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NJPTAid Newservice: APTA Alert on Medicare Cap
Posted on Monday, December 19 @ 04:22:57 EST by Ken Mailly |
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Interest Area: Medicare
Priority: High
We are sending you this message as a result of many inquiries regarding the status of the "Medicare Cap". Questions regarding this information should be addressed directly to APTA.
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Breaking News - Budget Deal Includes Modified Therapy Cap
APTA Disappointed with Implementation of Therapy Cap; Concerned that New Policy will Limit Rehabilitation Services
December 19, 2005 – Congressional negotiators reached an agreement late Sunday evening on the Deficit Reduction Omnibus Reconciliation Act (S. 1932) that will allow a modified version of the Medicare therapy cap to go into effect January 1, 2006. The US House of Representatives passed the agreement by 212-206 vote early Monday morning and the US Senate is expected to take action on the measure as early as this morning. The agreement modifies the Medicare law to allow patients to apply for additional therapy services if their treatment is expected to exceed the cap.
APTA is extremely disappointed that therapy caps will go into effect and concerned about the new exceptions process outlined in the legislation and its potential burden on Medicare beneficiaries. Although this process appears to be intended to make the caps less arbitrary, the uncertainty in how the Secretary will implement a process that allows individuals to obtain an exception to the uniform dollar limit is a significant concern. A process that picks which patients qualify for additional benefits could be as arbitrary and discriminatory to beneficiaries as the cap itself.
The policy also did not address a long-standing problem - a shared $1740 cap between physical therapy and speech language pathology services. Physical therapy and speech language pathology are distinct and separate professional services and implementation of the therapy caps without separating the two services is confusing to beneficiaries and will limit access. Despite the efforts of more than a majority of the US House of Representatives, 40 US Senators, and more than 40 patients and health care professional groups to ensure access to rehabilitation by eliminating the therapy caps, the conference agreement falls short of that objective.
Michael P. Matlack
Michael P. Matlack
Associate Director of Grassroots & Political Affairs
American Physical Therapy Association
1111 North Fairfax Street
Alexandria, VA 22314-1488
703/706-3163; fax 703/838-8919
michaelmatlack@apta.org
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American Physical Therapy Association - 1111 N. Fairfax Street, Alexandria, VA, 22314. 800-999-APTA (2782).
To manage the types of e-mail messages you receive from APTA, please visit www.apta.org/email.
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