The Medicare Access to Rehabilitation Services Act (S. 539), a bill that would permanently repeal Medicare’s outpatient therapy cap, was introduced Feb. 24 to the U.S. Senate by Sens. Ben Cardin, D-Md. and Susan Collins, R-Maine, according to a news release.
The bill first was introduced this session Feb. 5 in the U.S. House of Representatives. Rep. Charles Boustany Jr., R-La., MD, serves as the bill’s lead sponsor in the 114th Congress, working in close collaboration with key champions Reps. Xavier Becerra, D-Calif., Marsha Blackburn, R-Tenn., and Lois Capps, D-Calif. The House version (H.R. 775) had bipartisan support upon introduction and has accumulated more than 50 original co-sponsors. The therapy exceptions process and provider cut delay are set to expire March 31, according to the release.
“With the current therapy exceptions process set to expire on March 31 and a hard cap just on the horizon, early introduction of this legislation is critical to demonstrating to Congress the support behind repealing this long-flawed policy,” Tim Casey, director of federal affairs for the American Occupational Therapy Association, said in the release. “We are thankful to the champions of this bill for lending their voices to an issue that has far-reaching effects on the ability of our nation’s seniors to get the care they need and deserve.”
The AOTA supports full repeal of the Medicare Part B Outpatient Therapy Caps, which limit access to medically necessary rehabilitation services for Medicare patients across all outpatient settings. The arbitrary therapy cap established for 2015 is $1,940 for occupational therapy services, and $1,940 for physical therapy and speech-language-pathology services combined.
During Congress’ last session, progress was made on the Medicare payment reform and therapy cap repeal. With more than 225 co-sponsors, efforts to address these two long-flawed policies largely were bipartisan; however, negotiations collapsed as negotiators disagreed about how to finance the cost of the legislation, according to the AOTA. It is critical Congress continues to focus on the problem of the cap to ensure Medicare beneficiaries get the proper care, for the appropriate duration of time, within the correct timeframe throughout the disease process to maximize their ability to function so they can be as independent and productive as possible, according to the AOTA.
“For hundreds of thousands of Medicare beneficiaries seeking much-needed occupational therapy to improve or maintain their quality of life, the therapy cap continues to serve as an arbitrary barrier to care,” AOTA Executive Director Frederick P. Somers, said in the release. “It’s time we move beyond the harmful cycle of short-term extensions and address the therapy cap once and for all by fully and permanently repealing Medicare’s outpatient therapy cap.”
Bethesda, Md.-based AOTA, which was founded in 1917, represents the professional interests and concerns of more than 185,000 OTs, OTAs and students nationwide.