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Coalition to Congress: Protect Seniors By Protecting Therapy Services

Advocating on behalf of hundreds of thousands of Medicare beneficiaries who receive outpatient rehabilitation services every year, the Therapy Cap Coalition on February 14 urged members of the Congressional Conference Committee to show their love to seniors this Valentine’s Day by providing the longest possible exceptions extension for Medicare Part B therapy services in the Committee’s final agreement.

“An arbitrary therapy cap on services without regard to clinical appropriateness of care discriminates against the most vulnerable of Medicare beneficiaries,” stated Justin Moore, Vice President, Public Policy, Practice and Professional Affairs at the American Physical Therapy Association, a leading group in the Coalition. “We urge the Conference Committee to extend the exceptions policy that allows patients to receive needed services under Medicare.”

In a letter sent last month to Congressional leadership, the Coalition, made up of patient, provider and professional groups, highlighted the importance of extending the exceptions process, which has been in place since Congress passed the Balanced Budget ACT (BBA) in 1997. The law created an annual financial cap on physical therapy and speech-language pathology services as well as a separate cap on occupational therapy for most outpatient settings.

The letter noted that without action on a longer-term extension, some 640,000, or 14.5 percent, of Medicare Part B beneficiaries who receive outpatient rehabilitation services per year would be denied therapy. The caps have the potential to impact some of Medicare’s most chronically ill patients including those who experience stroke, hip fracture, Parkinson’s disease, neuromuscular diseases, arthritis or osteoporosis.

“Rehabilitation is time sensitive — it is critical for these beneficiaries to get the right care at the right time,” stated Tim Nanof, Director of Federal Affairs at the American Occupational Therapy Association. “The therapy cap limits access to appropriate care and the consequences can be catastrophic for the most vulnerable beneficiaries. This is not a question of party politics. The cap hits Republican and Democrat seniors alike and requires a bi-partisan solution.”

“Even though Congress provided temporary relief to Medicare patients affected by the caps, it is critical to extend the exceptions process for as long as possible or repeal the therapy caps altogether so that stroke survivors and other patients in need of vital rehabilitation services are not forced to forgo needed care,” said Sue Nelson, Vice President of Federal Advocacy for the America Heart Association.

Therapy Cap Coalition Members

  • American Academy of Physical Medicine and Rehabilitation
  • 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
  • Arthritis Foundation
  • Association of Rehabilitation Nurses
  • Autism Society
  • Brain Injury Association of America
  • Council for Learning Disabilities
  • Disability Rights Education and Defense Fund
  • Easter Seals
  • Family Voices
  • The Jewish Federations of North America
  • LeadingAge
  • National Association for the Support of Long-Term Care
  • National Association of County Behavioral Health and Developmental Disability Directors
  • National Association of Rehabilitation Providers and Agencies
  • National Association of Social Workers
  • National Association of State Head Injury Administrators
  • National Council on Independent Living
  • National Disability Rights Network
  • National Multiple Sclerosis Society
  • National Spinal Cord Injury Association
  • National Stroke Association
  • Parkinson’s Action Network
  • Private Practice Section of the American Physical Therapy Association
  • PTPN (National network of independent rehab practices)
  • RehabCare
  • The ALS Association
  • The Arc of the United States
  • The Association of Assistive Technology Act Programs
  • The Society of NeuroInterventional Surgery
  • United Cerebral Palsy
  • United Spinal Association
  • World Institute on Disability

Source: American Occupational Therapy Association

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