APTA to Congress: Arbitrary Cap Stops Therapy Services Regardless of Medical Necessity
Today, APTA testified before the United States House of Representatives Committee on Ways and Means Subcommittee on Health on the detrimental effect the therapy cap can have on Medicare beneficiaries. The hearing, which was held to examine various Medicare provider payment provisions that will expire this year, also included witnesses from the American Hospital Association, American Ambulance Association, and American Medical Association.
In his testimony, Justin Moore, PT, DPT, APTA vice president, Government and Payment Advocacy, provided background on the cap, described the types of patients who are most affected by the cap, and explained the association's work on a reformed payment system for outpatient physical therapy services that would ensure access to services and improve payment accuracy for therapy services under Medicare Part B. "Congress has long known that allowing the therapy caps to go into effect would have a profound impact on patient care," said Moore. "The pattern of yearly extensions without an exit plan is not in the best interest of patients, physical therapists, or the Medicare program."
The association also highlighted several cost saving proposals to address the therapy cap and payment reform under Medicare Part B. "We commend the committee for this hearing of expiring Medicare payment policies and encourage an extension of the therapy cap exceptions process, movement toward a reformed payment system, and refinements to the therapy benefit," Moore said in his closing remarks.
Update 9/22/11: The video of the hearing, previously linked in this story, has been removed from the Ways and Means Web site. If video is made available later, we will add the link back to this story.

Justin Moore, PT, DPT, APTA vice president of government and payment advocacy, testifies before the House Ways and Means Subcommittee on Health about Medicare therapy caps.

Rep Bill Pascrell (D-NJ) addresses Justin Moore, PT, DPT, about the impact of the therapy caps on patients with traumatic brain injuries.