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Patient groups want Medicare therapy exceptions extended

NEWS IN BRIEF — Posted Dec. 17, 2012

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Patient advocacy organizations are urging Congress to extend a process for avoiding Medicare therapy service caps in 2013.

The entitlement program covers physical, occupational and speech-language therapy treatments, but it caps the benefits at $1,880 for occupational therapy and a combined $1,880 for physical and speech therapy services each year.

Since 1997, Congress has adopted temporary therapy law exceptions that extend Medicare coverage beyond the annual limits when doctors say the additional care is needed, but the exceptions process will expire Dec. 31 if lawmakers don’t extend it again. About 20% of Medicare beneficiaries exceed the caps each year.

“The health of hundreds of thousands of seniors and individuals with disabilities who rely on Medicare for therapy services is in jeopardy if Congress does not act before Dec. 31,” said Sue Nelson, vice president of federal advocacy at the American Heart Assn.

Nelson joined officials representing the Arthritis Foundation, the Brain Injury Assn. of America, Easter Seals, the Parkinson’s Action Network, the National Multiple Sclerosis Society, the National Stroke Assn. and the United Spinal Assn. in calling on Congress to extend the cap exceptions process through 2013.

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