This article is more than 5 years old. Information may no longer be current.
ACR Applauds Congress for Bipartisan Framework to Repeal Medicare Therapy Caps
Click Here to Manage Email Alerts
The American College of Rheumatology praised Congressional leaders for creating a bipartisan framework that may permanently repeal the Medicare therapy caps set to commence in 2018, according to a press release.
Republican and Democratic leaders of the House Ways and Means, Energy and Commerce and Senate Finance Committees reached an agreement last week. The framework would repeal the caps. In addition, claims submitted above the new threshold would be marked with an appropriate modifier if the procedures are considered medically necessary. The agreement would also continue the targeted manual medical review process established by the Medicare Access and CHIP Reauthorization Act in 2015.
As part of the Balanced Budget Act, Medicare therapy caps were first introduced in 1997 and included physical therapy, speech language pathology and occupational therapy. The therapy caps were developed to reduce federal spending and balance the federal budget. On 13 different occasions, Congress has attempted to temporarily prevent implementation of the Medicare therapy caps. The current exemption expires at the end of December. If the caps go into effect in 2018, patients would be responsible for 100% of the additional cost of their care if their needs are above the threshold.
“This agreement brings us a big step closer to ensuring our Medicare patients continue to receive the vital rehabilitation services needed to maintain their mobility and quality of life,” ACR President, Sharad Lakhanpal, MBBS, MD, said in the release. “The ACR has been a longstanding and vocal advocate for eliminating the Medicare therapy caps and we are pleased to see Congressional leaders come together around a bipartisan path forward to full and permanent repeal.”
Reference: