Eli's Rehab Report

Published on Mon Mar 16, 2009 PDF

Lawmakers shoot for a full therapy cap repeal.

Looking for relief in recession? Therapy cap repeal is in the works again. Sen. John Ensign (R-Nev.) and Rep. Xavier Becerra (D-Calif.) recently introduced the Medicare Access to Rehabilitation Services Act (S 46/HR 43), which would repeal the Medicare Part B therapy caps.

"By introducing this legislation on the first day of the 111th Congress, our nation's leaders are sending a clear message that total repeal of the caps is the best long-term solution to ensuring that Medicare beneficiaries receive the rehabilitation services they need," said American Physical Therapy Association President R. Scott Ward, PT, PhD, who attended Congress' swearing-in ceremonies. "It's time to end the year-to-year fixes and pass legislation that fully protects beneficiaries."

"Every year in the Senate we debate this issue of therapy caps, and this year needs to be the last," Ensign said.

The therapy caps were originally adopted by Congress in the Balanced Budget Act of 1997. The caps require beneficiaries to pay 100 percent of the cost of rehab care once they exceed the caps, which are $1,840 for occupational therapy and $1,840 for physical therapy and speech combined in 2009.

Battle continues: Since 1997, Congress has acted -- often at the last minute -- by passing several moratoria and authorizing an exceptions process for rehab services above the caps. And the current therapy cap exceptions process will expire Dec. 31, 2009.

"Healthcare reform will be a big issue, but the therapy caps are still a problem," noted Christina Metzler, American Occupational Therapy Association chief public affairs officer.

Cosponsors of the new bill are Daniel Akaka (DHawaii), Ben Cardin (D-Md.), Robert Casey (D-Pa.), Susan Collins (R-Maine), Richard Durbin (D-Ill.), Lindsey Graham (R-S.C.), Patrick Leahy (D-Vt.), Blanche Lincoln (D-Ark.), Sheldon Whitehouse (DR.I.), Debbie Stabenow (D-Mich), Roy Blunt (R-Mo.), and Mike Ross (D-Ark.)