March 2010 E-Newsletter - Policy Focus

Health Reform

There is a lot of debate right now on the direction that national health care reform will go and it still appears to be uncertain.  The President held a bipartisan health care summit at the White House on February 25.  At the summit, he hoped to discuss additional ideas for making our health care system work better for the American people.  While it is unclear what eventually will come from the summit, and if or when the health reform legislation will be finalized, the Parkinson’s Action Network (PAN) is actively monitoring and working on specific provisions addressed in the Senate and House bills that are of interest to the Parkinson’s community.  The provisions of interest to those with Parkinson’s disease that, as of today, we see a collective interest in addressing include:

  • guaranteeing health care coverage regardless of preexisting conditions;
  • eliminating lifetime and annual caps on health insurance benefits;
  • eliminating therapy caps in Medicare (learn more below);
  • eliminating the Medicare prescription coverage doughnut hole; and
  • creating a new Cures Acceleration Network at the National Institutes of Health to more swiftly move research from the lab into promising new drugs and therapies.  

Regardless of what form health care reform takes in the legislative process, PAN will continue to advocate for these and other provisions that affect the quality of life for those living with Parkinson’s and their families. Stay tuned for updates on these issues as they move forward.

Medicare Therapy Caps

The Parkinson’s community should be aware of an important issue that is affecting many people living with Parkinson’s disease.  As of January 1, 2010, there was a change in Medicare’s therapy caps that could limit outpatient rehabilitation services.  These reimbursement caps apply to outpatient physical therapy, occupational therapy, and speech-language pathology services.

A limit of $1,860 in reimbursement is applied to those who receive outpatient therapy.  Once the limit of $1,860 has been reached, beneficiaries who require additional services in a 12-month period would be responsible for 100% of the cost.  Approximately 13% of Medicare beneficiaries who receive rehabilitation services exceed the arbitrary limit on coverage, yet more than 25% of those with Parkinson’s disease surpassed the cap in 2006.

These caps were first enacted in 1997 but since then, Congress has voted several times to temporarily keep the caps from going into effect.  Congress has not, however, enacted a permanent fix.

Congress has not yet voted to allow exceptions for 2010 and therefore the cap limit went into effect on January 1.  While both the House and Senate versions of health care reform include provisions to extend the therapy cap exceptions, without immediate Congressional action Parkinson’s patients are receiving Medicare reimbursement for up to $1,860 of therapy services in 2010.

This is a priority issue for PAN, as many living with Parkinson’s have already surpassed the arbitrary cap of $1,860 for their rehabilitation services in 2010.  We are working with a coalition of other disease groups that are similarly affected by the cap in Washington, DC to ensure the therapy caps exception process is reinstated as quickly as possible.  In addition, PAN will work to seek a permanent repeal of the therapy cap.  Please stay tuned as we may need your help to ensure this issue is taken care of in a timely manner.  

National Registry for Parkinson’s

Help the Parkinson’s community learn more about Parkinson’s disease by encouraging your Members of Congress to cosponsor H.R. 1362/S. 1273, the National MS and Parkinson's Disease Registries Act!  

We currently know very little about Parkinson's disease, such as how many Americans have Parkinson's or what factors may contribute to developing the disease.  The National MS and Parkinson’s Disease Registries Act will create national Multiple Sclerosis (MS) and Parkinson's disease registries that will measure how many people actually have MS and Parkinson's.  

Data will be collected from existing databases, such as Medicare, Veterans Affairs, state registries, and medical institutions, and coordinated to provide researchers with a better foundation for evaluating and understanding disease factors, such as geographic "hot spots," variances in gender ratio, and changes in disease burden.  Ultimately, better data about Parkinson's disease will help move important research and treatments forward. Learn more.

Help us get this important piece of legislation through Congress by asking your Representative and Senators to cosponsor the National MS and Parkinson's Disease Registries Act. Use the links below to take action!

Take Action on the House Parkinson's Disease Registry Action Alert
Take Action on the Senate Parkinson's Disease Registry Action Alert

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