Capping therapy costs not a good idea

Looking at the upcoming election, healthcare is and will be a hotly debated topic. However, far beyond the presidential race, there is a bill before Congress that will affect many of our lives, yet very few are even aware of the issue.

Did you know that as of July 1, Medicare will "cap" the amount of money its beneficiaries receive for physical, occupational and speech therapy? These "therapy caps" have no clinical basis and only allow for a combined $1,810 for physical and speech therapy per year (beneficiaries are allowed $1,810 for occupational therapy).

As we all know, $1,810 goes quickly in today's world, especially when it comes to healthcare. Unfortunately, Medicare beneficiaries are often the individuals who need the most care.

Let's say you decide to have a knee replacement in January. Now, surgery is done, physical therapy is done, and your "therapy cap" covered all the necessary rehabilitation. What if six months later, you hurt your shoulder while reaching into the back seat of the car? Suddenly, you're paying out-of-pocket for therapy or choosing to ignore the pain.

As a therapist, there is nothing I hate more than being forced to cut a patient's rehab short simply because his or her cap has been met.

So, how does this affect your life? For many of us, it means nothing at this moment in time. However, as we all know, injuries happen, and they happen unexpectedly. Injuries also tend to accumulate over the lifespan, and with a tough economy, paying out-of-pocket for healthcare becomes a real concern.

Presently there is a bill before Congress, the Medicare Access to Rehabilitation Services Act, which would permanently repeal the caps. This legislation has broad bipartisan support in both the House and the Senate and is in the best interest of all Medicare beneficiaries. However, this legislation needs support from you, the public.

In our practice, we find that many Medicare patients are unaware that this cap exists. Well, as they say, knowledge is power. If you have any concerns or questions regarding this matter, please feel free to contact our office at any time. We can also help to put you in touch with your senator or representative so that you can advocate for your rights.

Ben Kingan is a physical therapist at Whitefish Physical, Occupational & Speech Therapy.