Senators propose stop-gap measure on implementation of Medicare Part B therapy caps

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HHS Secretary Kathleen Sebelius
HHS Secretary Kathleen Sebelius

One bipartisan group of senators is petitioning Department of Health and Human Services Secretary Kathleen Sebelius to postpone implementation of the cap on Medicare Part B outpatient therapy reimbursements.

Sens. Chuck Grassley (R-IA), Blanche Lincoln (D-AR) and John Ensign (R-NV) sent a letter to Sebelius this week asking her to delay the onset of the caps. The limit on reimbursement for outpatient speech and physical, occupational therapy went into effect on Jan. 1 after the exceptions process expired. A provision that would extend the exceptions process is contained in the stymied healthcare reform bill. The limit for this year is $1,860 for speech and physical therapy combined, and $1,860 for occupational therapy.

The senators argued that the reimbursement limits are already affecting access to rehab services. One national provider has reported that more than 4,000 patients are expected to hit the cap by Feb. 28, 2010, the senators wrote. In a statement, the American Health Care Association noted that it has already received reports of beneficiaries with severe rehabilitation needs exceeding the financial caps. Senate Finance Committee Chairman Max Baucus (D-MT) may be drafting a bill to address the therapy cap exemption and other similar programs that expired on Jan. 1, The Hill newspaper reported.


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