To Whom It May Concern,
I have resided in Illinois for my life. I live in Greenfield, Illinois, which, if you are not sure, it’s a small town and everyone is here to help one another. I used to work at Blue Cross Blue Shield as a Customer Representative and due an unforeseen stroke, I had to quit work. As a community as well as a former BCBS representative, we are there to help other people. We see other people who been through the best and worst of things try to get better and move on with their lives. We also take care of the elderly and people with sickness, cancer etc., and we try to help out by taking care of each other. We are a tight knit community.
I am also not a big fan of politics. I want the people to get into their positions by what they stand for, be listening and “go with my gut feeling” so we can see some movement in our policies.
In that regard, I want to speak to you about Medicare and Physical Therapy for people with Parkinson’s and Multiple Sclerosis. People that have these diseases do benefit from repeated physical and speech therapy. Their quality of life depends on these benefits to gain a sense of normality. I have been working with a woman, ____, who has Parkinson’s disease for about a year now, and her condition has taken a down-ward spiral over the last couple of years. She used to work at the ______ _______, and although she had this disease, she could still work. About ten years ago, she was taken off working because her tremors were getting so bad. She used to walk, but now she is confined to a wheelchair. She now has a nerve receptor to handle the tremors and she has been signed up to receive physical and speech therapy to gain some access to walking and swallowing techniques.
According to Medicare, “There is currently a combined $1,920 yearly cap for physical therapy and speech-language therapy, and a separate $1,920 yearly cap for occupational therapy.” I know there can be an extension for additional services, however, after the $1,920 year-cap, it’s not getting approved through Medicare, and the facilities do not want to extend their services in fear on not getting paid. That would become the patient’s responsibility. Patients cannot afford to go under for physical and speech therapy. How would they recover?
I have seen ____ progress immensely with the therapy she has received but once that happens she has to start all over again to regain her strength back. It’s very sad to see her start over and over again to only gain her where she was before she stopped going to therapy. She could actually get up and walk! Her body responded well to the therapy. She actually could feel her gaining strength! That also affected using the bathroom and showers. She didn’t get so close to falling but, after a month or two she lost all her strength and she ended right back where she was before. It breaks my heart.
If we can use Medicare and have guidelines to approve extended visits, such a policy would be great. If they could send in records to show what improvements they have made with the physical therapy and speech therapy, to acknowledge what they did, then Medicare could cover it. I understand that some people will not make any improvements, and I understand that when there is no clear sign of effectiveness it makes sense to have a cap and say that after spending a certain amount and showing no benefit, that can be the end for the year. However, when people show improvement, the cap is too low; the people who should continue therapy will only gain strength with momentum and possibly have a pain free life if they get continuous therapy, so the cap on therapeutic services is very harmful and destructive. I know this is newer to Medicare with Parkinson’s and MS, so if we could take a look at this, we could improve Medicare for people who are relying on services. And let’s face it, $1,920 would not get very far with therapy, but that would really help those who need it and want to stay in their home without the use of nursing home and skilled care. To me, that would increase the payments going out, but would be a lot less for a nursing home care.
I appreciate your time and attention to this matter.