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The Medicare therapy caps and a 10.6% cut in Medicare fee schedule rates are scheduled to go into effect on July 1st as the result of a defeat on a procedural vote in the U.S. Senate. The Senate vote was to end the debate on the House bill H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008. Medicare providers should anticipate that therapy caps and Medicare fee schedule rate cuts will be in effect for at least a couple of weeks while a longer-term compromise on Medicare legislation is worked out.
Speech-language pathologists should notify their Medicare patients that the therapy cap exceptions process will expire on Monday, June 30. Absent congressional action, Medicare beneficiaries who have reached the cap and have been receiving services via the therapy cap exceptions process will be forced to either seek treatment at an outpatient hospital department or pay out-of-pocket for outpatient therapy services. The current therapy cap is set at a combined $1,810 for physical therapy and speech-language pathology services and a separate $1,810 for occupational therapy. Medicare beneficiaries also should be told that the Centers for Medicare and Medicaid Services (CMS) has been tracking therapy use to date for 2008 services.
The impasse on H.R. 6331, as passed by the House earlier in the week by an overwhelming margin, centers around congressional Democratic support of cuts in private fee-for-service Medicare Advantage plans. The White House threatened to veto any legislation that cuts payments to Medicare Advantage plans.
ASHA members are asked to contact their members of Congress to urge that they pass Medicare legislation to retain provisions in earlier Medicare bills that recognize a speech-language pathologist's ability to bill from a private practice and audiologist's participation in the Physician Quality Reporting Initiative (PQRI), as well as resumption of the therapy caps exceptions process and a fee schedule fix.
In less than 5 minutes, you can send a letter to your members of Congress through ASHA's Take Action site. For further information, please contact Ingrida Lusis, ASHA's Director of Federal and Political Advocacy, at ilusis@asha.org or by phone at 202-624-5951.
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