[Congressional Record Volume 151, Number 18 (Thursday, February 17, 2005)]
[Senate]
[Pages S1654-S1655]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      BY Mr. ENSIGN (for himself, Mrs. Lincoln, Mr. Hagel, Mrs. Murray, 
        Mr. Bingaman, Mr. Corzine, Mr. Johnson, Ms. Collins, and Mr. 
        Hatch):
  S. 438. A bill to amend title XVIII of the Social Security Act to 
repeal the medicare outpatient rehabilitation therapy caps; to the 
Committee on Finance.
  Mr. ENSIGN. Mr. President, I am pleased to reintroduce the Medicare 
Access to Rehabilitation Services Act to improve the Medicare program 
for our senior citizens. The bill, which enjoyed the support of a 
majority of the Senate in the 108th Congress, would repeal the 
beneficiary cap on rehabilitation therapy care and ensure quality 
healthcare for Medicare patients.
  The beneficiary cap is really two separate therapy caps: one cap for 
occupational therapy and one for both physical therapy and speech-
language pathology care combined. Congress has already shown its 
opposition to this arbitrary cap by placing a moratorium on enforcement 
of the cap in 1999, 2000, and 2003. The latest moratorium will expire 
on January 1, 2006. Without congressional action, the beneficiary cap 
on therapy services will be effective again in less than a year. It is 
time to repeal the cap once and for all.

[[Page S1655]]

  Each year, more than 3.7 million Medicare beneficiaries receive 
outpatient physical therapy, occupational therapy, and/or speech-
language pathology services to regain their optimum level of function 
and independence. The Center for Medicare and Medicaid Services, CMS, 
completed a long-awaited analysis of the therapy cap policy. The 
report, prepared by AdvanceMed, estimates that for Calendar Year 2002, 
some 638,195 beneficiaries receiving physical therapy, occupational 
therapy, and/or speech-language pathology services would have exceeded 
the cap threshold. This represents 23.7 percent of the outpatient 
therapy expenditures for that year. Failure to address the issue this 
year in Congress will have a significant impact on the access 
beneficiaries will have to necessary rehabilitation services.
  It is clear from recent reports prepared for CMS that patients with 
debilitating illnesses and injuries would be severely impacted by 
enforcement of the therapy caps. Based on data from 2002, patients 
suffering from conditions such as stroke, Parkinson's disease, 
congenital heart failure, and Dysphasia were certain to be negatively 
impacted by enforcement of existing statutory limits on rehabilitation 
coverage.
  Action is needed to address the therapy caps this year. Last 
Congress, this bill attracted 51 Senators as cosponsors. As a member of 
the Senate Budget Committee, I realize the budgetary constraints that 
are upon Congress. I understand that we need to prioritize spending. I 
believe that a meaningful solution to address the rehabilitation needs 
of senior citizens and individuals with disabilities in the Medicare 
program should be a priority.
  I would like to thank my colleagues, Senator Blanche Lincoln, Senator 
Chuck Hagel, Senator Patty Murray, Senator Jeff Bingaman, Senator Jon 
Corzine, Senator Tim Johnson, Senator Susan Collins, and Senator Orrin 
Hatch for joining me in this effort. I stand ready to work with my 
colleagues to enact a solution to the therapy caps that ensures access 
to quality restorative services provided by qualified professionals.
                                 ______