Help Stop the Medicare Cap on Physical Therapy
Medicare Therapy Cap
This legislation would repeal a provision of the Balanced Budget Act (BBA) of 1997 that placed an annual financial limitation on rehabilitation services under Medicare.
As part of the Deficit Reduction Act (DRA) in 2006, Congress passed legislation implementing the therapy caps but authorizing the Centers for Medicare and Medicaid Services (CMS) to create and employ an exceptions process to permit medically necessary physical therapy, occupational therapy, and speech language pathology services above cap levels as long as services met specified diagnostic and clinical criteria.
December 15, 2010, President Obama signed Senate Amendment to HR 4994, the Medicare and Medicaid Extenders Act of 2010. This legislation extended the therapy cap exceptions process until December 31, 2011.
On April 14, 2011, Congressmen Jim Gerlach (R-PA) and Xavier Becerra (D-CA) in the House of Representatives and Senators Ben Cardin (D-MD) and Susan Collins (R-ME) introduced The Medicare Access to Rehabilitation Services Act (HR 1546/S 829). This legislation will repeal the cap on therapy services for Medicare beneficiaries once and for all. If Congress does not take action by December 31, 2011, a hard therapy cap will again be imposed on Medicare-covered physical therapy, occupational therapy, and speech language pathology services.
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