Letter to the Editor

Medicare limit restricts therapy reimbursements

Sunday, November 2, 2003

To the editor:

On Sept. 1, Medicare imposed a $1,590 cap on its coverage for outpatient physical and speech therapy services in all settings except hospitals. Anyone who reaches this cap is required to pay out of pocket for needed therapy.

When a person is in a Medicare-certified bed in a skilled nursing facility, he is not permitted to go to a hospital-based clinic and have further therapy paid by Medicare.

If Congress fails to take action, this arbitrary cap could affect thousands of Medicare recipients in the Heartland.

For example, a person living in a skilled nursing facility recovers from a moderate stroke and is finally able to walk independently. Now, two months later, this same person falls and fractures his hip. Released from the hospital after four or five days, he has no money to pay for physical therapy to learn how to walk with his new disability.

Since Medicare demands that providers charge the lowest rate, the facility and therapists are barred from cutting this person a break. Therapy is expensive. The rates are set by Medicare.

I urge everyone who is a Medicare beneficiary or anyone who loves ones to contact your U.S. senator and representative immediately. Tell them to co-sponsor House Resolution 1125 and Senate Bill 569.

These bills give hope to the Heartland's best residents, who happen to be on Medicare, so they won't have to face the difficult and unfair choice of seeking speech or physical therapy.


Rehab Services Manager

Life Care Center of Cape Girardeau

Cape Girardeau