PAN Works to Extend Exceptions to Medicare Therapy Caps
Ray
Rayilyn Brown
Past Director AZNPF
Arizona Chapter National Parkinson Foundation
From: Diane Wyshak
Sent: Thursday, March 04, 2010 12:07 PM
To: ray ; Dr. Kong ; don reed
Subject: Fw: PAN Works to Extend Exceptions to Medicare Therapy Caps
----- Original Message -----
From: Parkinson's Action Network
To: Diane Wyshak
Sent: Thursday, March 04, 2010 1:07 PM
Subject: PAN Works to Extend Exceptions to Medicare Therapy Caps
PAN Works to Extend Exceptions to Medicare Therapy Caps
Thursday, 04 March 2010-The Parkinson's Action Network (PAN) joined together with other leading patient advocacy and provider groups at a press conference urging Congress to extend exceptions to Medicare therapy caps and ultimately repeal the therapy caps. The press conference was hosted by the Therapy Cap Coalition, of which PAN is a member. John Schall, PAN Deputy Chief Executive Officer, spoke at the press conference, noting the toll the therapy caps have on people living with Parkinson's and other diseases.
"For Parkinson's, therapy is literally a life-saver," said Schall. "We are talking about therapy that both provides invaluable benefits to a patient's way of life and does so in a cost-effective manner."
The Medicare therapy caps are limits on the amount of outpatient physical, speech, and occupational therapy a Medicare beneficiary can receive each calendar year. For 2010, Medicare will cover a combined therapy cap of $1,860 for outpatient physical therapy and speech language pathology services, and a separate cap of $1,860 for outpatient occupational therapy services. Once the limit of $1860 has been reached, beneficiaries who require additional services in a 12-month period are responsible for 100% of the cost. In 2006 Congress created an exceptions process that allows access to medically necessary services without additional costs.
"We are talking about a lot of patients," Schall added. "We estimate a half-million Medicare patients living with Parkinson's, and in 2006, almost 26% of beneficiaries diagnosed with Parkinson's surpassed the cap threshold."
Congress allowed the exceptions process to expire on December 31, 2009 and therefore the cap limit of $1,860 went into effect on January 1, 2010. In a very hard fought victory, on March 2, Congress extended the Medicare therapy cap exceptions process through March 31, 2010 and retroactively to January 1, 2010. Unfortunately, this is only a temporary fix. Additional Congressional action will be needed to ensure that the exceptions process is available to people living with Parkinson's on April 1, 2010 when the current extension expires. PAN will work in coalition for a permanent repeal of the Medicare Therapy Caps.
Please stay tuned for updates as this important issue continues to move forward.
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