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In a letter to Congress as of late, greater than 40 organizations representing sufferers, well being care suppliers, and advocates joined the American Bodily Remedy Affiliation (APTA) in urging individuals of Congress to increase the Medicare treatment cap exception procedure past 2006.The present monetary caps are set at $1,740 for bodily treatment and speech language pathology mixed and $1,740 for occupational treatment.

With out motion by way of Congress, the exceptions provision followed as a part of the Deficit Aid Act of 2005 (permitting Medicare beneficiaries desiring care above the capped quantity to use for exceptions) will expire on December 31, 2006. This is able to depart many senior electorate and other people with disabilities who want bodily treatment care essentially the most going through a call between forgoing essential care or paying one hundred pc out of pocket when their Medicare protection runs out.

“The treatment cap discriminates in opposition to Medicare beneficiaries who’re in essentially the most want of bodily therapist services and products,” stated APTA President R Scott Ward, PT, PhD. “Knowledge display that sufferers with stroke, hip fracture, Parkinson’s illness, and different stipulations that require intensive rehabilitation are in all probability to be suffering from the Medicare treatment caps.” He added, “Whilst regulation repealing the treatment caps would resolve this downside as soon as and for all, permitting the exceptions procedure to proceed past 2006 will lend a hand give protection to Medicare beneficiaries from the consequences of a treatment cap, even though this is a temporary answer. We urge the Area and Senate leaders to behave at the treatment caps this 12 months.”

Regulation to fully repeal the treatment caps, The Medicare Get admission to to Rehabilitation Products and services Act of 2005 (HR 916/S 438), has robust bipartisan fortify in each the Area and the Senate. Senators John Ensign (R-NV) and Blanche Lincoln (D-AR) presented the Senate regulation and Representatives Phil English (R-PA), Ben Cardin (D-MD), Roy Blunt (R-MO), and Frank Pallone (D-NJ), presented the Area regulation.

“It might be irresponsible to set an arbitrary cap on how a lot treatment a Medicare beneficiary can obtain. The Medicare outpatient treatment cap ignores the well being wishes of our senior inhabitants — particularly the oldest and sickest. Remedy is an important for the a success rehabilitation of seniors affected by stipulations equivalent to stroke, Parkinson’s illness and congenital middle failure. No matter limits are put on their treatment choices also are put on their possibilities for restoration. If Congress fails to behave this 12 months, the arbitrary treatment caps will go back on January 1, 2007, and can lead to limited get admission to to rehabilitation services and products,” stated Senator John Ensign (R- NV).

“The treatment cap is arbitrary to our maximum inclined seniors and disabled American citizens,” Senator Blanche Lincoln (D-AR) stated. “I’ve supported entire repeal of the treatment cap because it used to be first enacted. Whilst repealing the arbitrary caps is the most suitable choice, extending the present exceptions procedure past 2006 will give protection to Medicare beneficiaries from the arbitrary treatment caps returning on January 1, 2007.”

“For just about a decade, the similar toxic coverage has haunted the long-term well being of The us’s oldest and frailest seniors,” stated Rep. Phil English (R- PA). “If Congress does no longer act this 12 months, seniors will likely be left to undergo the brunt of an unfair monetary burden related to required treatment services and products. By means of extending the present exceptions procedure we will be able to be certain seniors’ rehabilitative wishes will likely be met with out proscribing care to an arbitrary price ticket.”

“Whilst the exceptions procedure has no longer been highest, as soon as the system faults were corrected, it could actually function a viable possibility to supply beneficiaries get admission to to wanted services and products. There are fewer than 60 legislative days ultimate this 12 months, and advised consideration to this subject is needed. By means of extending the exceptions procedure no less than via 2007, seniors who’ve advanced stipulations will have the ability to get essential care. Congress nonetheless must paintings with the Management to increase a long-term selection to treatment caps,” stated Rep. Benjamin L. Cardin (D-MD).

The rehabilitation coalition contains: American Academy of Bodily Drugs and Rehabilitation, American Academy of Neurology, Alzheimer’s Affiliation, American Affiliation of Houses & Products and services for the Getting old, American Affiliation on Psychological Retardation, American Dance Remedy Affiliation, American Well being Care Affiliation, American Middle Affiliation/American Stroke Affiliation, American Scientific Administrators Affiliation, American Scientific Rehabilitation Suppliers Affiliation, American Song Remedy Affiliation, American Community of Group Choices and Assets, American Nurses Affiliation, American Occupational Remedy Affiliation, American Bodily Remedy Affiliation, American Speech-Language and Listening to Affiliation, American Healing Sport Affiliation, Amputee Coalition of The us, Arthritis Basis, Mind Damage Affiliation of The us, Catholic Well being Affiliation of america, Middle for Medicare Advocacy, Inc., Christopher Reeve Basis, Easter Seals, HealthSouth, Nationwide Affiliation for the Improve of Lengthy Time period Care, Nationwide Affiliation of Councils on Developmental Disabilities, Nationwide Affiliation of Administrators of Nursing Management/LTC, Inc., Nationwide Affiliation of Rehabilitation Suppliers and Businesses, Nationwide Affiliation of Social Employees, Nationwide Affiliation of State Head Damage Directors, Nationwide Council for Group Behavioral Healthcare, Nationwide Incapacity Rights Community, Nationwide A couple of Sclerosis Society, Nationwide Rehabilitation Affiliation, Nationwide Rural Well being Affiliation, Nationwide Stroke Affiliation, Parkinson’s Motion Community, Energy Mobility Coalition, The Arc of america, United Cerebral Palsy and United Spinal Affiliation.

The American Bodily Remedy Affiliation is a countrywide skilled group representing greater than 65,000 individuals. Its purpose is to foster developments in bodily treatment apply, analysis, and training. The textual content of the letter despatched to Senate Majority Chief Frist, Senate Finance Committee Chairman Grassley, Speaker Hastert, Area Tactics and Way Committee Chairman Thomas and Area Power and Trade Committee Chairman Barton follows:

Expensive Congressional Leaders:

As , those caps had been put on outpatient bodily treatment, occupational treatment, and speech language pathology services and products as a part of the Balanced Funds Act of 1997. Since this time, Congress has acted 3 times to put a moratorium at the treatment caps. Those caps went again into impact on January 1, 2006. Thankfully, below your management, Congress handed regulation as a part of the Deficit Aid Act of 2005 that equipped beneficiaries with a clinically based totally exceptions procedure to this monetary limitation on rehabilitation services and products below Medicare. The exceptions procedure seems to be running neatly to make sure suitable get admission to to wanted rehabilitation services and products in a fiscally accountable way.

For the reason that Deficit Aid Act licensed the exceptions procedure just for 2006, we respectfully request an extension of this exceptions procedure for at least 2 further years. This may occasionally permit the Facilities for Medicare and Medicaid Products and services to proceed to observe the implementation of this coverage and help within the building of a long-term selection to the treatment cap. We respect your attention of this request to increase the exceptions procedure past 2006 for at least 2007 and 2008.

On behalf of the undersigned affected person, supplier, and well being care trade organizations, we write to request your complete attention of the desire for passage of regulation in 2006 to deal with the Medicare outpatient treatment caps. Within the 109th Congress, regulation to repeal the caps has received the fortify of greater than 40 individuals of america Senate and greater than 250 individuals of america Area of Representatives. If Congress fails to behave this 12 months, the arbitrary treatment caps will go back on January 1, 2007, and can lead to limited get admission to to rehabilitation services and products and a shift in sufferers and prices to inpatient settings.