General Admissions & OTCAS Call for Lobbying: Repeal of Therapy Cap is on the Table!

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Therapy Cap Repeal Bill Re-introduced in Congress

Send a letter to your Senator and Congressional Representative here:
Stop the Therapy Cap

Or for a text to send to your House Rep:

As your constituent I am writing to ask that you cosponsor H.R. 807/S. 253 the Medicare Access to Rehabilitation Services Act.
The Medicare Part B Outpatient Therapy Caps were first enacted 20 years ago in 1997.

If allowed to take effect, the hard cap on Medicare outpatient OT, PT, and Speech services would deny Medicare beneficiaries access to needed health care services regardless of medical necessity.
The arbitrary therapy cap for 2016 is $1960 for occupational therapy services and a separate therapy cap of $1960 for physical therapy and speech-language-pathology services combined.

The caps have only been imposed for a few months because Congress passed moratoriums or exceptions avoiding the full impact of the policy in multiple bills.

In order to fix this flawed policy permanently, Rep. Erik Paulsen (R-MN) and Rep. Ron Kind (D-WI) introduced the Medicare Access to Rehabilitation Services Act (H.R. 807). This bill would permanently repeal the therapy cap.

The current �exceptions process� expires at the end of 2017. Congress must prioritize repealing and replacing the cap before December 2017.

This 20 year old policy is outdated. Payment for outpatient therapy services needs to be aligned with new policies passed by Congress that focus on providing high-quality, coordinated care.
Congress must support a pathway to care for beneficiaries that is determined by need, not an arbitrary dollar amount. Now is the time to fix the therapy cap.

If you have already cosponsored H.R. 807 we greatly thank you. Please consider speaking to leadership about supporting a long term solution before the current policy expires in 2017.

If you have not yet cosponsored H.R. 807, please sign onto the Medicare Access to Rehabilitation Services Act of 2017 and stop the cap today!

Sincerely,


For your Senator:


As your constituent I am writing to ask that you cosponsor S. 253 the Medicare Access to Rehabilitation Services Act.

The Medicare Part B Outpatient Therapy Caps were first enacted 20 years ago in 1997.

If allowed to take effect, the hard cap on Medicare outpatient OT, PT, and Speech services would deny Medicare beneficiaries access to needed health care services regardless of medical necessity.
The arbitrary therapy cap for 2016 is $1960 for occupational therapy services and a separate therapy cap of $1960 for physical therapy and speech-language-pathology services combined.

The caps have only been imposed for a few months because Congress passed moratoriums or exceptions avoiding the full impact of the policy in multiple bills.

In order to fix this flawed policy permanently, Sen. Cardin (D-MD), Sen. Collins (R-ME), Sen. Casey (D-PA), and Sen. Heller (R-NV) introduced the Medicare Access to Rehabilitation Services Act (S. 253). This bill would permanently repeal the therapy cap.

The current �exceptions process� expires at the end of 2017. Congress must prioritize repealing and replacing the cap before December 2017.

This 20 year old policy is outdated. Payment for outpatient therapy services needs to be aligned with new policies passed by Congress that focus on providing high-quality, coordinated care.
Congress must support a pathway to care for beneficiaries that is determined by need, not an arbitrary dollar amount. Now is the time to fix the therapy cap.

If you have already cosponsored S. 253 we greatly thank you. Please consider speaking to leadership about supporting a long term solution before the current policy expires in 2017.

If you have not yet cosponsored S. 253, please sign onto the Medicare Access to Rehabilitation Services Act and stop the cap today!

Sincerely,



Last week, Representatives Eric Paulsen (R-MN), Ron Kind (D-WI), Marsha Blackburn (R-TN), and Doris Matsui (D-CA), and Senators Ben Cardin (D-MD), Susan Collins (R-ME), Dean Heller (R-NV), and Bob Casey (D-PA) introduced the “Medicare Access to Rehabilitation Services Act” (H.R. 807/S.253), a bill that would permanently repeal the Medicare Outpatient Therapy Cap.



For the past 20 years, an arbitrary cap has existed on how much outpatient therapy a beneficiary can receive each year, regardless of medical necessity. Since the policy’s enactment, Congress has stopped this “hard cap” on services by implementing multiple, temporary moratoria and “exceptions processes”. In April 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which fixed other flawed Medicare policies, but failed to pass a permanent fix to the therapy cap. Despite strong bipartisan support for a permanent solution, Congress ultimately approved a two-tiered "exceptions process" through December 31, 2017.



AOTA strongly supports full repeal of the Medicare Part B Outpatient Therapy Cap, which currently limits access to medically necessary rehabilitation services for Medicare patients in outpatient settings such as skilled nursing facilities, rehabilitation hospitals, and clinics. This policy puts the government between the patient and the health care provider. A pathway to appropriate care is a critical promise to Medicare beneficiaries and one that allows them a chance to maximize their function and live as independent and productive lives as possible.



AOTA and other organizations such as the American Physical Therapy Association, the American Speech-Language-Hearing Association have been working with Congress on long-term policy solutions to repeal and replace the therapy cap once and for all. The Medicare Access to Rehabilitation Services Act has long demonstrated Congress’s support of fixing this deeply flawed policy. Last year the bill had 238 co-sponsors in the House and 36 co-sponsors in the Senate.

AOTA urges Congress to revisit this important issue before it expires at the end of 2017. This 20 year old policy is outdated. Payment for outpatient therapy services needs to be aligned with recent policies enacted by Congress that focus on providing high-quality, coordinated care.

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