Two decades of advocacy comes to fruition
in budget deal providing the nation’s most vulnerable
with access to outpatient Medicare therapy services
BETHESDA, MD (Feb. 9, 2018) — After two decades of advocacy, the American Occupational Therapy Association (AOTA) is rejoicing today that a full repeal of the Outpatient Medicare Therapy Cap was achieved this morning. President Donald J. Trump signed the budget agreement into law just this morning which, among other provisions, in the two-year funding deal includes a repeal of the cap on Medicare outpatient occupational therapy, physical therapy, and speech-language pathology services.
“For 20 years the therapy cap threatened to undermine the health and quality of life of millions of Medicare beneficiaries. Occupational therapy practitioners were faced with the possibility of denying services to those who needed them. This victory is a collective one that brought AOTA members, consumer groups, other providers, and Congress together to find a solution,” said Amy J. Lamb, OTD, OT/L, FAOTA, President of AOTA. “I am grateful that Congress has finally put an end to this flawed policy and would like to thank all of our Congressional champions for their tireless work.”
The repeal came just as some beneficiaries were beginning to hit the $2,010 therapy cap. With the turn of the calendar year, the therapy cap of $2,010 went into effect, and putting more than a million beneficiaries at risk of losing access to essential outpatient Medicare Part B therapy services. Since the passage of the Balanced Budget Act in 1997, consumers have been threatened with a limitation on the amount of occupational therapy, physical therapy, and speech-language pathology they could receive under Medicare Part B. During this time, AOTA has worked alongside the American Physical Therapy Association (APTA), the American Speech-Language-Hearing Association (ASHA), and a broad coalition of consumer and provider organizations to repeal the arbitrary and harmful barrier to care for a wide spectrum of Americans in need of rehabilitation and habilitation services.
AOTA has fought this policy since 1997. A bipartisan proposal was agreed to last fall, following release of AOTA’s study on the positive impact of medical review over the past several years. The data showed patients were still receiving therapy even at the highest levels, yet costs were going down. Because of this information, the cost for a full repeal went down substantially, making the path to repeal more open.
Nationwide, more than 213,000 occupational therapy practitioners help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Legislation supporting access to occupational therapy and other rehabilitation services can reduce overall health care costs by facilitating independence among patients. A 2016 independent study found that occupational therapy reduces hospital readmission and costs to patients.
For more news on how the therapy cap repeal affects occupational therapists and assistants, visit www.aota.org.
Founded in 1917, AOTA represents the professional interests and concerns of more than 213,000 occupational therapists, assistants, and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations, and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential. For more information, visit www.aota.org.
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