APTA disappointed by Congress's failure to pass
legislation ensuring care for seniors
ALEXANDRIA, VA, December 27, 2009—Medicare beneficiaries
recovering from stroke, hip fracture, or other conditions that require
extensive therapy will soon be faced with arbitrary financial limits on
their rehabilitative services, as Congress has failed to extend an
exceptions process for services above the financial "cap" based on
diagnosis, clinician evaluation, and judgment, says the American
Physical Therapy Association (APTA).
The lack of action by Congress is troubling, especially as it had the
opportunity to attach a temporary extension to the caps exceptions
process to the Department of Defense Authorization Act as it did with
physician and provider payments, including those to physical therapists.
APTA is discouraged and disappointed that Congress is allowing an
arbitrary annual cap on outpatient rehabilitation services to be placed
on Medicare beneficiaries on January 1, 2010. This is clearly
inconsistent with efforts by President Obama's administration and the
Democratic majority to reform health care by eliminating arbitrary
limits imposed by private insurance companies. Congress must hold the
Medicare program to the same standard. Ensuring payments to providers,
including physical therapists, while allowing this cut to rehabilitation
services for seniors and people with disabilities during the health care
reform debate is gravely disconcerting.
The Medicare therapy caps were originally adopted by Congress in the
Balanced Budget Act of 1997. Since 1999, Congress has acted to prevent
implementation of the caps by passing several moratoria and authorizing
the exceptions process. An 18-month extension of the exceptions process
was included in the Medicare Improvements for Patients and Providers Act
(HR 6331), which passed July 15, 2008. The exceptions process is set to
expire December 31, 2009.
"We're disappointed that Congress has not taken action to extend the
caps exceptions process and ensure that America's seniors will received
the full spectrum of rehabilitative services needed to recover from a
fall or stroke or to manage Parkinson's or other chronic diseases and
conditions," said APTA President R. Scott Ward, PT, PhD. "APTA supports
permanent and full repeal of financial caps. However, until such time,
the exceptions process must remain intact."
The Patient Protection and Affordable Care Act (HR 3590) and the
American's Affordable Health Choices Act (HR 3962), the US Senate's and
the US House of Representatives' health care reform proposals, both
contain provisions to extend the caps exceptions process. However, as it
is unlikely that reform will pass by December 31, a temporary extension
of the exceptions process would guarantee that Medicare beneficiaries
would receive uninterrupted rehabilitative care until comprehensive
reform legislation is passed.
Physical therapists are highly-educated,
licensed health care professionals who can help patients reduce pain and
improve or restore mobility — in many cases without expensive
surgery or the side effects of prescription medications. APTA represents
approximately 76,000 physical therapists, physical therapist assistants,
and students of physical therapy nationwide. Its purpose is to improve
the health and quality of life of individuals through the advancement of
physical therapist practice, education, and research. In most states,
patients can make an appointment directly with a physical therapist,
without a physician referral. Learn more about conditions physical
therapists can treat and find a physical therapist in your area at www.moveforwardpt.com.