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House leaning toward repealing therapy cap

Rehab Regs, December 9, 2005

With less than a month to go before the current moratorium on Medicare therapy caps expires, a majority of the US House of Representatives has endorsed legislation to repeal the financial limit on therapy benefits, according to an APTA press release.

The Medicare Access to Rehabilitation Services Act of 2005 (HR 916) has reached 220 cosponsors. The bipartisan legislation was introduced by Representatives Phil English (R-PA), Benjamin L Cardin (D-MD), Roy Blunt (R-MO), and Frank Pallone (D-NJ) earlier this year. Similar legislation with bipartisan support has also been introduced in the Senate.

If passed, the legislation would repeal the Medicare therapy caps which now force the people who need physical therapy the most-senior citizens and people with disabilities-to face a choice between forgoing care or paying 100% out of pocket when their Medicare coverage runs out.

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

"The cap on therapy services unfairly targets our oldest and frailest seniors," said Rep Phil English (R-PA). "Whether a person receives speech, occupational, or physical therapy, it should be a decision made between a healthcare provider and patient, not by accountants monitoring a set limit. I am encouraged that so many of my colleagues support the bill to get rid of this arbitrary cap."

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