Medicare Therapy Caps: Time for a Permanent Fix
Dear Parkinson's Community,
With this session of Congress on track to be the least productive session in history, the Parkinson's community has the opportunity to make an impact on one of the few pieces of legislation that may actually pass. Congress is exploring comprehensive legislation to change the Medicare Sustainable Growth Rate (SGR), which determines how doctors are reimbursed for providing Medicare services. Now is our time to push for a permanent fix to the Medicare therapy caps.
In your own experience, and those of family and friends, you have likely seen firsthand how regular access to therapy services can provide relief to Parkinson's symptoms, ease pain, and enhance daily quality of life. Because a 1997 law limited the amount of outpatient physical, occupational, and speech-language therapy a Medicare beneficiary can receive each calendar year ($1,900 in 2013), Congress created an exceptions process for services deemed medically necessary, which allows people with Parkinson's to continue receiving medically necessary therapy services.
Typically, this "exceptions process" gets extended one year at a time as part of a temporary SGR fix, and if Congress doesn't act, it will expire once again on December 31. But now with momentum shifting to a more permanent solution to Medicare reimbursement, PAN is pushing for a permanent fix of Medicare therapy caps to be included in the final deal. In just over a week, the Senate Finance Committee is scheduled to consider SGR reform legislation, and both the House and Senate are eager to find common ground on a deal to end the cycle of expensive patches to an outdated system.
PAN staff, both independently and as part of broader national coalition on therapy, has been meeting with Congressional leaders to make the case for full repeal of the Medicare therapy caps as part of SGR reform – or at the very least, a permanent extension of the therapy caps exceptions process until a broader legislative solution is reached. While the conversations have been productive, ending years of uncertainty for people with Parkinson's and other chronic diseases will require our best and strongest political capital – you.
We thank you for your dedicated work throughout the year, your enthusiasm, and your personal journeys that inspire us every day.
Amy Comstock Rick
Date originally posted: December 4, 2013.