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This past weekend, Congress passed H.R. 6111, the Tax Relief and Health Care Act of 2006, which includes provisions to extend the therapy cap exception process and halts the scheduled 5% cut in the Medicare fee schedule for speech-language pathology, audiology and other providers. President Bush is expected to sign the legislation in the near future.
The legislation calls for a one-year extension of the therapy cap exception process which was authorized by Congress as part of the Deficit Reduction Act of 2006. Therapy services are capped at an annual per-patient level of $1,780 for speech-language pathology and physical therapy combined. There is a separate cap of $1,780 for occupational therapy. Information on the exception process that allows beneficiaries in need of medically-necessary services above the therapy caps to receive those services can be found on ASHA's Web site.
The legislation also stops the scheduled 5% cut to the Medicare Physician Fee Schedule (MPFS) for 2007. In addition to freezing this rate at 2006 levels, Congress also authorized a 1.5% bonus for eligible providers that report quality measures. Because of outcomes measures developed by ASHA, speech-language pathologists (SLP) are specifically defined as eligible for the bonus beginning in 2008. ASHA will continue to work with the Centers for Medicare and Medicaid Services (CMS) in adopting the National Outcomes Measurement System (NOMS) as the quality measurement tool for SLP services.
As part of the negotiations on the Medicare legislation, ASHA moved one step closer toward its legislative priority of recognizing speech-language pathologists in private practice as suppliers under the Medicare outpatient program. This recognition would allow SLPs to bill Medicare through their own billing number. The version of the legislation proposed by Senate contained the SLP supplier language. However, in negotiations with the House of Representatives, the language was dropped due to concerns raised about the possible cost to Medicare.
For further information on ASHA's legislative efforts, please contact Elizabeth Mundinger, ASHA's Director of Federal and Political Advocacy, by e-mail at emundinger@asha.org or by calling 800-498-2071, ext. 4473. For more information concerning the exceptions process and quality measures, please contact Ingrida Lusis, ASHA's Director of Health Care Regulatory Advocacy, by e-mail at ilusis@asha.org or at 800-498-2071, ext. 4482.
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