Take Action to Continue Therapy Cap Exceptions Process in 2012 – Write Congress Today
The end of the year is quickly approaching, leaving Congress little time to address Medicare therapy caps by extending the current therapy cap exceptions process. It is imperative for all therapists to contact their members of Congress and let them know the detrimental impact of the therapy caps on Medicare beneficiaries.
U.S. Representatives Jim Gerlach (R-PA) and Xavier Becerra (D-CA), Senator Ben Cardin (D-MD) have introduced the Medicare Access to Rehabilitation Services Act (H.R. 1546/S. 829). This legislation would repeal the cap on therapy services for Medicare beneficiaries. If Congress does not take action by December 31, 2011, therapy caps will be imposed on Medicare-covered physical therapy, occupational therapy, and speech language pathology services.
Congress needs to hear from front-line health care providers within the long-term care community that the therapy cap is bad public policy that would be especially hard on patients in long-term care settings. With congressional focus on debt reduction and recommendations from the “Super Committee”, we need to ensure that Congress does not lose sight of Medicare extenders that are set to expire at the end of the year. Please contact your member of Congress today on this critical issue – we need to take action NOW to ensure the cap does not go back into place.
Please log onto the NASL (National Support for Long Term Care) website and with just a few clicks, you can send letters to your Legislators today. http://capwiz.com/nasl/issues/alert/?alertid=42500531&type=CO
(Notes taken from ASHA and NASL websites)
January 20th, 2012 at 11:42 am
I think hard caps are a good thing for the industry. Too many contract therapy providers and long term care companies have been abusing the system for so long. They are the first ones to cry when there are cutbacks, but take advantage of every loophole. It is ridiculous how many patients that are not rehab appropriate are treated annually in order to capture more revenue.
The days of a therapist evaluating and determining a treatment plan are long gone. Therapists are now told what RUG level a patient will achieve and how long they will be receiving services by building administrators. All Med B patients will be treated for 75 minutes 5 times/week regardless of need.
Bring on the hard cap. Our profession needs to focus more on protecting our scope of practice and not allowing non-therapists to drive our caseload.
January 24th, 2012 at 11:41 am
Well, I have to say that I agree with some of what you’re saying. I believe there is abuse of the system but where I disagree with you is that I don’t think that hard caps are the answer. There is no clinical basis for the capitated limit and for many patients the amount is far too little. How do hard caps protect our scope of practice or meet our patient’s needs? Also I have to stop at this point and say that in my twenty years working in long-term care I’ve never seen a provider require that all Part B’s are seen 5 times/week for 75 minutes per treatment. I just haven’t seen that. There may be places where that happens but likewise, I’ve personally experienced individual therapists that have been unethical and I know our company will not tolerate that. You point an accusing finger at the long-term care industry but all industries try to maximize their revenue. And I don’t see anything wrong with that. I’m not condoning greed by any means. What I’m saying is that all businesses, even healthcare, have to manage their finances and managing finances does not create dishonesty. In my experience honesty and dishonesty are not bred in industries they are within people. I would be willing to say that in every segment of industry known to man there are good people and bad people. I don’t think we can legislate honesty and certainly not through an arbitrary therapy cap. No matter what laws are created there will be unethical people. Creating a hard cap won’t change that but it will hurt people who need care. I think the answer is personal accountability and patient advocacy.