Is this the year therapy caps finally get repealed? Probably not

Share this content:
John O'Connor
John O'Connor

Earlier this week, we saw lawmakers again take aim at Medicare's outpatient therapy caps.

Sens. Ben Cardin (D-MD) and Susan Collins (R-ME) introduced the latest incantation of the Medicare Access to Rehabilitation Services Act in the Senate. Reps. Jim Gerlach (R-PA) and Xavier Becerra (D-CA) did the honors in the House.

Provider groups predictably lauded the effort. Rightfully so. Therapy caps are a dubious idea that ought to be given a decent burial. But it's a rare barnacle that can cling better.

The trouble started nearly a decade and a half ago, when the Balanced Budget Act of 1997 imposed a $1,500 cap on outpatient therapy services. While the numbers have been tinkered with a bit over the years, therapy caps have given “chronic condition” a whole new meaning.

But it's not like legislators have been reluctant to take aggressive, fruitless action:

·      In 2001, Sen. John Ensign (R-NV) introduced the first Medicare Access to Rehabilitation Services Act, which also attempted to repeal the cap. Went nowhere.

·      The next year, Reps. Phil English (R-PA), Roy Blunt (R-MO), Frank Pallone (D-NJ), and Ben Cardin (D-MD) did the same. Went nowhere.

·      In 2003, Ensign and Sen. Blanche Lincoln (D-AR) introduced a measure bearing an identical title in the upper chamber. Companion House legislation was delivered by English, Cardin, Blunt and Pallone. We seem to be in full-blown trend mode.

·      In 2005, legislation to repeal the therapy caps was introduced by English in the House and Ensign in the Senate. Again, nothing changed.

·      In 2007, 2009 and 2011, the same legislation was put forth again. Care to guess what happened?

If you are among the few hopefuls who think this is the year therapy caps finally meet their match, feel free to bask in that opinion. But wagering on such an outcome might not be a good idea.


Next Article in Daily Editors' Notes

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.