With less than a month to go before the current moratorium on Medicare therapy caps expires, a majority of the US House of Representatives has endorsed legislation to repeal the financial limit on therapy benefits. The Medicare Access to Rehabilitation Services Act of 2005 (HR 916) has reached 220 cosponsors. The bipartisan legislation was introduced by Representatives Phil English (R-PA), Benjamin L Cardin (D-MD), Roy Blunt (R-MO) and Frank Pallone (D-NJ) earlier this year. Similar legislation with bipartisan support has also been introduced in the Senate.

If passed, the legislation would repeal the Medicare therapy caps which now force the people who need therapy the most – senior citizens and people with disabilities – to face a choice between forgoing care or paying 100 percent out of pocket when their Medicare coverage runs out. The current moratorium is set to expire December 31, 2005, allowing the cap to be implemented on January 1, 2006, by the Centers for Medicare and Medicaid Services (CMS). Current law provides for two caps on rehabilitation benefits, one for physical therapy and speech therapy and a separate cap for occupational therapy.

"The cap on therapy services unfairly targets our oldest and frailest seniors," says Rep Phil English (R-PA). "Whether a person receives speech, occupational or physical therapy, it should be a decision made between a health care provider and patient, not by accountants monitoring a set limit. I am encouraged that so many of my colleagues support the bill to get rid of this arbitrary cap."

"Only three weeks remain before financial limits are placed on rehabilitative services for Medicare beneficiaries. It's imperative that Congress act now to repeal these caps so that Medicare beneficiaries continue to receive the rehabilitative therapy they require to recover from strokes, hip fractures and other serious conditions," says Rep Benjamin L Cardin (D-MD).

"Medicare beneficiaries should receive the appropriate amount of therapy that is ordered by their health care providers, not bureaucrats in Washington," says Rep Frank Pallone, Jr (D-NJ). "Congress needs to resolve this issue before the caps go into effect, and ensure appropriate access to outpatient rehabilitation services."

"We are encouraged that the majority of the House understands the severity of the impact of the therapy cap on Medicare beneficiaries but we need even more support," says American Physical Therapy Association (APTA) President Ben F Massey, Jr, PT, MA. "The Medicare Access to Rehabilitation Services Act would protect patients with stroke, hip fracture, Parkinson disease or any other condition that requires extensive rehabilitation. The current therapy cap is short-sighted Medicare policy that must be done away with once and for all for the benefit of the beneficiaries who need physical therapy services the most."

Source: APTA