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Action Alert

• Historic Day in Connecticut
• Medicare Therapy Cap Legislation Update
• Change to Medicare Reimbursement Ruling
• Virginia: Statewide Legislation Addressing Lymphedema Treatment Passes
• Women's Health and Cancer Rights Act (WHCRA)

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Medicare Therapy Cap Legislation Update

A one-year moratorium on implementation of the Medicare therapy caps is one of the physical therapy provisions included in legislation (H Con Res 95) passed by the Senate Finance Committee October 25 by a vote of 11 to 9.

The full Senate and House will need to take action before the caps go into effect on January 1 because the current therapy cap moratorium is set to expire December 31, 2005.

Current law provides for two caps on rehabilitation benefits, one for physical therapy and speech therapy and one cap for occupational therapy. Without action by Congress, many beneficiaries may face a choice between forgoing necessary rehabilitative care or paying 100 percent out-of-pocket expenses when their Medicare coverage runs out.

Legislators need to hear from CONSTITUENTS ASAP. Lymphedema patients will be impacted by the $1750 combined PT/SLP cap. Hospital outpatient is exempt from the cap, but not everyone lives within reach of a hospital based lymphedema clinic

The National Lymphedema Network urges you to write to your local representative or senator, using the following links to find their contact information:

http://www.house.gov/writerep/
http://www.senate.gov/general/contact_information/senators_cfm.cfm

Here's a sample letter:

To the Honorable (name of legislator)
Address
Address

Dear Senator / Representative (name):

As my voice in the US (Senate / House of Representatives) I would like you to support repeal of the Medicare Therapy Cap.

This legislation was enacted in 1997 as part of the balanced budget act, and has had a moratorium for almost all of the years it has been in effect. Physical, Occupational, and Speech therapy are regulated to prevent abuse or overutilization, and this cap is an arbitrary and harmful measure. People who have the most physical problems and need therapy to be able to live active lives, will be most affected.

Don't allow our Medicare benefits to be taken away from us! Please support repeal or another moratorium on the therapy cap.

Respectfully,
(name, address, etc)

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