Several have contacted ASHA regarding the recent MedPAC report and recommendations to Congress. Attached is a letter that ASHA has written to Congress in response to MedPAC recommendations regarding a lowering of the cap threshold to $1,270 and completion of manual medical review for half of the services rendered to Medicare beneficiaries.
- ASHA believes the recommendations would negatively impact Medicare beneficiaries and their access to medically necessary services. Overall, the report does not reflect the entirety of the discussion by the Commission regarding repeal and replacement of the therapy cap.
- ASHA supports the increased attention to inappropriate high utilization, targeted geographic areas and individual providers and encourages MedPAC to consider measures that support predictive analytics and manual review focused on problem providers.
- ASHA does not support the implementation of cost containment strategies as the sole solution to therapy payment reform, such as the implementation of the Multiple Procedure Payment Reduction (MPPR) for therapy services or the reduction of the therapy cap amount.
- ASHA maintains that the long-term reimbursement of therapy services must take into consideration the complexity and severity of the patient's condition for speech-language pathology services as opposed to a "one-size-fits-all" model for all therapy services, and proposes the use of the National Outcomes Measurement System as a tool for collecting functional outcomes for Medicare beneficiaries receiving speech-language pathology services.
- ASHA requests that any new reimbursement policy take into consideration that speech-language pathology is a unique and distinct service from that provided by physical and occupational therapists.
If you or your colleagues have any questions, please contact Ingrid Lusis, ASHA's Director of Federal Advocacy at email@example.com.