American Speech-Language-Hearing Association
December 12, 2011

House Introduces Legislation to Address Medicare Payment Policies

The House of Representatives has introduced the Middle Class Tax Relief and Job Creation Act of 2011 [PDF], to address Medicare reimbursement issues, extend the payroll tax cut, and reform and extend unemployment insurance. The House is expected to vote on the bill Tuesday, December 13. The legislation contains language that would provide for a two-year extension of the therapy cap exceptions process as well as avert dramatic cuts to the Medicare physician fee schedule, providing a 1% increase in payments for both 2012 and 2013. Extension of the therapy cap exceptions process has traditionally been part of a larger group of 15 Medicare extender provisions that have been considered as part of the yearly fee schedule fix. This year, only 3 extenders were included in the legislation and, of those, only the therapy caps received a two-year extension.

In extending the exceptions process, the House legislation would require additional medical review of outpatient therapy services that go beyond the cap and would place hospital outpatient rehabilitation services under the therapy caps and exceptions process. The legislation would also require MedPAC to develop a report on recommendations for a new payment system and the General Accounting Office to develop reports related to the effectiveness of the medical review process.

The Senate is expected to soon release its legislation to address Medicare reimbursement rates and Medicare extenders. The House and Senate will need to reconcile their differences before they adjourn for the holidays. For additional information, contact Ingrida Lusis, ASHA’s director of federal and political Advocacy, at

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