US Senate Fails to Take Action on Vote to Suspend Therapy Cap

The American Physical Therapy Association (APTA) and American Occupational Therapy Association (AOTA) websites provide Medicare Updates. Quoted below is the June 27 update by APTA.

The US House of Representatives passed HR 6331 – Medicare Improvements for Patient and Providers Act (MIPPA) but the US Senate failed to pass the bill before adjourning for recess. HR 6331 contains key provisions critical for physical therapists and our patients including provisions to avoid the 10.6% reduction in payments under the Medicare physician fee schedule and extension of the therapy cap exceptions process starting on July 1, 2008.

Congress will reconvene on Monday, July 7, and is expected to begin negotiations on a Medicare package that can achieve the needed votes in the US House, the US Senate, and be signed by the President. Continued advocacy to voice your support for quick action on Medicare legislation in July is essential.

Statement by APTA President R. Scott, PT, PhD.
Friday, June 27, 2008

“I’m extremely disappointed that Congress has failed to take action on behalf of Medicare patients and their providers before the July 1 deadline. In failing to pass legislation to assure that beneficiaries continue to get the therapy care they need, Congress has placed the health of many seniors and persons with disabilities in jeopardy.

“The situation is made worse by the fact that the $1,810 cap on therapy care will include services provided to beneficiaries since January 1 of this year, even if those services qualified for an exception to the therapy cap. Evidence suggests that roughly 12.6% of beneficiaries will exceed the therapy cap, and because of this interpretation some patients are likely to already have reached their “cap” on services when the exceptions process expires on June 30. This could force many patients to pay out of pocket for the therapy services they need.

“The 10.6% cut in payments under the Medicare fee schedule will also have a detrimental impact on the physical therapists who provide outpatient therapy services. Many physical therapists practices that provide care for a large number of Medicare beneficiaries are already operating on tight cash flow margins and may not be able to stay afloat if this cut remains in effect.

“The American Physical Therapy Association will continue to work on behalf of Medicare patients and the physical therapists who are their partners in recovery. We will explore all viable options for keeping these policies from harming patients, and we urge Congress to come to a speedy resolution when it reconvenes in July and pass legislation that remedies this critical situation.”

Source: APTA

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