NASL Article Details



Press Release

Therapy Cap Repeal Legislation Would Benefit Medicare Patients & Ensure Access to Care

Cynthia Morton, 4/15/2011


For Immediate Release
Contact: Cynthia Morton
(703) 549-8500

April 15, 2011 (Alexandria, VA) - The National Association for the Support of Long Term Care (NASL) today is hailing the introduction of legislation that would repeal the arbitrary caps on Medicare outpatient therapy services.

Senator Ben Cardin (D-MD) and nine cosponsors yesterday introduced S. 829, while in the House, Representatives Jim Gerlach (R-PA) and Xavier Becerra (D-CA) introduced H.R. 1546. Both bills would repeal the arbitrary caps on therapy services that have threatened patient access to medically necessary therapy caps since 1997.

“Therapy caps discriminate against the very Medicare beneficiaries who are most in need of therapy services,” said Cynthia Morton, Executive Vice President of NASL. “Studies have shown that patients with stroke, hip fractures, Parkinson's disease, and other conditions requiring extensive rehabilitation are most likely to be affected,” she said.

Patients in Skilled Nursing Facilities (SNFs) often are the most chronically ill, so they are most affected by the imposition of the therapy cap. Congress acted several times to delay imposition of the therapy cap by extending moratoria. In 2006, Congress allowed the cap to become effective, but it authorized an exceptions process that enables patients needing extended rehabilitative care to receive it.

The exceptions process has been reauthorized several times, but a lapse allowed the rigid caps to go into place last year. Thousands of people were affected between January 2010 and March 2010, when Congress extended the exceptions process. The therapy cap exceptions process is currently authorized through December 31, 2011.

The current cap for physical therapy and speech language pathology services combined is $1,870. For occupational therapy services, the limit is $1,870 in 2011.

“Senator Cardin and Representatives Gerlach and Becerra have been stalwart supporters for ensuring continued access to rehabilitative services for Medicare beneficiaries,” said Morton. “We applaud their work in building a strong bipartisan base of support for Medicare therapy services,” she said.

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The National Association for the Support of Long Term Care (NASL) is a trade association representing providers of both ancillary services and products to the long-term care industry. Member companies provide speech-language pathology; physical, occupational and respiratory therapy; portable x-ray/EKG and ultrasound; pharmacy; long-term care (LTC) information technology systems; and other ancillary services. NASL members also provide products such as complex medical equipment; parenteral and enteral supplies, equipment and nutrients; and additional specialized supplies for post-acute care settings nationally.

 If you have questions or would like additional information, please contact NASL, 1321 Duke Street, Suite 304, Alexandria, Virginia, 22314-3563, (703) 549-8500, www.nasl.orgmembership@nasl.org.