Rehab

AOTA urges CMS to continue paying after cap limit

Rehab Regs, January 13, 2006

As limits to Medicare reimbursements for outpatient occupational therapy services go into effect, the American Occupational Therapy Association (AOTA) is urging the Centers for Medicare & Medicaid Services (CMS) to use administrative authority and continue paying for services beyond the arbitrary limit of $1,740 per patient.

Provisions to allow patients to exceed the therapy caps when it is medically necessary are contained in the budget-reconciliation bill that is still awaiting final passage in Congress.

"Medicare patients should not be victims in the Washington budget battle," said AOTA President Dr. Carolyn Baum in a press release. "CMS should use its authority to enable patients to receive the services they need as we wait for the Congress to pass a federal budget."

The tentative provisions in the budget reconciliation bill are limited to only one year. Further legislative action will be necessary to permanently fix how Medicare covers occupational therapy services. Congress originally passed the therapy cap in 1997, but delayed implementation each year. At issue is the arbitrary nature of the Medicare reimbursement amount that Congress set with little regard for the needs of patients.

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