From APTA:
****APTA LEGISLATIVE ACTION ALERT****
Immediate Attention Requested
Congressmen Xavier Becerra (D-CA), Phil English (R-PA), Mike Ross (D-AR), Charles Pickering (R-MS) and Roy Blunt (R-MO), and Senators John Ensign (R-NV) and Blanche Lincoln (D-AR) introduced "The Medicare Access to Rehabilitation Services Act" January 31, 2007 that would repeal the cap on therapy services for Medicare beneficiaries once and for all (HR 748/S. 450). If Congress does not take action by January 1, 2008, the therapy cap will again be imposed on Medicare-covered physical therapy, occupational therapy, and speech language pathology services. We need to take action NOW to ensure the cap does not go back into place.
Points to Make - Repeal the Cap
· Don’t discriminate against the most vulnerable Medicare beneficiaries – The therapy cap would apply to all Medicare beneficiaries in all Part B health care settings, except hospital outpatient departments. Most Medicare beneficiaries would never exceed the annual cap, but it would force many senior citizens who need physical therapy care the most to choose between forgoing necessary care or paying 100% of the cost out-of-pocket over their Medicare coverage that is capped. Beneficiaries who suffer from a stroke, or have Parkinson’s disease, spinal cord injuries, or osteoporosis are more likely to be the type of patient needing such care.
· Congress has repeatedly recognized the fallacy of the beneficiary cap on therapy services – For the past 7 years Congress has prevented a hard therapy cap from taking place except for 3 months in 2003. Three times Congress imposed a moratorium to keep the beneficiary cap on therapy services from limiting beneficiary coverage (1999-two years, 2000-one year, and 2003-two years). In 2006 and 2007 a therapy cap exceptions process was instituted to prevent a hard cap on therapy services. In addition, a bipartisan majority of Members of Congress in both chambers recognized the problems associated with the beneficiary cap by supporting legislation in previous Congresses to repeal the therapy cap.
· It’s time to solve this problem and not do another short-term fix – Rather than addressing the underlying problem, every year Congress considers a short-term step to prevent the therapy cap from being enacted. Although this results in protecting beneficiaries access to rehabilitation care, this legislation is not passed until very late in the year. This disrupts the continuity of care to Medicare patients because PTs must adjust their plan of care to their patients and creates a high level of uncertainty for beneficiaries regarding their access to physical therapy, occupational therapy, and speech language pathology. It’s time for Congress to eliminate this flawed policy entirely.
What You Can Do
It is important that you send a strong message to your Members of Congress to request that they become cosponsors to repeal the therapy cap once and for all. Please contact your Members of Congress and ask them to cosponsor HR 748/S. 450. You can contact your Members of Congress by calling 202/224-3121 or by utilizing APTA’s Legislative Action Center at http://www.apta.org/AdvocacyLegislative Action Center”. You can write a letter or e-mail to your Members of Congress regarding this important issue. by clicking on “
In your call or letter to your Members of Congress, include specific examples of your patients that will be affected if the therapy cap is imposed again. Also, have your patients contact their legislators. Provide them with a letter they can sign and you can mail or have them access APTA’s Patient Action Center on the therapy cap. If you have any questions please contact APTA at 1/800-999-2782, ext. 8533.
Mailly & Inglett Consulting, LLC
Wayne, NJ
973-692-0033
www.NJPTAid.biz
Bridging the Gap!
Member APTA Practice Management Consulting Network
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