Scott Nossek, a physical therapist with Payson Physical Therapy, said a recent federal agreement has had a direct impact on many people in the community.
Nossek is referring to the Medicare Reform Refinement Bill (HR 3426) which Congressman J.D. Hayworth talked about when he met with residents here last week at the American Legion.
Nossek said when the White House and congressional leaders agreed to lift the $1,500 cap on outpatient rehabilitation for two years beginning Jan. 1, it opened the way for many Medicare beneficiaries who chose to rehabilitate in a nonhospital setting to receive the treatment they need.
Nossek said one local resident, Phyllis Manthe, had undergone two surgeries in 1999 and had reached her Medicare cap.
Manthe said she was very pleased that she could continue her therapy without worrying about her Medicare coverage.
Dr. Jan K. Richardson, president of the American Physical Therapy Association, said, "The APTA applauds Congress for taking this action to undo the unintended consequences of the Balanced Budget Act."
Hayworth told folks at the American Legion Thursday that he was on the House Ways and Means Committee and was pleased to help develop the Medicare reform package through refinements to the Budget Balanced Act of 1997, an act that fundamentally changed the Medicare program.
The latest legislation dedicates $16 million over the next five years to strengthen and improve Medicare, Hayworth said.
Hayworth outlined the following provisions that are contained in the Refinement Bill:
• Out-of-pocket costs are reduced for seniors by limiting the hospital outpatient co-pay. The co-pay varies widely and often exceeds Medicare's standard 20-percent co-pay. Outpatient co-pay will be limited to $776, the same amount as the deductible for inpatient care;
• The legislation creates incentives for health plans to offer Medicare HMO options for seniors. It does this by increasing payments to plans that do offer such options;
• The Medicare Competitive Pricing Demonstration Project is delayed until January 2002;
• Payments will be increased for renal dialysis services;
• There will be better access to durable medical equipment like wheelchairs and oxygen;
• Medicare's coverage of anti-rejection drugs for organ transplant patients is expanded beyond the three-year limit previously imposed;
Nossek said the greatest impact for local residents has been the elimination of the arbitrary cap on physical, speech and occupational therapy.