Medicare Update

Medicare Update January 2007
APTA Applauds Signing Of Health Care Act OF 2006

Bill Includes Extension of Therapy Cap Exceptions Process

ALEXANDRIA, VA, December 20, 2006 — The American Physical Therapy Association (APTA) applauded today’s signing by President Bush of legislation that will prevent Medicare beneficiaries from facing arbitrary financial limitations on their outpatient rehabilitation services, or “therapy caps,” through 2007. One in seven Medicare beneficiaries is likely to have required therapy services next year that would have exceeded the therapy cap. The Tax Relief and Health Care Act of 2006 (HR 6111) will extend the process allowing Medicare beneficiaries needing care above the financial limits to apply for additional coverage.

Thanks to the leadership of Senators Grassley (R-IA) and Baucus (D-MT) and the lead sponsors of the therapy cap repeal legislation, Senators Lincoln (D-AR) and Ensign (R-NV) and Representatives English (R-PA), Cardin (D-MD), Blunt (R-MO), and Pallone (D-NJ), seniors will not have to face arbitrary caps on rehabilitation services—without exceptions—for at least 1 more year,” said APTA President R Scott Ward, PT, PhD. “By extending the therapy cap exceptions process, Congress has recognized the need to take action to protect Medicare beneficiaries who need rehabilitation services the most. Data show that patients with stroke, hip fracture, Parkinson disease, and other conditions that require extensive rehabilitation are most likely to be affected by the arbitrary Medicare therapy caps. While passing legislation to completely repeal the therapy caps is the best long-term policy solution, this new law takes an important step forward to protect Medicare beneficiaries from the impact of a “hard” therapy cap. We look forward to continuing to work with Congress toward a long-term solution, to repeal the caps—solving this issue once and for all.”

Therapy caps keep patients from receiving the care they need for successful rehabilitation from serious medical conditions, and I will continue my efforts to end them permanently,” said Sen John Ensign (R-NV), who is responsible for putting the language in the final bill. “Therapy is critical to helping seniors remain independent and healthy, improving their quality of life. With greater access to rehabilitative services, seniors will be stronger and healthier and less likely to need inpatient facilities, saving seniors and taxpayers money.”

I am pleased that Congress has acted to extend the therapy cap exceptions process to protect the most vulnerable among us, our seniors and disabled Americans,” Sen Blanche Lincoln (D-AR) said. “As a long-time supporter of full repeal of the therapy caps, I will continue to urge my colleagues to find a legislative solution so that patients receive the care they need without undue burden.”

Whether a person receives speech, occupational, or physical therapy, it should be a decision made between a doctor and a patient, not by accountants monitoring a set limit,” said Rep Phil English (R-PA), a member of the House and Means Health Subcommittee. “By extending the current exceptions process we will ensure seniors’ rehabilitative needs will be met without limiting care to an arbitrary price tag.”

Since its implementation, the exceptions process has worked to help preserve seniors’ access to critical rehabilitative services under Medicare. Last week, Congress acted to help extend the current exceptions process through 2007 and ensure that our most vulnerable citizens are not subjected to an arbitrary cap on the health care they need and deserve. While I applaud this latest action, I look forward to working with my colleagues over the next year to find a more permanent solution to this problem,” said Rep. Frank Pallone (D-NJ), who serves on the House Energy and Commerce Health Subcommittee.

There are currently two caps on rehabilitation coverage, one for physical therapy and speech therapy combined and a separate cap for occupational therapy. Medicare beneficiaries can apply for additional medically necessary coverage through the exceptions process. For more information about the therapy cap and the exceptions process visit www.apta.org.

Medicare Update January 2007APTA Applauds Signing Of Health Care Act OF 2006

Medicare Update January 2007
APTA Applauds Signing Of Health Care Act OF 2006