A bipartisan, bicameral proposal unveiled on February 6 would end Medicare’s flawed sustainable growth rate (SGR) formula, but it does not contain any language around the therapy cap. APTA's advocacy team is now encouraging grassroots efforts to turn legislators' attention to extenders such as the therapy cap for inclusion in the final bill.
The SGR Repeal and Medicare Provider Payment Modernization Act (HR 4015) would permanently repeal the SGR and provide annual increases of 0.5% from 2014 through 2018. For the next 5 years after 2018, rates would remain unchanged, but providers could receive additional payments through a quality incentive system. The agreement is the product of the Senate Finance, House Ways and Means, and House Energy and Commerce committees.
Still lacking from the agreement, however, is any mention of repeal of the outpatient Medicare therapy cap—something included in the Senate committee's original version of the legislation. If Congress passes legislation permanently addressing the SGR formula but does not include a repeal of the Medicare therapy cap, patients could face a hard cap on outpatient therapy services after the current therapy cap exceptions extension expires on March 31.
“Congress has indicated it will now turn its attention to which Medicare extenders to include in the legislation, so it is imperative that APTA members use APTA’s advocacy resources in favor of repealing the cap," said Justin Moore, PT, DPT, vice president of public policy, practice, and professional affairs for APTA.
The APTA advocacy team has issued an action alert calling for members and supporters to urge their legislators to include a repeal of the therapy cap in the final bill, and members interested in the latest news on the SGR and therapy cap reform can now download a new "Heard On The Hill" podcast that provides more details about the proposal. APTA members can take action via the Legislative Action Center and nonmembers and the public can take action via the Patient Action Center.
APTA will continue to work the members of Congress to ensure the final reform package includes policies that reflect the interests of physical therapists and the patients and clients we serve. Members interested in joining APTA's advocacy efforts to reform SGR and repeal the therapy cap can sign up for PTeam.
Editor's note: This story was updated at 3 pm ET (February 10) to correct a typo in Justin Moore's quote. News Now regrets the error.
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