Urge Your Congressperson to Stop the Therapy Gap

I'm forwarding to you an announcement from the American Physical Therapy Association that asks individuals to urge their Congressperson to extend the exisiting Medicare therapy cap exceptions for physical therapy. CRPS is an exception to the cap.

ALEXANDRIA, VA, November 13, 2006 — In less than 50 days, one in seven Medicare beneficiaries1 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.

Below are two websites to locate your Congressperson: House and Senate

Best of health, Jim Broatch

December 8, 2006