Letters to the Editor

February 18, 1999

Low cap is poor therapy

To the editor:

A provision of the Balanced Budget Act calls for an arbitrary $1,500 cap on outpatient rehabilitation services for Medicare beneficiaries. These services are performed in nursing home, often after an elderly person has suffered a stroke or a fall.

The Physical Therapy Caucus of the Western Maryland AHEC is gravely concerned that patients will not receive adequate rehabilitation if this cap is allowed to stand. For instance, an average stroke patient requires a substantial amount of therapy to regain function or learn to live safely with limitations. If inadequate amounts of therapy are provided, the patient may be subject to falls, need more substantial home care or develop other injuries or conditions. Senior citizens' health and independence will be threatened without the benefit of full rehabilitation services after an accident or illness.

The American Physical Therapy Association points out that: 1) The $1,500 limitation will deny Medicare beneficiaries access to necessary rehabilitation treatment; 2) The $1,500 cap does not consider the medical condition of the patient or the health outcomes of rehabilitation services; 3) The $1,500 cap dramatically reduces Medicare beneficiaries' choice of care giver. Beneficiaries in rural areas will have a particularly difficult time obtaining access to needed services; 4) The $1,500 limit was imposed without congressional hearings; 5) The $1,500 limit combines physical therapy and speech therapy under the same cap. There is no rationale on which to base this shared cap. It is illogical and contrary to current practice.


Senior citizens deserve access to necessary treatment. This arbitrary cap puts the government squarely between the patient and his or her medical caregiver. Such interference in medical decision-making is the wrong direction for the Medicare program. Bipartisan bills to repeal this provision were entered in the last Congress but not heard. The caucus strongly recommends that concerned citizens write their representatives in Congress to support new legislation to repeal this cap and move to a more efficient, patient-centered manner of controlling use of therapy services. For more information and a sample letter, contact the American Physical Therapy Association at on the Internet or at 1111 N. Fairfax Street, Alexandria, VA 22314. For more information about the Physical Therapy Caucus, visit the Western Maryland AHEC's Website at

Michael Stagger


Physical Therapy Caucus

A special family

To the editor:

To the Thomas and The Rickett Families: I want to thank you all for the hospitality that you have shown me in your homes. You are beautiful, warm, living, caring people. You are good God-loving people and it shines through; God has blessed you all.

I believe that your family is the idea of what God is looking for in families. Thank you all for making me feel welcome in your homes. I know you all realize that God will evaluate all you do and you have learned to live wisely, remembering that he is present each day, obeying his guidelines for living.

So Steve, Tammy, Harry, Pat, Mary, Ray, David and all children, I thank all for caring about me. I believe that you all are wonderful people: Thank you. Marion, Hazel, and Janet my home providers, I thank you three very, very much, for your help.

And John Mark and Gray Naugle, volunteers of the Reach Program, a special thanks to you two. Thank you all for making it possible for me to live in my own apartment, and not a hospital. I hope that all of you have a great New Year. Thank you all so very, very much.

James Harrison Twyman Jr.


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