Resolution Adopted by the CCAR
Resolution on Medicare Annual Cap on
Rehabilitation Services
Resolution adopted by the Board of Trustees of the
Central Conference of American Rabbis, May 1999
Background
The Jewish textual tradition unquestionably demands that we show special concern for the welfare of the elderly. The Holiness Code of Leviticus declares that we must “rise before the aged and show deference to the old,” (Lev. 19) and the Psalmist pleads “cast me not away in my old age.” It goes without saying that the Torah equates zeqenim, elders, with those worthy of our attention and respect.
Effective January 1, 1999, Medicare began severely limiting coverage of non-hospital based (Medicare Part B) rehabilitation services to a fixed amount per year per Medicare beneficiary. Physical and speech therapy are capped at $1500, and occupational therapy is capped separately at $1500. These artificial and arbitrary limits hurt the most frail elderly who can exhaust $1500 of physical therapy in two weeks during an acute episode. For example, in one facility which is home to 425 elderly residents in California (average age 90), four months into the year, twenty-two residents had already gone over their $1500 limit for physical therapy, and another 34 were within $50 of reaching the limit. The list of residents over the limit will grow dramatically over the next eight months.
Over the past two decades, Medicare has continually tightened the purse strings for coverage of rehabilitation services. Twenty years ago Medicare covered elderly persons’ rehabilitation until they returned to their prior level of functioning. Some years later, the coverage paid only for the period during which a patient made rapid progress. When progress slowed down, Medicare stopped paying. As of January 1, 1999, Medicare no longer covers the rapid progress stage and rehabilitation benefits for the elderly are cut off at the $1500 limit.
These policy changes, which penalize and mistreat the frail, elderly and vulnerable among us, are unconscionable in a nation as wealthy as the United States.
THEREFORE BE IT RESOLVED, that the Central Conference of American Rabbis strongly protest and condemn Medicare’s policy of limiting Part B annual coverage of physical and speech therapy to $1500 and of occupational therapy to $1500, and
BE IT FURTHER RESOLVED, that the CCAR requests that the Health Care Financing Administration immediately retracts this policy.