Eli's Rehab Report

Therapy cap exceptions expire and Medicare pay plummets starting Jan 1, 2010, without Congressional action. And the key legislative moves that would help therapists are getting jammed in the Senate.

On Oct. 13, the Senate Finance Committee passed health care reform legislation (America's Healthy Future Act) by a vote of 14 to 9, which contained critical fixes for therapists billing Medicare, according to PT Bulletin Online. The legislation included:

• A two-year extension of the therapy cap exceptions process;

• A one-year fix for the sustainable growth rate (a 0.5 percent increase); and

• An extension of the 1.00 geographic practice cost index floor for two years.

Also of note, the legislation included a ban on specialty hospital self-referral, a higher monitoring of financial relationships between physicians and referred services, and a program to research physical therapy direct access models for expanding access to Medicare beneficiaries in rural areas, the Bulletin said.

This Senate bill still must merge with the House of Representatives' recently-passed Affordable Health Care for America Act (HR 3962), which also authorizes a two-year extension of the therapy cap exceptions process. Yet Congress still has to compromise on the health care reform provisions in these bills.

Note: On Oct. 21, the full Senate blocked a separate bill (the Medicare Physicians Fairness Act of 2009) that would permanently avoid fee schedule cuts.

Meanwhile, Sens. Ben Nelson (D-Neb.) and Olympia Snowe (R-Maine), met with Senate Majority Leader Harry Reid (D-Nev.) to discuss the final Senate health care reform bill, the Bulletin reported. Snowe indicated that voting on a final, amended bill by the end of November would be difficult, despite lawmakers' hopes to vote on health care packages by Thanksgiving.