Medicare Update

Medicare Physical Therapy Cap Update (7/2/03)

The Centers for Medicare and Medicaid Services (CMS) have delayed implementation of the outpatient physical therapy cap until September 1, 2003 giving patients, physical therapists and other professionals 60 more days to intensify their lobbying for a total repeal.

The delay was granted as a result of a lawsuit filed for a temporary restraining order to benefit numerous beneficiary groups who felt CMS had not provided them with sufficient notice of a change in their coverage. CMS plans to begin informing such groups of the changes immediately, and to proceed as planned with its therapy cap come September 1, 2003.

The decision comes as a relief—albeit a temporary one—to physical therapist who have spent months campaigning to have the therapy cap delayed or repealed altogether. Most likely, this last-second reprieve will only intensify lobbying throughout the PT community.

Lobbying efforts of the TriAlliance (APTA, ASHA and AOTA) are beginning to make some headway in Congress where the Medicare Prescription Drug and Modernization Act (HR2473) calls for a full year’s moratorium on therapy caps. A similar Medicare reform bill is on the table in the Senate, but includes no language about a cap moratorium. The two legislative bodies are expected to discuss a single bill to bring to vote later this month.