All therapists are encouraged to contact their members of Congress and ask them to address the therapy cap issue before the end of the year.

The current moratorium enforcement of the Medicare therapy cap will expire at the end of this year. Without action by Congress, many citizens and people with disabilities who need physical therapy care the most may face a choice between forgoing necessary care or paying 100 percent out of pocket when their Medicare coverage runs out. The Senate has voted to extend the therapy cap moratorium year in its Budget Reconciliation package; the House has not included the provision in its version of the budget bill.

A bipartisan group of members of the US Senate and US House of Representatives introduced The Medicare Access to Rehabilitation Services Act of 2005 (S 438 & HR 916) earlier this year to repeal the financial cap on Medicare outpatient physical therapy benefits. The legislation would eliminate the ongoing threat that would force a significant number of seniors and individuals with disabilities to delay or alter the course of their care by changing providers or facilities. The Medicare Access to Rehabilitation Services Act of 2005 currently has 38 cosponsors in the Senate and 203 cosponsors in the House.

The current moratorium, set to expire December 31, 2005, allowing the cap to be implemented on January 1, 2006, by the Centers for Medicare and Medicaid Services, current law provides for two caps on rehabilitation benefits, one for physical therapy, speech therapy, and a separate cap for occupational therapy.

Reference:  APTA Legislation Action Alert

ACTION ALERT FROM APTA:  Congress must take action on the therapy caps prior to their implementation on January 1, 2006. Without Congressional action in 2005, Medicare beneficiaries will be subject to a $1740 limit on their combined outpatient physical therapy and speech language pathology services and a $1740 limit on their occupational therapy services. In November, both the House and Senate passed separate Budget Reconciliation bills. The Senate version contained a one year extension of the therapy cap moratorium while the House version contains no Medicare provisions.

A Conference Committee will be appointed when Congress reconvenes the week of December 5 to merge the two different versions into one bill. We must make sure that the one year extension of the therapy cap moratorium is included in the final bill.

If the therapy caps go into effect, 15-20% of seniors and persons with disabilities will see their outpatient rehabilitation services provided by physical therapists, occupational therapists, and speech language pathologists limited to this arbitrary amount. Your action TODAY will help ensure that patients have the rehabilitation services they need TOMORROW! Our objective is clear: SUPPORT THE ONE YEAR EXTENSION OF THE THERAPY CAP MORATORIUM.

Reference: APTA Legislation Action Alert