Will the Cap Return? Medicare Beneficiaries Could Face $1,500 Limit Policy Analysis
Policy Analysis  |   December 01, 2002
Will the Cap Return?
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Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   December 01, 2002
Will the Cap Return?
The ASHA Leader, December 2002, Vol. 7, 1-11. doi:10.1044/leader.PA.07122002.1
The ASHA Leader, December 2002, Vol. 7, 1-11. doi:10.1044/leader.PA.07122002.1
If Congress does not act by the end of this year, the $1,500 Medicare cap will come back with a vengeance—with potentially serious impact on the employment of rehabilitation providers and the availability of services to Medicare beneficiaries.
Bills have been introduced in both the U.S. House of Representatives and the Senate to end the cap, but a new threat has emerged that may make repeal even more of an uphill battle. Unconfirmed reports from Capitol Hill indicate that the Congressional Budget Office may assign a much higher cost estimate to the cap’s repeal than originally anticipated.
“If the cost ‘scores’ rise to the level that’s been reported, it will be much harder to get the legislation passed, since any costs must be somehow offset,” said Reed Franklin, director of ASHA’s Capitol Hill office.
ASHA President Nancy Creaghead stressed the urgency of the need for grassroots action to build support for the House bill (H.R. 3834) and the Senate bill (S. 1394), which would end the cap once and for all.
“The situation is critical. We need immediate and strong advocacy by members with their representatives in Congress,” Creaghead said. “No one wants to see another crisis like that we faced three years ago.”
In 1998—as many speech-language pathologists painfully recall—Congress authorized several “therapy caps” on outpatient rehabilitation services as part of the Balanced Budget Act of 1997. The caps were particularly punitive for SLPs, who, because of a quirk in the law, had to share a single $1,500 cap with physical therapists.
As a result, Medicare beneficiaries who needed both speech-language services and physical therapy had only $1,500 per year for the combined services and often had to decide whether to “walk or talk.”
Public pressure—thanks in large part to advocacy by ASHA members—persuaded Congress to impose a two-year moratorium on implementation of the cap in 1999. That was extended for a third year at ASHA’s urging, but the moratorium will expire at the end of this year.
“Time is running out, and members of Congress need to hear from their constituents as soon as possible,” Creaghead said. “ASHA members need to contact their representatives and encourage consumers to do the same.”
ASHA continues its vigorous lobbying for a repeal of the cap, and is working with professional and consumer organizations concerned about the severe limits on services to people who need them.
“In 1999, we won an important victory through grassroots action,” Creaghead added. “With the possibility of increased resistance to the repeal effort, it would be a shame to be strapped with this punitive cap because we didn’t stand up to be counted.”
To contact your members of Congress, visit http://takeaction.asha.org/asha2/home/ for issues, talking points, and letters that you can personalize and send to your federal legislators.
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December 2002
Volume 7, Issue 12