Applied Behavior Analysis

30 Groups Emphasize The Urgency Of Repealing Medicare Part B Therapy Caps Exceptions Process For Thousands of Americans

WASHINGTON, Jan. 27 /PRNewswire-USNewswire/ -- A coalition of organizations representing consumers, health professionals and providers recently sent a letter to Congressional Leadership, calling for the immediate reinstatement of the exceptions process for Medicare Part B outpatient therapy services. Without such efforts, thousands of Medicare beneficiaries will exceed arbitrary limitations on physical therapy, occupational therapy, and speech-language pathology services.

"There is a critical need for uninterrupted Medicare therapy benefits, and we urge Congress to protect America's vulnerable populations from the adverse effects of arbitrary financial caps on medically-necessary rehabilitation services for Medicare beneficiaries," stated R. Scott Ward, PT, PhD, President of the American Physical Therapy Association (APTA).

"The long term care profession is deeply committed to enhancing the quality of care and services provided to high-acuity patients in our facilities, such as those patients recovering from strokes and joint replacements, and access to therapy services plays an integral role," stated Bruce Yarwood, President and CEO of the American Health Care Association (AHCA).

The letter from industry leaders indicates that 14.5 percent of Medicare beneficiaries who receive rehabilitation services per year are estimated to exceed the cap, and once the arbitrary limit on coverage is reached, many individuals with disabilities and senior citizens may have to forego necessary care.

"Patient needs are not arbitrary - and monetary caps on therapy do not take into account the importance of rehabilitation when it comes to returning Medicare beneficiaries to good health," stated Tommie L. Robinson, Jr. PhD, CCC-SLP, President of the American Speech-Language Hearing Association (ASHA). "Current law and its arbitrary ceiling for therapies limits access to care, and hinders Medicare beneficiaries' ability to recuperate."

According to the letter, Congress has repeatedly responded six times in the past to prevent Medicare beneficiaries from being negatively impacted by the therapy cap policy. This is a redundant task, organizational leaders said, that only temporarily resolves the issue, and ignores the need to permanently fix this problem for Medicare beneficiaries. While both the House and Senate versions of health care reform legislation addressed the therapy cap by expending the exceptions process for a short period of time, failure to enact reform has put beneficiaries who require rehabilitation after an illness or injury at considerable risk.

The letter also urges Congress to review options for repeal of the therapy caps as it prepares to modify its health care reform legislative proposal. Currently, Representatives Xavier Becerra (D-CA) and Roy Blunt (R-MO) have authored legislation to repeal the therapy caps, Medicare Access to Rehabilitation Services Act of 2009 (HR 43), which currently has one hundred and thirty cosponsors. A companion bill (S 46), introduced by Senators John Ensign (R-NV), Ben Cardin (D-MD) and Blanche Lincoln (D-AR), has twenty six cosponsors.

"We thank these Congressional champions for leading the fight in Congress to protect Medicare beneficiaries' access to critical rehabilitative services they need and deserve," stated Penelope Moyers Cleveland, EdD, OTR/L, BCMH, FAOTA, President of the American Occupational Therapy Association (AOTA).

To obtain a copy of the letter, please contact Katherine Lehman at 202-898-2816.

Organizations signing the letter:

American Assoc. of Homes & Services for the Aging

American Association of People with Disabilities

American Health Care Association

American Heart Association/American Stroke Association

American Medical Rehabilitation Providers Association

American Music Therapy Association

American Occupational Therapy Association

American Physical Therapy Association

American Speech-Language Hearing Association

Amputee Coalition of America

Autism Society

Brain Injury Association of America

Council for Learning Disabilities

Disability Rights Education and Defense Fund

Easter Seals

Family Voices

National Association of County Behavioral Health and Developmental Disability Directors

National Association of Social Workers

National Association of State Head Injury Administrators

National Association for the Support of Long-Term Care

National Disability Rights Network

National Multiple Sclerosis Society

National Spinal Cord Injury Association

Private Practice Section of the American Physical Therapy Association

PTPN (National network of independent rehab practices)

The Arc of the United States

The Association of Assistive Technology Act Programs

United Cerebral Palsy

United Spinal Association

World Institute on Disability

SOURCE American Health Care Association