American Speech-Language-Hearing Association
December 22, 2011

House and Senate at Stalemate Over Taxes

Medicare Rates and Therapy Caps Affected

With members of the Senate at home and vowing not to return before the New Year and the House voting down the Senate version of H.R. 3690, the "Temporary Payroll Tax Cut Continuation Act of 2011," which would have extended the payroll tax holiday for 2 months, Congress once again is at a stalemate over taxes and spending. The House approved a resolution 229–193 to disagree with the Senate bill and appoint members to a House-Senate conference committee to try to resolve differences between two different versions of H.R. 3690. While sharp differences exist between Democrats and Republicans over how to pay for the payroll tax reduction (6.2% to 4.2%) for another year, the effect of the gridlock is to create uncertainty for employers computing payroll taxes starting January 1, 2012.

The gridlock over the payroll tax holiday extension creates uncertainty for ASHA, its members, and consumers in two other important ways:

  1. a 27.4% Medicare payment cut is scheduled for providers on January 1, 2012, and
  2. the therapy caps exceptions process ends on December 31, 2011.

In anticipation of gridlock, the Centers for Medicare and Medicaid Services announced it will hold claims for 2012 Medicare provider services for 10 business days, until January 17, 2012, to avoid processing at the lower rate. While the House is scheduled to return on that date, there are reports it may move its return date to January 3. In addition, if Congress does not pass the payroll tax package extension, expiring Medicare provisions before year-end, those patients needing the most serious speech-language and physical therapy outpatient services will face a cap on those services in 2012. If Congress fails to act before the end of the year, it may make legislation that eventually passes retroactive to January 1, 2012, for the payroll tax holiday, Medicare fee schedule, and therapy caps exceptions.

For additional information, please contact George Lyons, ASHA's director of government relations and public policy, at

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