Medicare Reimbursement Caps

Paper Summary:

This research paper explores the reasons why Congress imposed in 1997 caps on reimbursement under the Medicare program of charges for various types of outpatient rehabilitation services, the specific content of such caps, proposals for removing such caps and the rationales therefor.

From the Paper:

"MEDICARE CAP ON REHABILITATION SERVICES

This research paper explores the reasons why Congress imposed in 1997 caps on reimbursement under the Medicare program of charges for various types of outpatient rehabilitation services, the specific content of such caps, proposals for removing such caps and the rationales therefor.

Caps Imposed by the Balanced Budget Act of 1997
Under Part B of the Medicare program, full reimbursement was available, subject to a 20 percent coinsurance payment by the beneficiary and a $100 annual deductible, for rehabilitation services provided to eligible patients on an outpatient patient by qualified medical service providers. To be eligible for home health care generally under Medicare, the beneficiary would have to show that they were homebound and needed intermittent care."

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