Update on Medicare Therapy Caps and ADA Restoration Act

MS Exceptions Set to Expire on Medicare Therapy Caps
Rehabilitation therapy under Medicare might no longer be affordable for some people living with multiple sclerosis and other conditions. The exceptions process to Medicare's arbitrary reimbursement limits, or therapy caps, on rehabilitation services is set to expire on December 31, 2007.

MS activists have long been determined to eliminate Medicare therapy caps altogether on reimbursement for physical therapy (PT), speech language pathology, and occupational therapy (OT) services. In 2008, the therapy cap reimbursement level is scheduled to be $1,810 for PT and speech therapy, and a separate cap of $1,810 will apply to OT services.

To help alleviate the burden, Congress instituted a process for exceptions that allow beneficiaries to apply for therapy services through Medicare above the current dollar cap. MS currently has an automatic exception, making it easier for people with MS and their healthcare providers to continue therapy without interruption. But without Congressional action, the therapy cap exceptions will be eliminated, further complicating and limiting necessary therapy services.

On November 6, Congressman Earl Pomeroy (ND) introduced the Long Term Care Quality and Modernization Act (H.R. 4082). Part of this bill (Section 108) seeks to extend the therapy caps exceptions process through December 31, 2009.

In addition, the Medicare Access to Rehabilitation Services Act (S. 450/H.R. 748) seeks to repeal the permanent therapy caps altogether — the best long-term solution. However, if the therapy caps cannot fully be repealed, then it is imperative to extend the exceptions process in the short term. We will keep you posted as this issue moves forward in Congress.


Have Your Legislators Co-Sponsored the ADA Restoration Act Yet?
During the past year, the Society and MS activists nationwide have supported the ADA Restoration Act (H.R. 3195/S. 1881) introduced by Representatives Steny Hoyer (MD) and James Sensenbrenner (WI), and Senators Tom Harkin (IA) and Arlen Specter (PA). This bill seeks to restore the protections and intent of the landmark Americans with Disabilities Act (ADA), as passed by Congress in 1990 with regard to disability discrimination and employment.

The House bill has 235 bipartisan co-sponsors, which is more than half of all the members of the House of Representatives. Click here to see whether your Representative is a co-sponsor. The ADA Restoration Act will help restore protections for people living with MS and other disabilities. People living with MS manage their symptoms with medication to help prevent or ease their disability. But that can sometimes make them appear too functional and could preclude them from ADA protections. Despite the ADA's intent to create a level playing field in the workplace, the full promise of the law has never been fulfilled.

The Senate bill still needs more support. Senators Harkin, Specter, and Edward Kennedy (MA) are the only sponsors so far. Take action. Click here and enter your ZIP code to urge your Senators to co-sponsor this important legislation on disability rights.