Wednesday, November 15, 2006

APTA, Coalition Urge Congress to 'Stop the Therapy Cap'

ALEXANDRIA, Va., Nov. 13 /PRNewswire/ -- In less than 50 days, 1 in 7 Medicare beneficiaries(1) will be subject to an arbitrary financial limit on outpatient rehabilitation services, or a "therapy cap," without Congressional action. The American Physical Therapy Association (APTA) and a coalition representing patients, health care providers, and advocates are calling on Congress to support an extension of the therapy cap exceptions process to allow Medicare beneficiaries needing care above the limit to apply for additional coverage.

"It is urgent that Congress takes action to protect Medicare beneficiaries from an arbitrary therapy cap," said APTA President R Scott Ward, PT, PhD. "Data show that patients with stroke, hip fracture, Parkinson's disease, and other conditions that require extensive rehabilitation are most likely to be affected by the Medicare therapy caps. APTA believes that the current therapy cap exceptions process has maintained access to needed rehabilitation services in a fiscally responsible manner. APTA continues to advocate for the best long-term solution to the arbitrary caps: full repeal of the therapy caps. But in the current situation, Congress must take action immediately to, at a minimum, extend the exceptions process for another year and protect our patients from the arbitrary caps," said Ward.

There are two caps on rehabilitation coverage, one for physical therapy and speech therapy combined and a separate cap for occupational therapy. Earlier this year, Congress passed a provision in the Deficit Reduction Act that authorized the Centers for Medicare and Medicaid Services (CMS) to implement an exceptions process to allow beneficiaries who need care above the financial cap to apply for additional medically necessary coverage -- but only through 2006. Earlier this year, 179 members of the U.S. House of Representatives and 46 U.S. Senators signed on to a letter urging an extension of the therapy cap exceptions process, but neither the House nor the Senate has passed legislation addressing the measure. In addition, extension of the therapy cap exceptions process is supported by over 40 patient and provider groups.

The American Physical Therapy Association is a national professional organization representing nearly 70,000 members. Its goal is to foster advancements in physical therapy practice, research, and education.

List of coalition members below.

Coalition Members Supporting an Extension of the Therapy Cap
Exceptions Process

(Organizations marked with an asterisk will also be participating in
advertisements on the issue running in Capitol Hill publications this week.)

American Academy of Physical Medicine and Rehabilitation*
American Academy of Neurology
Alzheimer's Association
American Association of Homes & Services for the Aging
American Association on Mental Retardation
American Dance Therapy Association
American Health Care Association*
American Heart Association/American Stroke Association*
American Medical Directors Association
American Medical Rehabilitation Providers Association*
American Music Therapy Association
American Network of Community Options and Resources
American Nurses Association*
American Occupational Therapy Association*
American Physical Therapy Association*
American Speech-Language and Hearing Association*
American Therapeutic Recreation Association
Amputee Coalition of America
Arthritis Foundation*
Brain Injury Association of America*
Catholic Health Association of the United States
Center for Medicare Advocacy, Inc.
Christopher Reeve Foundation
Easter Seals*
Military Officers Association of America*
National Association for the Support of Long Term Care*
National Association of Councils on Developmental Disabilities
National Association of Directors of Nursing Administration/LTC, Inc.*
National Association of Rehabilitation Providers and Agencies*
National Association of Social Workers
National Association of State Head Injury Administrators
National Council for Community Behavioral Healthcare
National Disability Rights Network
National Multiple Sclerosis Society
National Osteoporosis Foundation*
National Rehabilitation Association
National Rural Health Association
National Stroke Association
Parkinson's Action Network*
Power Mobility Coalition
The Arc of the United States*
United Cerebral Palsy*
United Spinal Association

(1) Advancemed Report "Outpatient Rehabilitation Services Payment System Evaluation" prepared for Centers for Medicare and Medicaid Services 11/15/04, Table 8, Page 18