Since Congress failed to act, a hard Medicare therapy cap returned on Medicare beneficiaries. In 1997, Congress passed the Balanced Budget Act, which created an annual financial limit on physical therapy and speech-language pathology services, and a separate “cap” on occupational therapy, for all outpatient settings except hospitals. Since 1997, Congress has acted 16 times to prevent implementation of the cap, including the 2006 creation of an exceptions process allowing patients to receive medically necessary services exceeding the annual cap amount. Historically, Congress has passed short-term extensions of the therapy cap exceptions process along with the sustainable growth rate (SGR) extension. In 2015 the therapy cap exceptions process received an extension through December 31, 2017, but Congress did not pass any extension beyond that.
Recently the Congressional Committees that handle healthcare agreed to a bipartisan, bicameral policy that would permanently repeal the hard cap on therapy services. This policy will protect patients, provide better care, and allow physical therapists to treat their patients at a higher level. This policy was not passed, and a hard cap on therapy services went into effect on January 1, 2018.
Ask your Members of Congress to immediately repeal the hard Medicare Therapy Cap on February 8th once and for all. Click here for a link to the Patient Action Center. Thank you for your help.