The House of Representatives and the Senate could reach agreement early next year on proposals to permanently repeal the flawed sustainable growth rate (SGR) formula and possibly end the therapy cap. These legislative packages are part of a shift in the health care system away from the current fee-for-service system and toward programs focused on quality outcomes. APTA has created a webpage with detailed information on the proposals.
While an agreement looks possible, it will not be reached before the House and Senate adjourn for the holidays. In the meantime, Congress is expected to pass a 3-month SGR patch early next week to prevent a 20.1% cut to the conversion factor announced by CMS in the physician fee schedule and extend the current therapy cap exceptions process. This short-term fix would be effective January 1–March 31, 2014, and will give the House and Senate time to reach a final agreement on the SGR reform package. The Senate is expected to return on January 6 and the House on January 7. Congress will resume negotiations and begin discussing how to pay for the cost of the legislation.
APTA has been a strong advocate for repeal of the therapy cap and SGR, and worked with committees in the House and Senate to include several APTA public policy priorities in the SGR reform packages now being discussed.
The Senate Finance Committee proposal includes a range of actions on the SGR and various Medicare extenders. The Senate plan:
The proposal passed by House Ways and Means Committee repeals the SGR formula but does not include a repeal of the Medicare therapy cap or changes to any other Medicare extenders. During the hearing, Reps Xavier Becerra (D–-CA) and Erik Paulsen (R-MN) spoke about the need to address the Medicare therapy cap in the final SGR reform package. ChairDavid Camp (R–MI) agreed that the Medicare extenders need to be addressed and said that he intends work on these issues as the SGR legislation moves forward in the House.
The proposal passed by the House committee:
No action can be taken on the reform package until both chambers return in 2014. APTA will continue to work with members of Congress and their staff to best position the profession throughout the legislative process.
How You Can Get Involved
APTA will continue to work with members of Congress to advocate for the profession and will be seeking your help to best position physical therapy throughout the legislative process. Members interested in joining APTA’s advocacy efforts to reform SGR and repeal the therapy cap can sign-up for PTeam.
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