Eli's Rehab Report

Published on Fri Nov 20, 2009 PDF

Waiting for the Medicare therapy cap exceptions process to expire once again at the end of 2010? Good news: It may hang on for another two years if the latest Senate Finance Committee's health care reform legislation goes through.

In mid-September, Sen. Max Baucus (D-Mont.) released a summary of this legislation, which includes a two-year extension of the therapy cap exceptions process, according to PT Bulletin Online. The proposal also includes a one-year fix for the Medicare Physician Fee Schedule's sustainable growth rate (a 0.5 percent increase, as opposed to the 21.5 percent decrease included in the MPFS final rule). In addition, the proposal would extend the 1.00 floor for geographic practice cost indices for two more years.

Also of note, the Senate bill bans specialty hospital self-referral and requires "increased transparency on disclosure of financial relationship between physicians and referred professional services," the Bulletin noted.

Two Congressional committees marked up this legislation, and Sen. Blanche Lincoln (D-Ark.) proposed an amendment which passed that would eliminate the requirement for physician referral/certification of a plan of care for Medicare beneficiaries living in rural areas who want to get physical therapy, the Bulletin said.

The bill would cost $856 billion and instead of government-run healthcare, would require a co-op system of health insurance to provide competition for the private health insurance plans, the Bulletin clarified.