[Congressional Record Volume 151, Number 33 (Thursday, March 17, 2005)]
[Senate]
[Pages S3010-S3011]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ENSIGN (for himself and Ms. Landrieu):
  S. 657. A bill to amend title XVIII of the Social Security Act to 
make a technical correction in the definition of outpatient speech-
language pathology services; to the Committee on Finance.

  Mr. ENSIGN. Mr. President, today I introduced a bill that would 
expand access to speech-language pathology care.
  Speech-language pathology, or speech therapy, includes services for 
patients with speech, hearing and language disorders, which result in 
communication disabilities. Speech therapy also includes the diagnosis 
and treatment of swallowing disorders, regardless of the presence of 
communications disability. Communications disabilities most frequently 
affect patients who suffer from a stroke, tumor, head injury, or have 
been diagnosed with Parkinson's disease, amyotrophic lateral sclerosis 
(ALS) , or other neuromuscular diseases.
  As a result of a legislative anomaly, patients cannot receive 
Medicare coverage for speech-language pathology care in a private 
practice setting. Under the Medicare program, the same patient is able 
to receive such care in a hospital, skilled nursing facility, or 
rehabilitation facility. This bill would not create a new benefit. 
Rather, it would provide a technical correction to a section of 
Medicare statute that originated more than 30 years ago. Under current 
law, physical therapy and occupational therapy care can be received by 
patients in the private practice setting.
  In 1972, speech-language pathology services were added to the 
Medicare statute under the physical therapy definition section. 14 
years later, occupational therapy was defined under a separate section. 
Unlike speech-language pathology services, occupational therapy 
services were not incorporated within the physical therapy definition. 
As a result, a patient can receive both physical and occupational 
therapy care in an independent practice setting. The legislation I am 
introducing today would enable patients to likewise receive speech-
language therapy services in private practice settings.
  Without this legislative fix, beneficiaries may confront situations 
in which they either do not have access to a Medicare-covered setting 
or do not meet the requirements to receive care from other settings. 
This can be especially problematic in rural communities with fewer 
hospitals, skilled nursing facilities, and rehabilitation facilities.
  For example, consider an elderly patient who is discharged from a 
hospital, but requires follow-up physical therapy and speech-language 
pathology care. The patient would be able to obtain necessary physical 
therapy care in an independent practice setting, but would not be able 
to receive necessary speech-language pathology care in the same 
setting. The patient would have to see the necessary speech-language 
pathology care in another Medicare setting, possibly having to travel 
farther distances to receive such care or not receive it all.
  Essentially, the legislation I am introducing today would ensure that 
patients have access to speech-language pathology services, 
particularly in rural areas. I urge my colleagues to join me in 
supporting this commonsense legislation.
  This legislation compliments the measure I introduced last month, 
called the Medicare Access to Rehabilitation Services Act (S. 438). 
Both bills ensure access to needed therapy care within the Medicare 
program. I am committed to working toward their enactment and believe 
that they will help Medicare beneficiaries obtain the quality health 
care that they deserve.

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