ASHA Urges Congress to Take Immediate Action to Repeal Therapy Caps That Would Threaten Health of Medicare Patients Beginning January 1

Association Joins Other Leading Organizations in Calling for Permanent Solution to Arbitrary Caps That Limit Access to Necessary Rehabilitation Services for Stroke and Other Conditions

December 15, 2017

(Rockville, MD)  In a letter sent to U.S. House and Senate leaders today, the American Speech-Language-Hearing Association (ASHA) and 25 other leading health and consumer organizations implored Congress to take action before the end of 2017 to prevent outpatient therapy caps that would limit treatment options for millions of Medicare beneficiaries from going in to effect.

The groups, which make up the Therapy Cap Coalition, represent the concerns of Medicare beneficiaries as well as health care professionals and providers. 

ASHA strongly supports a full repeal of the Medicare Part B outpatient therapy caps, which restrict access to vital outpatient rehabilitative services in settings such as skilled nursing facilities, rehabilitation hospitals, and clinics. For 2018, the therapy cap is $2,010 for speech-language pathology and physical therapy services combined.

Under the cap, Medicare beneficiaries who suffer from speech-language disorders due to life-altering events—such as a stroke, head injury, Alzheimer's, or Parkinson's disease—risk being denied therapy and/or being forced to pay out of pocket for services to help them regain their ability to communicate effectively. Repealing the Medicare therapy cap would ensure high-quality, medically necessary treatment and remove the uncertainty of care for both therapy providers and recipients.

"The health and quality of life of millions of Americans is at stake if Congress does not take immediate action to stop the therapy cap from becoming reality starting January 1," said ASHA 2017 President Gail Richard, PhD, CCC-SLP. "For 20 years, Congress has taken temporary measures to prevent this dangerous policy from being enacted, but we are now at a critical juncture—with patients at serious risk."

Bipartisan efforts in the House Ways and Means Committee, House Energy and Commerce Committee, and Senate Finance Committee have achieved a policy that would permanently end arbitrary limits on beneficiary access to necessary physical therapy, occupational therapy, and speech-language pathology services. After 20 years, permanent repeal would ensure that beneficiary access to necessary therapy services would continue. These committees have worked with beneficiaries, health professionals, providers, and consumer advocacy groups to realize this substantial achievement.

At a minimum, the Coalition asks that the House and Senate include language in the upcoming Continuing Resolution to ensure that a short-term gap of coverage does not occur until a permanent solution can be enacted. 

Read the full letter

About the American Speech-Language-Hearing Association (ASHA)

ASHA is the national professional, scientific, and credentialing association for 191,500 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. Audiologists specialize in preventing and assessing hearing and balance 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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