Therapy Cap Extension Expiring End of February: Contact Congress Now
By Stephanie Yamkovenko
Update: Congress has one more month to address the Medicare therapy cap. It is important for occupational therapy practitioners to contact their legislators asking them to extend the exceptions process to the therapy cap. Take action now. The current extension will expire on March 1.
The end of 2011 was more partisan than usual—with Democrats controlling the Senate and Republicans controlling the House. Despite Congress having a 9% approval rating, neither party seemed willing to compromise on important legislative issues, resulting in a lawmaking gridlock.
One of those important issues affects occupational therapy practitioners and the clients we serve. The Medicare therapy cap sets an arbitrary limit—$1,880 a year in 2012—on the amount of occupational therapy a Medicare beneficiary can receive, putting the government between the patient and the health care provider. For more than 5 years, the American Occupational Therapy Association (AOTA) has advocated successfully for an extension to the therapy cap exceptions process, which allows beneficiaries with certain conditions to exceed the therapy cap limit.
The exceptions process to the therapy cap was set to expire on December 31, 2011. The House passed a bill with a 2-year extension in December, but the Senate decided instead to pass a short-term extension for 2 months to allow for more time to deliberate on the issues in 2012. Following intense political wrangling, the House finally agreed on the 2-month extension, days before Christmas. President Obama signed the bill into law, and the exceptions process to the therapy cap will now expire on March 1, 2012.
If Congress does not act before the deadline, hundreds of thousands of Medicare beneficiaries will not have access to the therapy they need. In coalition with the American Physical Therapy Association (APTA) and the American Speech-Language-Hearing Association (ASHA), AOTA will be meeting with House and Senate committees to urge Congress to act soon, before the cap exceptions process expires.
AOTA needs every member to contact their legislators and urge them to take action to address the cap before March 1. Occupational therapy practitioners can take action now by visiting the Legislative Action Center for materials and form letters to send to Congress.
“Every practitioner can be affected by the therapy cap—no matter your work setting or whether you treat Medicare clients,” says AOTA Director of Federal Affairs Tim Nanof. “Private and public payers use Medicare as a model for payment, and every occupational therapy practitioner should advocate for repealing the cap or extending the exceptions process so clients can receive the care they need.”
Stephanie Yamkovenko is AOTA’s staff writer.
December 2011 Cap History
The situation in Washington changed quickly during December. See below for the history.
December 23, 2011
Both the House and Senate have approved an extenders package that includes a 2-month extension of the therapy cap exceptions process and SGR "doc fix." Current indications are that discussions will resume in January regarding a long-term solution for both the caps and SGR.
December 20, 2011
House Republicans voted today to block the Senate’s short-term 2-month extension of the Medicare therapy cap exceptions process. The House is trying to force a conference committee with the Senate, which has already adjourned as of Saturday. House Republicans claim the Senate’s 2-month extension bill is bad policy and that a decision on the impending cuts should be made before Congress adjourns for the holidays. Once again, this leaves the issues of the Medicare therapy cap exceptions process and the physician fee schedule fix unresolved and set to expire on December 31, 2011.
December 19, 2011
Instead of passing the House bill, which included a 2-year extension of the Medicare therapy cap exceptions process, the Senate passed a short-term 2-month extension of the cap fix and physician fee schedule fix to buy more time to deliberate on the issues and allow congress to recess for the holidays. Despite bipartisan support in the Senate, the House republicans rejected the Senate’s short-term fix and will not vote on the bill. Unfortunately, the political wrangling means the issue of the Medicare therapy cap is still in flux.
December 16, 2011
Congressional action on the Medicare therapy cap remains in flux. Discussions in the Senate include a 2-year extension, 1-year extension, or the possibility of a short-term 2-month extension to the Medicare therapy cap and the physician fee schedule fix.
December 14, 2011
The U.S. House of Representatives passed a bill that would extend the exceptions process to the Medicare therapy cap for 2 years. Also in the bill is a 2 year physician fee schedule fix. Of the dozen or so other Medicare extenders that will expire at the end of 2011, the Medicare therapy cap exceptions process was the only one to receive a 2-year extension in the House bill, thanks to your advocacy and AOTA’s legislative efforts. The House bill passed mainly on party lines, with a handful of Republicans and Democrats voting against their respective parties. AOTA is waiting on the U.S. Senate to address the bill (either with amendments or with their own proposal) and then President Obama’s signature, which all needs to happen before December 31.
December 12, 2011
The U.S. House of Representatives will vote on a bill Tuesday, December 13, that would extend the exceptions process to the Medicare therapy cap for 2 years. Also in the bill is a 2 year physician fee schedule fix.