The Medicare outpatient therapy cap exceptions process is set to expire on December 31, 2013. Without Congressional action, patients will be faced with a hard cap on outpatient therapy services in 2014. The American Speech-Language-Hearing Association and the Therapy Cap Coalition—a group of almost 50 associations, organizations, and patient and consumer groups—are working together to prevent the therapy cap from going into effect, but we need your help!
Congress has been working on legislation to reform the sustainable growth rate (SGR) formula. Contact your members of Congress today and ask them to include a full repeal of the Medicare therapy cap in the SGR reform legislation or—at the very least—extend the exceptions process. Please write to your members of Congress today.
The SGR formula and the Medicare therapy cap were created together in the Balanced Budget Act of 1997. Since 1997, Congress has repeatedly addressed the SGR formula and the therapy cap together through annual extensions in the SGR/Medicare extenders package. If Congress passes legislation addressing the SGR formula, but does not include a repeal of the Medicare therapy cap, it is likely that patients will face a hard cap on outpatient therapy services in 2014.
For more information on this issue, please visit ASHA's Therapy Cap Advocacy Center or view ASHA's issue brief on the Medicare Outpatient Therapy Cap [PDF]. Please contact Ingrida Lusis, ASHA's director of federal and political advocacy, at firstname.lastname@example.org with questions.