U.S. Sens. Susan Collins (R-ME) and Ben Cardin (D-MD) called for a permanent end to capping limits on therapy services for Medicare patients with their reintroduction last week of the Medicare Access to Rehabilitation Services Act.
The legislation would protect patients covered by Medicare from arbitrary limits placed on outpatient physical therapy, occupational therapy and speech-language pathology services.
“This legislation would ensure appropriate access to important outpatient rehabilitation services under the Medicare program,” Collins, chairwoman of the Senate Special Committee on Aging, said. “I am concerned that the current, arbitrary caps could prevent Medicare beneficiaries recovering from a stroke, hip fracture, or other diseases or conditions requiring extensive therapy from receiving all of the services they need.”
“In addition, Medicare patients would have an incentive to seek services in hospital-outpatient settings, which are not subject to the caps and are more expensive,” Collins said. Arbitrarily capping these vital rehabilitation services would cause some beneficiaries to delay necessary care, force others to assume higher out-of-pocket costs, and disrupt the continuum of care for many seniors and persons with disabilities.”
Services such as speech-language pathology and physical or occupational therapy are very often required by victims of debilitating illnesses, such as multiple sclerosis and arthritis, or those who have suffered a stroke. With limits on a patient’s care, the patient sometimes cannot receive the care he or she desperately needs.
The limits on certain rehabilitation therapy services under Medicare first surfaced in 1997 as part of the Balanced Budget Act. In the 17 years since, Congress has intervened over a dozen times to adjust, temporarily, the therapy caps. The Collins-Cardin bill aims to be a long-term solution to this issue.
“We need a full repeal of the existing caps on physical therapy, occupational therapy and speech-language pathology services,” Cardin, a member of the Finance Health Care Subcommittee, said. “These annual financial caps limit services often needed after a stroke, traumatic brain injury or spinal cord injury, or to effectively manage conditions such as Parkinson’s disease, multiple sclerosis and arthritis. Arbitrary caps on these vital Medicare outpatient therapy services are simply unacceptable.”