The New Jersey State Association of Jewish Federations is spearheading a drive to repeal a nine-year-old federal budget-cutting measure on Medicare.

The association fears that Medicare spending caps on rehabilitation therapy could imperil needed services for thousands of nursing home residents in the state and potentially millions of people across the country.

The targets of the new intense lobbying effort are the $1,740-per-year Medicare limit on a patient’s physical and speech therapy, aimed at improving a patient’s ability to walk and talk after strokes and other impairments, and a second $1,740 cap on payment for occupational therapy aimed at strengthening upper bodies and helping people become independent in grooming and caring for themselves.

Such a limit on insurance coverage “puts undue hardship on people least able to afford therapy for multiple conditions,” said Jeffrey Maas, the association’s executive director.

“A patient who has Parkinson’s and a stroke and a broken hip in the same year will have costs that will go way over $1,740. We are asking to temper economics with humanity,” said Maas. “We would like to repeal the caps.”

The caps became law in 1997 as part of the Balanced Budget Act, but, according to Maas, “they have not proved effective in saving Medicare money.”

Instead, the notion backfired and “has arbitrarily penalized the sickest of Medicare patients, those suffering from serious conditions requiring intensive rehabilitation, and denied them needed care.”

Although Congress suspended the caps twice since 1999, a moratorium lapsed on Jan. 1. The federations are urging New Jersey’s senators, Frank Lautenberg and Robert Menendez, and the state’s 13 House members to eliminate the caps or, minimally, to hold them at bay with a third moratorium.

“It is difficult to gauge how urgent this is. Everything is urgent. We’ve seen two moratoriums and we’re hoping it will happen again, but there is no guarantee,” said Maas.

“The Jewish community gets more money from Medicare and Medicaid than from UJA campaign dollars,” said Maas. “They are the major source of funding for our nursing homes.” The caps apply only to care received at free-standing practices, not at hospital-affiliated centers or nursing homes.

According to Maas, what adds to the urgency is the demographics of the 5.2 million members of the American-Jewish community. According to the National Jewish Population Survey 2000-01, 19 percent of American Jews — as opposed to 12 percent of the general population — are 65 years of age or older.

“We are aging faster than the national average,” he said. “Anything that affects seniors is going to impact on the Jewish community all the more because of our demographics.”

Frank Byrne, who represents 375 nursing homes as vice president of public policy of the NJ Association of Non-Profit Homes for the Aging, is taking an active part in the repeal effort.

“We can’t really forecast the amount of people the caps affect,” he told NJ Jewish News.

But he insisted that nonprofit nursing homes “are not going to stop doing therapy for someone because their benefits have been exceeded. If the patient needs additional therapy, the facility will provide it.”

U.S. Rep. Frank Pallone (D-NJ Dist. 6) has introduced The Medicare Access to Rehabilitation Services Act of 2005 to repeal the caps. A majority of House members has endorsed the bill.

Susan Grosser is the associate executive director of the Daughters of Israel nursing home in West Orange, one of the seven not-for-profit homes in New Jersey operated by Jewish organizations.

The caps, she told NJ Jewish News, “can stop needed therapy if the benefits have been exhausted and the patients will not be able to receive that type of therapy through Medicare.”

Grosser calculated that among the 298 residents of Daughters, such needs “fluctuate at any given time. We can have 20 to 30 patients receiving any type of therapy at one time. To reach the $1,740 cap, it can be approximately eight weeks of therapy three times a week.”

Along with Maas and Byrne, she is urging New Jerseyans to write to their federal legislators — thanking some for past support and urging others to get behind the repeal effort.

Were the caps to remain in place, Grosser said, they “could have a very severe impact on nursing home patients who require continued therapy. They use up their allotments, and then let’s say three months later, another medical situation arises. They would benefit from some therapy, and they can’t have it anymore. Their benefits have been exhausted.”