Washington, DC – The American Health Care Association (AHCA) praised Senators Chuck Grassley (R-IA), Blanche Lincoln (D-AR), and John Ensign (R-NV) for their 
letter to Health & Human Services (HHS) Secretary Kathleen Sebelius, which asks the Secretary to impose an administrative delay on implementation of the financial cap on Medicare Part B outpatient therapy services. The arbitrary cap of $1,860 for either physical and speech language therapies combined, or occupational therapy alone, went into effect on January 1, 2010.
“Our provider community appreciates the efforts of Senators Grassley, Lincoln, and Ensign, especially since the high-acuity patients we care for – like those recovering from strokes or joint replacement surgery – need significant therapy services to improve their functioning and return home,” remarked AHCA President & CEO Bruce Yarwood.
The Senators’ letter to Secretary Sebelius reads in part:
At this point in time, Congress has not passed a comprehensive health reform bill. And, certain extender provisions, including the extension of therapy caps exceptions process have been stalled….
We are concerned that implementation of the Medicare outpatient therapy caps is causing undue hardship on Medicare beneficiaries, particularly for those who are recovering from a stroke or a debilitating injury such as a hip or joint fracture. We have already received reports that beneficiaries with severe rehabilitation needs have already exceeded the financial caps. In fact, one national provider has reported that as of February 1, 2010, approximately 1 050 of its patients across the country will hit the caps. This number is expected to grow to more than 4000 patients by February 28, 2010. We are concerned that implementation of the therapy caps could result in longer lengths of stay and a shift in patients and costs to inpatient settings.”
“Patients’ care needs are not arbitrary; so, it is unfortunate that the present statute capping therapy services is not only arbitrary, but based on cost, not care considerations,” continued Yarwood. “Senators Grassley, Lincoln, and Ensign understand this distinction.”
AHCA thanks the three Senators for proposing this stop-gap measure, and looks forward to legislation that will immediately reinstate the exceptions process and ensure Medicare beneficiaries’ continued access to needed patient therapy.