Critical time for Medicare attention

I have tended to take health-care coverage by Medicare for granted. However, inaction at this juncture will bring some needed services to an abrupt halt. Without Congressional action, the therapy cap without exceptions for medical need will go into effect on Jan. 1, 2008, and physical therapists and physicians paid under the Medicare Fee Schedule will be subject to a 10.1 percent reduction in the conversion factor in 2008. These policies will severely impact rehabilitation coverage for Medicare beneficiaries.

Background: Therapy caps authorized by Congress in 1997 have been delayed three times by Congress-approved moratoriums on enforcement. Congress then passed legislation allowing for exceptions for beneficiaries needing care above the financial limit, allowing them to apply for additional medically necessary care—but this expires Jan. 1, 2008.

Therapy caps reduce patients’ choice of providers, require them to pay out-of-pocket for necessary treatment, and delay care. Studies show that the caps discriminate against the most vulnerable Medicare beneficiaries: those who have had a stroke or amputation or who have multiple disabilities.

The House this year approved another two-year moratorium, though current negotiations have stalled. Meanwhile, the Medicare Access to Rehabilitation Services Act (S. 450 and H.R. 748), which would permanently repeal the caps, has 182 cosponsors in the House and 36 in the Senate.

Let’s let our members of Congress know how we feel: Ask them to cosponsor H.R. 748 and S. 450 to repeal the therapy cap and support legislation to prevent cuts in the 2008 physician-fee-schedule payments.

I realize that Medicare needs to be reformed. However, we can avoid crisis now by repealing the therapy cap, and we can prevent serious cuts to providers to ensure that needed rehabilitation services remain available to our seniors.

We’re running out of time.

— Idelle Packer
Physical therapist and daughter of 92-year-old mother
Asheville