[Congressional Record Volume 163, Number 17 (Wednesday, February 1, 2017)]
[Senate]
[Pages S596-S597]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. CARDIN (for himself, Ms. Collins, Mr. Casey, and Mr. 
        Heller):
  S. 253. 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. CARDIN. Mr. President, I rise in support of the Medicare Access 
to Rehabilitation Services Act, which I am introducing today with my 
colleagues Senators Collins, Casey, and Heller. This important bill 
repeals the monetary caps that limit Medicare beneficiaries' access to 
medically necessary outpatient physical therapy, occupational therapy, 
and speech-language pathology services.
  Limits on outpatient rehabilitation therapy services under Medicare 
were first imposed in 1997 as part of the Balanced Budget Act. The 
decision to impose limits on these services was not based on data, 
quality-of-care concerns, or clinical judgment--its sole purpose was to 
limit spending in order to balance the Federal budget. Since 1997, 
Congress has acted 12 times to prevent the implementation of the 
therapy caps through moratoriums and an exceptions process. While these 
short-term actions have provided necessary relief to our seniors, a 
long-term solution is essential to bring permanent relief and much-
needed stability for both patients and providers.
  We need a full repeal of the existing caps on physical therapy, 
occupational therapy, and speech-language pathology services. These 
annual financial caps limit services often needed after a

[[Page S597]]

stroke, traumatic brain injury, or spinal cord injury, or to 
effectively manage conditions such as Parkinson's disease, multiple 
sclerosis, and arthritis. Arbitrary caps on these vital Medicare 
outpatient therapy services are simply unacceptable. They also 
discriminate against the oldest and sickest Medicare beneficiaries, who 
typically require the most intensive therapy, and disadvantage Medicare 
beneficiaries who live in regions with higher health care costs.
  In a 2009 report issued by the Medicare Payment Advisory Committee, 
MEDPAC, it was estimated that the therapy cap, if enforced without an 
exceptions process, could negatively impact 931,000 Medicare 
beneficiaries. Arbitrarily capping outpatient rehabilitation therapy 
services would likely cause some beneficiaries to delay necessary care, 
force others to assume higher out-of-pocket costs, and disrupt the 
continuum of care for many seniors and individuals with disabilities.
  I urge my colleagues to join me and Senator Collins in supporting the 
Medicare Access to Rehabilitation Services Act to ensure that our 
seniors have access to the outpatient rehabilitation therapy services 
that they need.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 253

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Access to 
     Rehabilitation Services Act of 2017''.

     SEC. 2. OUTPATIENT THERAPY CAP REPEAL.

       (a) In General.--Section 1833 of the Social Security Act 
     (42 U.S.C. 1395(l)) is amended by striking subsection (g).
       (b) Conforming Amendments.--Section 1842(t)(2) of the 
     Social Security Act (42 U.S.C. 1395u(t)(2)) is amended--
       (1) by striking ``(2) Each request'' and all that follows 
     through ``1833(a)(8)(B),'' and inserting ``(2)(A) Each 
     request for payment, or bill submitted, for therapy services 
     described in subparagraph (B)''; and
       (2) by adding at the end the following new subparagraph:
       ``(B) The following therapy services are described in this 
     subparagraph:
       ``(i) Physical therapy services of the type described in 
     section 1861(p) and speech-language pathology services of the 
     type described in such section through the application of 
     section 1861(ll)(2), including services described in section 
     1833(a)(8)(B), and physical therapy services and speech-
     language pathology services of such type which are furnished 
     by a physician or as incident to physicians' services.
       ``(ii) Occupational therapy services of the type that are 
     described in section 1861(p), including services described in 
     section 1833(a)(8)(B), through the operation of section 
     1861(g) and of such type which are furnished by a physician 
     or as incident to physicians' services.''.
                                 ______
                                 
      By Mr. CORNYN (for himself, Mr. Risch, Mr. Roberts, Mr. Portman, 
        Mr. Tillis, Mr. Cassidy, Mr. Rubio, Mr. Grassley, Mr. McCain, 
        Mr. Inhofe, Mr. Flake, Mr. Heller, Mr. Thune, Mr. Daines, Mr. 
        Moran, Mr. Blunt, Mr. Cochran, Mr. Scott, Mr. Toomey, Mr. 
        Johnson, Mr. Isakson, Mr. Shelby, and Mr. Wicker):
  S. 260. A bill to repeal the provisions of the Patient Protection and 
Affordable Care Act providing for the Independent Payment Advisory 
Board; to the Committee on Finance.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 260

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Protecting Seniors' Access 
     to Medicare Act of 2017''.

     SEC. 2. REPEAL OF THE INDEPENDENT PAYMENT ADVISORY BOARD.

       Effective as of the enactment of the Patient Protection and 
     Affordable Care Act (Public Law 111-148), sections 3403 and 
     10320 of such Act (including the amendments made by such 
     sections) are repealed, and any provision of law amended by 
     such sections is hereby restored as if such sections had not 
     been enacted into law.

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