House members urge extension of therapy cap exception

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Members of the House of Representatives are asking Congress to extend the exceptions process for beneficiaries who exceed caps for Medicare-paid outpatient therapy.

"We respectfully request an extension of this exceptions process for a minimum of the 2007 calendar year," 177 members of the House said in a May 30 letter sent to the Ways and Means, and Energy and Commerce committees.

After years of delays and moratoria, the Medicare Part B outpatient therapy caps went into effect in January. But the Deficit Reduction Act, signed by President Bush in February, allowed beneficiaries to request an exception if their therapy exceeds the annual caps — $1,740 for occupational therapy and $1,740 for speech and physical therapy combined. The exceptions process currently is valid only through 2006.

Continuing the exception will allow the Centers for Medicare & Medicaid Services to monitor the implementation of this policy and assist in the development of a long-term alternative to the therapy cap, the letter said. CMS estimated that the exceptions process would allow an estimated 80% of the 800,000 expected to exceed a cap to continue their therapy.