Regulatory Action

If you thought the rehabilitation therapy caps were behind us, think again. They were hiding under the cloak of a "moratorium" for two years. Scheduled to be implemented 01/01/06, we are actively working to eliminate this arbitrary ceiling on rehab services.

To understand the need for legislative Action, we should look at the history of the therapy caps:
- The first cap (circa 1999) was for $900.00. The 2006 version is double that amount, $1,750.00.
- There have been two implementations of the caps; both times the implementation has been stopped through legislative actions.
- Today, there are close to 150 co-sponsors of legislation to repeal the caps in the US House and close to 50 US Senators who are doing the same.

What 2006 will look like is unknown but we have very good reason to believe that the legislated therapy caps will look different than they do today if they are there at all!

What can you do?

You can help eliminate this arbitrary ceiling for rehabilitation of Medicare Beneficiaries by communicating with your legislators. Contact your Representatives and Senators to urge support for these Congressional bills: H.R. 916 and S. 438. By cosponsoring these Bills, legislators become instrumental in providing rehabilitation therapy to Medicare's frailest beneficiaries. There are several methods to communicate with legislators:

Send a letter to your Representatives and Senators.
Call your Representatives or Senators' offices in Washington DC
Call your Representatives or Senators in their state offices.
Visit your Representatives and Senators.
Send a letter-to-the-editor of your local newspaper.

Talking Points

Unfortunately, the caps will become effective on January 1, 2006 if Congress fails to act now Below are some points to include in your communication and form letters you may use:

The caps on therapy services discriminate against the oldest and sickest Medicare beneficiaries. The beneficiary caps bear no relationship to patients' medical and clinical needs for therapy services, simply cutting off care when it reaches the now estimated $1,750 mark. The caps are insensitive to patients suffering from acute diseases or injuries, or patients who have multiple injuries or diseases in a single year.
Absolute dollar limits on outpatient rehabilitation services are unnecessary. All outpatient rehabilitation services are now being paid according to the Medicare physician fee schedule.
Approximately 14-17% of senior citizens who are in the greatest need for rehabilitation services would be forced to decide between forgoing such care and paying 100% of the cost out-of-pocket. Beneficiaries who suffer from a stroke, hip fracture or have Parkinson's disease or osteoporosis are most likely to require access to rehabilitation services. It is unfair to make them pay more just because they are sicker.
Congress has already recognized the problems posed by the beneficiary caps. It has imposed a moratorium (stopped implementation) on the caps three times:
- In 1999, it placed the caps under a two-year moratorium.
- In 2000, Congress extended the moratorium by one additional year.
- After a brief implementation of the caps, in the Medicare Prescription Drug, Modernization, and Improvement Act of 2003, Congress extended the moratorium until December 31, 2005.

Download and Print Letters to Legisltators

You may also download and print the following letters to mail to your legislators. Feel free to use them as they are, or customize them with personal experience or some of the talking points listed above. Use the links (below) to determine where to send these letters.

Contact Information

To call by phone:

White House - (202) 456-1414
Congressional Switchboard - (202) 224-3121

To e-mail the President

president@whitehouse.gov

To e-mail a Senator

Go to http://www.senate.gov
Click on "Senators"
Select the appropriate state
Click on the Senator's e-mail address

To find a Representative's e-mail address

Go to http://www.house.gov
Click on "Member Offices" on the right-hand side of the screen, then click on the Congressperson's name
Fill out the required information, then write your text message
Hit "Submit" when you are finished.