Medicare Therapy Caps Jeopardizes Care of Persons with Parkison's
Posted Dec 04 2012 8:40pm
The information below is from the website of the Parkinson’s Action Network (PAN).
What are the Medicare Therapy Caps?
The Balanced Budget Act of 1997 created limits, or caps, on the amount of outpatient physical, speech language, and occupational therapy a Medicare beneficiary could receive each calendar year. Beginning in 1997, Congress voted several times to keep the caps from going into effect. However, on January 1, 2006, Congress allowed the therapy caps to take effect. The cap for 2012 is $1,880. Once the cap is reached, beneficiaries who require additional services in the calendar year are responsible for 100% of the cost.
Exceptions to the Medicare Therapy Caps
To mitigate the impact of the therapy caps on Medicare beneficiaries who need therapy services beyond the cap, in 2006, Congress created an exceptions process for services deemed medically necessary. Unfortunately, the exceptions process is temporary and must be reauthorized by Congress almost every year. In February 2012, Congress passed, and the president signed, a continuation of the exceptions process. This extension expires December 31, 2012.
PAN supports a repeal of the Medicare therapy caps. People with Parkinson’s disease commonly have a medical need for physical and speech language therapy. The Medicare therapy caps place an unnecessary burden on many individuals with Parkinson’s and other diseases, whose annual costs for these services exceed the cap. In addition, if an exception is not granted by Medicare, the beneficiary may face the decision of forgoing care, paying out of pocket for the services, or traveling to an outpatient hospital for continued care. PAN supports the Medicare Access to Rehabilitation Services Act of 2011 ( H.R. 1546 / S. 829 ), which wouldeliminate Medicare therapy caps all together. Voice your support to your Representative and Senator today!
Access to Therapy in Jeopardy:Act Now!
Congress has less than 30 days to extend the Medicare therapy caps exceptions process . Tell your Member of Congress to act today to prevent harmful restrictions on physical, occupational, and speech-language therapy from going into effect on January 1!
Medicare therapy caps disproportionately impact people with chronic diseases like Parkinson’s. Twenty-five percent of Medicare beneficiaries with Parkinson’s exceed the arbitrary annual cap Congress has placed on medically necessary therapy services. Congress has just days left to act to ensure that people with Parkinson’s won’t be denied the treatments they need to maintain their quality of life.