Eye On Physical Therapy
Commentary By Dr. Tim Rohrs, DPT
In addition to providing treatment to patients, health care providers are often needed to be patient advocates. Those that have the privilege of treating patients, also have the responsibility to lobby the powers that be, on our patient's behalf. Often, our elderly are our most vulnerable population health wise, and don't have the knowledge or savvy to access up-to-the-minute information available on the Internet.
The Balanced Budget Act of 1997 imposed an arbitrary monetary limit on the amount of physical therapy, occupation therapy and speech therapy a senior can have. This legislation was originally adopted by Congress in order to save money. Since then, Congress has acted to prevent implementation by passing several moratoria. This past year, 2006, was the first full year that the cap was implemented. I cannot speak to the efficacy in saving the system money, but I can attest to the fact that this legislation has had a profound detrimental effect on the health function of our elderly in the Rockaway community.
Currently, the cap is $1,780. For physical therapy, this money is shared with speech therapy. Depending on the therapy needed this could amount to a total of between 18 and 22 visits. If the patient is receiving both physical and speech therapy, then each profession gets about nine visits. Generally, patients are seen two to three times per week. So out of 52 weeks per year a person who has suffered a stroke has three weeks to get better. When the cap is reached they are cut off from benefits. They then have to pay out of pocket. As you can probably guess the vast majority of elderly cannot afford to pay this.
This cap affects our elderly in a most hideous fashion. I am sure most would agree that some conditions are worse than others. Those that have suffered a stroke and can no longer walk need extensive therapy. They usually have speech impediments, and limitations in using their hands for fine motor skills. It is the patient with the worst condition that needs the most therapy and they are the ones that this cap hurts the most.
Senators John Ensign (R-NV), Blanche Lincoln (D-AR), Ben Cardin (D-MD), and Susan Collins (R-ME) and Representatives Xavier Becerra (D-CA, 31st), Phil English (R-PA, 3rd), Mike Ross (D-AR, 4th), Chip Pickering (R-MS, 3rd), and Roy Blunt (R-MO, 7th) introduced legislation, The Medicare Access to Rehabilitation Services Act of 2007 (S.450/H.R.748), to repeal the financial limit or "therapy cap" on Medicare outpatient physical therapy benefits. If this legislation is successful, the cap on benefits would end. Patients that need treatments the most will be able to get better. I urge you to contact Senators Clinton and Schumer and Congressman Weiner to support this legislation. You can call or write them to let them know you expect their support for this bill. You can also stop by Sands Point Physical Therapy on Beach 102 Street, to sign a pre-printed letter and I will mail them all together. You do not need to be elderly or on Medicare to support this legislation. You just have to care.