Proposed Therapy Caps could limit therapy services and choice of providers for disabled Medicare Beneficiaries.

The fate of disabled Medicare beneficiaries is in the hands of the U.S. Congress. Our Senators are debating bill S.1, Prescription Drug and Medicare Improvement Act of 2003. The bill as written does not address “caps” on Medicare benefits for outpatient rehabilitation therapy services, specifically Occupational Therapy, Physical Therapy and Speech Therapy.

The caps are slated to go into effect on July 1, 2003. If the caps go into effect patients on Medicare will only have available $1,590 annually for outpatient Occupational Therapy and $1,590 annually for outpatient Physical and/or Speech Therapy, unless they go to a hospital for services. This amounts to an average of just 15 hours of OT, and 15 hours of PT or Speech Therapy.

Without improvement through therapy, individuals may not recover from a disabling condition. Their disabilities will likely persist and, in many cases, may get worse. This chain reaction would create even higher medical costs for Medicare and individuals.

Outpatient therapy caps were first included in an act of Congress in 1997, but have consistently been postponed by congressional action. Last year’s 107th Congress failed to address the caps, which means the caps will go into effect in two weeks unless the current Congress acts quickly.

The House version of the Medicare Bill extends the moratorium on “therapy caps,” but the Senate version does not. While a permanent moratorium on these caps would be ideal, another two-year postponement of the caps would immensely help individuals needing rehabilitation therapy.

I have been in this industry for 25 years and have rarely been as concerned about access to therapy services for Medicare beneficiaries who are disabled or may become disabled.

Our senators should follow the bill passed by the U.S. House of Representatives and include a moratorium on “therapy caps” for outpatient services. The time is now to let senators know that limiting access for essential outpatient therapy for Medicare beneficiaries is not an appropriate “reform.”

Don Harkins
President and CEO

Persons with disabilities will soon have more choices and expanded opportunities when attempting to become employed.

This year nearly 200,000 Missourians who receive supplemental Social Security or Social Security Disability benefits will qualify for Ticket to Work. The Ticket to Work and Self-Sufficiency Program is the centerpiece of new legislation signed by former President Clinton in December 1999. It is a nationwide initiative designed to bring significant positive change to the lives of individuals with disabilities.

This comprehensive national initiative is designed to assist people with the training and support they need to go to work by increasing their choices. SSA beneficiaries with disabilities can access employment, vocational rehabilitation and other support services from public and private providers.

For more information about the Ticket to work initiative visit www.mo-tickettowork.com or cal 1-877-627-3367.