Cap

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Congress Urged to Extend Therapy Cap

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