Part B caps

[Guest guest]

 

FYI

ALERT: $1,810 Therapy Caps Begin on July 1

Efforts to Delay Exceptions Process Failed

Only four days remain before the Medicare Part B Therapy Caps exceptions process

expires on July 1, 2008.  As we have been reporting, this means that an annual

cap of $1,810 for occupational therapies, and a separate $1,810 cap for both

physical and speech/language therapies will go back into effect.  According to

the Centers for Medicare and Medicaid Services (CMS) any such services that were

provided between January 1, 2008 and June 30 will count towards the $1,810 cap. 

What Does This Mean for Providers?

On July 1, skilled nursing facilities will have patients needing continued Part

B rehabilitation services, however depending on the outpatient therapies

provided earlier this year, they may have already exceeded the cap. In

accordance with federal regulations, the SNF must continue to provide necessary

therapies. This presents a financial difficulty for facilities with

dual-eligible residents who are unable to pay privately for such services. 

CMS has published an article explaining this issue for providers:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0815.pdf.  

Why Is The Exceptions Process Expiring?

As we reported yesterday the House of Representatives voted earlier this week

overwhelmingly, 355-59, to pass the Medicare Improvements for Patients and

Providers Act of 2008, H.R. 3101, which would have extended the current therapy

cap exceptions process until December 31, 2009.  Unfortunately, the Senate was

unable to pass the bill last night.

What Happens Next?

The House and Senate will be out of session next week for a Fourth of July

recess. AHCA continues to work with our Congressional champions, and we

anticipate that this issue will be revisited as soon as Congress returns to

Washington, DC, on July 8.

 

Egbert PT WCC CKTP

Director of Rehab

Draper, UT