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  • Legislation Would Eliminate 'Cap' on Physical Therapy Services for Medicare Beneficiaries

    Legislation introduced April 14, 2011, would eliminate the onerous therapy cap that has imposed arbitrary limits on physical therapy services so often needed by senior citizens after a stroke, traumatic brain injury, or hip fracture, or to effectively manage conditions such as Parkinson disease, multiple sclerosis, or arthritis, says APTA.

    The Medicare Access to Rehabilitation Services Act (HR 1546 /S 829) introduced in the US House of Representatives by Reps Jim Gerlach (R-PA) and Xavier Becerra (D-CA), and in the US Senate by Senators Ben Cardin (D-MD) and Susan Collins (R-ME) would permanently repeal the $1,870 therapy "cap" imposed on physical therapy and physical therapy and speech-language pathology services for all outpatient settings, with the exception for hospital outpatient departments. A separate cap applies to occupational therapy.

    "The detrimental effects of the therapy caps on patients are well-documented," said APTA President R. Scott Ward, PT, PhD. "The cap is simply a bad policy that must be completely reversed."


    • At last another achievement by the APTA and its members. I am happy for my patients and my colleagues in the private practice setting!

      Posted by Jose Arves Santos, PT on 4/15/2011 1:39 PM

    • This is a great achievement not only for the profession but most especially for the patients!!

      Posted by Gemmarie Ramiscal, PT on 4/15/2011 2:45 PM

    • Way to go, great accomplishment which will benefit the patients for sure.

      Posted by AMJAD BHATTI, PT on 4/15/2011 3:34 PM

    • good news! Hope it succeeds. Maybe lead to DA for Medicare...

      Posted by James on 4/15/2011 3:39 PM

    • APTA efforts to eliminate this therapy "cap" needs to continue until the "cap" is gone. Only through continued lobbying and member involvement with their elected officials will the physical therapy profession attain professional recognition and independent practice. Keep the pressure on!

      Posted by Bruce C. Diven, DPT on 4/15/2011 3:57 PM

    • Right on!! Thanks for your hard work.

      Posted by Marnee Crawford on 4/15/2011 4:08 PM

    • Good work APTA. Not surprising that Becerra is an author. He is truly one of the good guys in politics.

      Posted by Paul Gaspar on 4/15/2011 4:18 PM

    • I can't believe it! This is a long time coming. If the cap is eliminated on PT in private practice I will celebrate and cheer to the roof tops. Hopefully the rest of Congress will pass the new bill. Thank you for the info - GOOD NEWS. Pam Chaney, PT

      Posted by Pam Chaney on 4/15/2011 5:37 PM

    • This is a nice first step ...still a long way to go and a lot of work to do..we've been down this road before

      Posted by joe napolitano,P.T. on 4/15/2011 8:45 PM

    • This is woonderful news!!!

      Posted by Julie Agbasi on 4/15/2011 9:08 PM

    • The hospital based clinics have had an unfair advantage over private practice clinics which has never made sense for cost control. Hopefully this is it for good and allows fair treatment practices for all.

      Posted by Nadine De freitas on 4/15/2011 9:45 PM

    • Great news! Hopefully things are going to start changing in Capitol Hill to benefit our beloved patients.

      Posted by Nilma Elias PT,DPT on 4/16/2011 7:30 AM

    • I've been at this wonderful profession for 50 years and this is significant news for all of us that provide services for our patients. Everyone is to be commended. This is one of those days it makes me proud to be a member of APTA.

      Posted by Peter Lord on 4/16/2011 7:44 AM

    • Great, just in time to eliminate medicare!

      Posted by Fred DiBernardo on 4/16/2011 8:07 AM

    • Thank you for all your hard work and determination. We thank you, and our patient's thank you.

      Posted by Vicki Wilkins PT, DPT on 4/16/2011 11:47 AM

    • It's unfair and foolish to encourage patients to seek the higher priced hospital setting for services that can be provided efficiently and locally by qualified and motivated local professionals. Clearly this is not a plan that was meant to help our country survive a financial crisis. Thank you APTA for standing up for the Davids of physical therapy in this Goliath world of big business and back room deals.

      Posted by Alan Silk, PT on 4/16/2011 11:53 AM

    • Before we get too celebratory over pending legislation we should reflect on how APTA and ASHA allowed PT and SLP to be lumped into the same cap while the AOTA was able to maintain their separate cap. It has taken a long time to get a proposed change to this point so hopefully the tea party will be a short one. The reason that hospital settings had an exemption is that their therapists have no direct financial benefit from providing excessive therapy. Despite our conceptions of PTs being above reproach ethically there is at least a subconscious tendency to extend the full length of the prescription or maintain 3x/week instead of decreasing frequency when there are lots of open slots in a private practice's schedule. The biggest drain on Medicare rehab dollars, however, is the continued provision of "therapy" within MD offices.

      Posted by Eric Bradford PT, MBA on 4/16/2011 2:28 PM

    • I believe the lumping of PT and ST goes way back to the original legislation in the early 70s setting outpatient regs. At that time only PT and ST were covered in the regs and OT was added later, therefore as other reimbursement issues were addressed the original language and regulation were used. When the caps first emerged, the lumping of PT and ST was a done deal and the APTA has been fighting for complete repeal ever since.

      Posted by Barb Amidon on 4/17/2011 8:17 AM

    • With the tea party's recent influence on legislation does this bill have any chance of becoming law? A huge thank you to those on the ground lobbying for this important repeal. Jennifer

      Posted by Jennifer F on 4/17/2011 2:00 PM

    • It's great news about elimation of cap for medicare patient.Good Job APTA. we should fight hard until it's implemented.PT can do help

      Posted by muthu murugan on 4/17/2011 9:20 PM

    • Great job APTA. Congratulations. This will tremendously help for our elderly population.

      Posted by Jayantha Liyanage on 4/18/2011 9:49 AM

    • What can we do to help this legislation along?

      Posted by Brett Fahnstrom on 4/18/2011 10:32 AM

    • I don't see this bill reaching the house floor for debate. Continuous changes of reimbursement through the continuum of care. The push for allocations of dollars to hospitals for government control/ budgeting. The fight was lost many years ago. This is bigger than a Pt. care issue now. Good luck APTA.

      Posted by Jim D on 4/18/2011 1:09 PM

    • This is goo

      Posted by Linda Coetzee on 4/18/2011 7:08 PM

    • My 81-year-old mother suffered a traumatic brain injury one year ago. We have struggled so much to get her the therapy she needs. I am heartened by the pending legislation, but even moreso by reading these comments from a community of people who are so passionate about what they do. It shows me there is hope. How can I help to push the legislation?

      Posted by Maria B on 4/19/2011 10:22 AM

    • Great job, APTA! I am so proud to belong to an association strongly dedicated to the patients they serve. Keep up the excellent work!

      Posted by Carmencita Walls -> >OP\BG on 4/27/2011 7:52 AM

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