Lifting Therapy Caps Is a Load Off Medicare Beneficiaries' Shoulders

Federal law has been revised so eligible Medicare beneficiaries will still be able to use therapy services even if they exceed their allotted yearly benefits, reports Kaiser Health News . The federal budget plan approved by Congress in February eliminates annual caps on how much Medicare pays for physical, occupational, or speech therapy and simplifies the medical review process. It is applicable to people in traditional Medicare as well as those with private Medicare Advantage policies. Since Jan. 1, Medicare beneficiaries have been eligible for therapy indefinitely, provided their doctor — or in some states, physician assistant, clinical nurse specialist, or nurse practitioner — verifies their need for therapy and they continue to meet other mandates. The Centers for Medicare & Medicaid Services told healthcare providers about the amendment last month. Another key revision permits private Medicare Advantage plans in 2020 to offer special benefits to members with a chronic illness and meet other criteria. These plans currently limit members to a network of providers and give all members identical treatment, but the budget law says benefits targeting those with chronic illnesses do not have to be primarily health-related and only require a "reasonable expectation" of improving health.