Washington Watch
What happens on Capitol Hill affects ASHA members.
Congress Votes to Extend the Therapy Cap Exceptions Process
What's Next?
On February 17, 2012, the House and Senate passed the conference report for H.R. 3630, the Middle Class Tax Relief and Job Creation Act, which among other things addressed the anticipated 27.4% cut to Medicare Part B reimbursements and extended the therapy caps exceptions process through December 31, 2012.
In extending the therapy cap exceptions process, Congress added additional safeguards to the exceptions process, including:
- The use of an NPI for the physician reviewing the need for therapy;
- Requirement of the KX modifier on claims above the cap; and
- Requirement for medical manual review when therapy expenditures hit $3,700 (combined physical therapy/speech-language pathology) for services furnished on or after October 1, 2012.
The bill will temporarily apply the therapy caps and exceptions to hospital outpatient departments for services provided no later than October 1, 2012, and ending December 31, 2012. In addition, the legislation will require two reports:
- A MedPAC report on how to improve the outpatient therapy benefit; and
- A General Accounting Office report on the effectiveness of the manual medical review process.
While extending the therapy caps exceptions process offers short-term relief to many patients and providers, ASHA and its partners are still working on a permanent solution. ASHA has been working closely with the American Physical Therapy Association and the American Occupational Therapy Association, as well as Congress, in the development of alternatives to the therapy cap and to develop an appropriate pathway to care for Medicare beneficiaries.
We urge you to get involved and supplement our efforts by writing your members of Congress through our Take Action Center.
Congressional Hearing Health Caucus Revived
The Congressional Hearing Health Caucus (CHHC) has been revived with the start of the second session of the 112th Congress. While the CHHC was not active last session, Representatives Tom Latham (R- IA) and Carolyn McCarthy (D-NY) have decided to revive the Caucus to broaden support and knowledge of hearing health issues within Congress. This bipartisan effort will allow for an educational setting for discussion of issues related to hearing health through periodic events and correspondence with all Members of Congress.