Eli's Rehab Report

Published on Mon Nov 08, 2010 PDF

Payment cut not as drastic as proposed.

The 2011 PPS final rule offered good news in the form of relaxed therapy reassessment requirements, but therapy will be taking a hit from another direction.

The 2011 Medicare Physician Fee Schedule will slash payments across therapy disciplines by 25 percent under the multiple procedure payment reduction (MPPR) provision.

Originally proposed as a 50 percent reduction, therapy advocates succeeded in reducing the impact on therapy payments from $500 million to $250 million. Private and other public payers will likely follow in Medicare's footsteps and implement the 25-percent reduction in payments despite the distinct differences in benefits, payment, and medical necessity standards, notes the American Occupational Therapy Association in a statement on its website.

Fallout: The MPPR provision will "put unreasonable constraints on access to occupational therapy services for Medicare beneficiaries," as well as conflate the contributions and challenges of each discipline, stated AOTA president Florence Clark, OTR/L, FAOTA.

"The failure to differentiate the three much-needed types of therapy creates a commodity-type reimbursement structure which, without sound justification, devalues the three professions," Clark explained. You can expect AOTA and other associations to continue fighting the provision.