(ROCKVILLE, MD – Nov. 25, 2003) The American Speech-Language-Hearing Association (ASHA) is pleased that Congress included a two-year moratorium on Medicare outpatient therapy caps, commonly called the $1500 cap, and reversed a substantial decrease in the Medicare fee schedule as part of the Medicare prescription drug bill that passed the Senate today. The bill passed the Senate by a 54-44 vote margin and the House passed the bill by a 220-215 vote margin over the weekend. President Bush has indicated he will sign the legislation into law.
“This is a big win for everyone involved in providing rehabilitation to Medicare patients, but most importantly to the patients themselves,” said ASHA president Glenda Ochsner, Ph.D., CCC-SLP. “This would not have been possible without sustained advocacy by ASHA and its members.”
The bill as passed by Congress contains a two-year (2004-2005) moratorium on Medicare outpatient therapy caps. The legislation also suspends the current year's (2003) caps upon becoming law. The Medicare legislation additionally requires previously mandated reports on alternatives to the single annual dollar cap for outpatient therapy to be submitted to Congress by the end of March 2004. Congress also requested the General Accounting Office (GAO) to develop criteria for identifying conditions or diseases that could be granted a waiver from the therapy caps by October of next year.
The Medicare outpatient beneficiary caps on rehabilitation therapy took effect on September 1, 2003, after twice being placed under a moratorium by Congress since 1999. During this process, the cap was raised to $1,590. These $1,590 beneficiary caps on speech-language pathology and physical therapy care combined and occupational therapy would have made it very difficult for seniors to receive the appropriate care once they reached the monetary cap on their therapy services.
“There is still a lot more work ahead as we seek a permanent solution to the cap,” said Ochsner.
The American Speech-Language-Hearing Association (ASHA) is the national professional, scientific, and credentialing association for more than 110,000 audiologists, speech, language pathologists, and speech, language, and hearing scientists. Audiologists specialize in preventing and assessing hearing disorders as well as providing audiologic treatment including hearing aids. Speech-language pathologists identify, assess, and treat speech and language problems including swallowing disorders.
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