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by Reed Franklin
Two new bills in Congress would bring a final—and welcome—end to the $1,500 Medicare cap that limited beneficiaries’ access to speech-language pathology services. In the Senate, Sen. John Ensign (R-NV) has introduced S. 1394 and, in the House, Rep. Phil English (R-PA) has introduced a companion bill, H.R. 3834.
Many speech-language pathologists recall the havoc created by the cap when it took effect in 1999. What SLPs may not realize is that—unless Congress acts by Dec. 31—the cap will clamp down again at the beginning of 2003.
The Medicare cap is an example of congressional reform gone wrong. The Balanced Budget Act of 1997 imposed the $1,500 cap on therapy services for Medicare patients starting in 1999. Because of a technical glitch in the Medicare law, SLPs had to share a cap with physical therapists, which meant that patients had access only to $1,500 of speech-language pathology and/or physical therapy services each year. Some patients had to choose whether "to walk or talk." Besides depriving patients of needed care, the resulting loss of reimbursement dollars caused pay cuts and job losses for SLPs.
Congress’ misstep prompted vigorous opposition by grassroots groups and lobbyists, and in 1999 Congress voted to place a two-year moratorium on the cap, offering clinicians temporary relief. In 2000, ASHA members and lobbyists convinced Congress to stretch the moratorium another year, through 2002.
With the threat of the cap again on the horizon, however, last year ASHA stepped up efforts to repeal it altogether, and now the effort is in full swing.
"It is vital that Congress repeal the cap before it comes back—which means building support for these two bills in Congress," said Nancy Swigert, a member of ASHA’s Health Care Economics Committee who owns a health care practice. "We need to mobilize ASHA members on this issue to protect the ability of Medicare patients to receive needed care and to preserve jobs."
What You Can Do
Don’t wait—contact your representative and senators now and urge them to cosponsor S. 1394 and H.R. 3834. For contact information and sample letters, visit ASHA's Political Action Center.
Personal contact is even more effective than letters. Members of Congress welcome visits from constituents at their Capitol Hill offices and in their home states, and you can tell your legislators in person how the cap has affected SLPs. To plan an effective visit, see the "how to" package on ASHA’s Web site.
This year, 2002, midterm elections will be held, and voting is essential. ASHA has developed a "Get Out the Vote Campaign," which can be accessed online.
Another important tool for bringing about legislative victories is the ASHA Political Action Committee, ASHA-PAC. Contributions to ASHA-PAC are used to support candidates for office who support professional issues that benefit SLPs and audiologists. ASHA-PAC was an essential tool in passing the cap moratorium and will be vital to the efforts to repeal the cap altogether. ASHA members can learn more about ASHA-PAC online.
For more information about the Medicare cap, ASHA’s legislative efforts, or ASHA-PAC, contact Reed Franklin through the Action Center at 800-498-2071, ext. 4473, or by email at rfranklin@asha.org.
Reed Franklin is the director of ASHA’s Capitol Hill office.
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