Stop the Therapy Cap

In 1997, Congress passed the Balanced Budget Act, which led to the creation of the sustainable growth rate reform (SGR) formula as well as the Medicare therapy cap. According to the APTA—and Congress—these measures were meant to save money. However, there are some serious flaws in both. As a result, every year, Congress has acted to address said flaws and stop the implementation of a hard cap. (For more information on the therapy cap and how it applies to you, check out this blog.)

This year, Congress hopes to permanently reform the SGR so that they no longer need to perform these annual fixes—and the APTA hopes to convince legislators to include a “full repeal of the Medicare therapy cap” in the 2013 SGR reform package. So why is this so important? Because according to the APTA: “If Congress fixes the SGR formula before the end of the year but does not repeal the cap, it is likely that there will be a hard cap on therapy services in 2014.” In other words, there would be no exception process next year—and we certainly don’t want that.

The good news is that there’s hope. According to the APTA, Representatives Jim Gerlach (R-PA) and Xavier Becerra (D-CA), along with Senators Ben Cardin (D-MD) and Susan Collins (R-ME), introduced the Medicare Access to Rehabilitation Services Act (HR 713/S 367) in both chambers on February 14, 2013. If it passes, this act would permanently repeal the physical therapy, occupational therapy, and speech-language pathology caps.

How can you help? Get involved. The APTA put together a grassroots campaign—backed by fellow members of the Therapy Cap Coalition (a group of almost 50 associations, organizations, and patient and consumer groups)—to ensure that Congress addresses the cap before the end of this year. You can make your support known by:

1. Raising awareness on social media

  • Use the "Stop the Therapy Cap" icon as your Twitter and Facebook profile photos December 2–6. (Icons will be available here in late November.)
  • Use the #StopTheTherapyCap hashtag on Twitter and direct your followers to www.apta.org/StopTheCap on December 2.

2. Sending an email

  • If you’re an APTA Member, go to the Legislative Action Center and click “Take Action” under “Repeal the Medicare Therapy Cap.” From there, follow the instructions.
  • If you’re not an APTA Member, go to the Patient Action Center, complete the form, and click “Send Message.”
  • The APTA suggests personalizing the email and telling Congress how the cap negatively impacts your patients’ lives

3. Meeting with your Congressperson

  • Click the corresponding links to see if your legislator is already cosponsoring HR 713 or S 367.
    • If he or she is, thank him or her for the support.
    • If he or she isn’t, ask him or her to do so, and be sure to bring with you the resource documents that the APTA has made available here. You can also contact the APTA’s government affairs department at advocacy@apta.org before your meeting. The staff there will help you prepare.

In the meantime, follow the APTA (@aptatweets) and WebPT (@webpt) on Twitter for updates and more information on repealing the cap.

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