In response to a troublesome provision included in the fiscal cliff package
passed by Congress on Tuesday, APTA is advising members to monitor APTA's website and the Legislative Action Center specifically for upcoming
action alerts regarding efforts to avert the increased multiple procedure
payment reduction (MPPR) included in the American Taxpayer Relief Act of 2012
(HR8).
Set to be implemented on April 1, the provision applies the MPPR to therapy
services at 50%, up from 20% for office settings and 25% for facility settings.
APTA estimates the application of a 50% MPPR policy will reduce payments by
approximately 6%-7%. This reduction will be partially offset by a 4% increase
that resulted from the Centers for Medicare and Medicaid Services' (CMS) use of
new survey data of practice expenses conducted by APTA. Coupled together, APTA
expects the net overall decrease for outpatient therapy services to be between
2%-3%, a lower cut than expected. Nevertheless, APTA will advocate to fix
this flawed policy. The association soon will call on APTA members to make
their voices heard on Capitol Hill.
The increase to a 50% MPPR was recently endorsed by the Medicare Payment
Advisory Commission (MedPAC). Despite months of aggressive lobbying
efforts to reject the provision, Congress ultimately included this and a number
of other spending cuts in the fiscal cliff package to offset other health care
related provisions, including the prevention of the 26.5% fee schedule cut and
the extension of the therapy cap exceptions process.
Once policy options are assessed,
APTA will issue additional alerts to PTeam. If you're not a member of PTeam, sign up today to receive the alerts. In the
meantime, APTA
members are encouraged to learn more about this and other important provisions
included in the legislation through the resources provided on APTA's 2013 Medicare Changes: January 2013 webpage
at www.apta.org/Payment/Medicare/2013/Changes/. These resources include a statement by
APTA's president on HR8, a congressional summary, a 2013 Medicare therapy cap
FAQ, and a 2013 Physician Fee Schedule and MPPR FAQ.
Additionally, APTA has updated the MPPR calculator to help association members determine their reimbursement for services based on the MPPR only.