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Senate Finance Chair Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA) have separately introduced competing Medicare bills to address larger Medicare issues, such as averting significant cuts to the physician fee schedule and extending the therapy cap exceptions process. Both proposals include provisions that would allow speech-language pathologists to bill from a private practice and recognize audiologists as eligible to receive bonus payments under Medicare's Physician Quality Reporting Initiative (PQRI).
Unfortunately, both bills face an uphill battle for passage. It is anticipated that the legislation will be altered as Senate leaders and the White House undertake cuts to off-set the larger cost items in the bill, such as the Medicare fee schedule fix.
Absent congressional action by June 30th, Medicare beneficiaries who have already exceeded the $1,810 combined SLP/PT cap will have to seek services at a hospital outpatient department. CMS has been tracking Medicare beneficiaries use of therapy services since January 1, 2008 and will apply the combined cap retroactively to the beginning of the year. Due to consolidated billing rules, skilled nursing facility (SNF) inpatients are not permitted to access additional rehabilitation services through the hospital outpatient department.
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. For further information about the therapy caps exceptions process, please visit ASHA's Therapy Cap Advocacy Center or contact reimbursement@asha.org.
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