Remaining Work Congress Must Do for People with Medicare
New York, NY—Congress is back in session, and the actions our legislators take—or don’t take—this week and over the next month will have a real impact on Medicare consumers’ ability to access care. Three issues require policymakers’ immediate attention in order to prevent interruptions in care: Medicare physician payments, the Qualified Individual (QI) program, and the therapy caps exceptions process.
The pending 25 percent reduction in payments to Medicare physicians under the Sustainable Growth Rate (SGR) formula enacted in 1997—a 21 percent cut effective December 1, followed by an additional 4 percent cut on January 1—are harmful to the 47 million people with Medicare, many of whom are anxious that they may no longer be able to see the doctors they’ve come to trust. Congress must pass legislation to avert these cuts before December 1.
Congress must also extend the Qualified Individual (QI) program and the therapy caps exception process, both of which are due to expire on December 31. The QI program helps pay the Part B premium for Medicare consumers with limited incomes. Renewing the program will provide states with funds and will prevent disruptions in coverage for QI enrollees, who without this program will face increased out-of-pocket costs that could amount to thousands of dollars per year. Lastly, if Congress does not extend the exceptions process to Medicare coverage limits for physical, speech and occupational therapy, exceptions that allow Medicare consumers to overcome financial hurdles to care, Medicare consumers may suffer an interruption to medically necessary therapy services.
The Medicare Rights Center urges all members of Congress to do right by their constituents and finish the work that still needs to be done before the 111th session comes to a close.