Urge Congress to Repeal the Medicare Part B Outpatient Therapy Cap
Take Action to urge Congress to ensure the agreement on the sustainable growth rate (SGR) (H.R. 4015) includes repeal of the Medicare Part B outpatient therapy cap
The National Association for the Support of Long Term Care (NASL) was very disappointed that recently introduced legislation did not contain a permanent repeal of the therapy cap given its inclusion in the Senate Finance Committee SGR bill. Furthermore, NASL supports strengthening the current medical review process for claims above $3,700 and must be streamlined to make it more uniform and efficient for providers and patients alike. It is imperative that the recent bipartisan bicameral SGR agreement (H.R. 4015) address these important beneficiary access issues before it is considered by the House and the Senate.
If Congress does not reach an agreement by March 31, 2014, it is very likely that patients will face a hard cap on outpatient therapy services in 2014. Reliant and NASL asks that you continue to show support by sharing the following message with colleagues and sending an email to Congress.
We are asking Congress for the following provisions to be included in any SGR agreement this year:
Extension of therapy exceptions process until end of year;
Clear and unequivocal requirement that medical reviews be conducted and completed within 10 days of contractor receiving necessary documentation;
Requirement that CMS simplify, standardize and automate contractor and provider communications; and
Requirement for GAO study to identify opportunities to better design Part B outpatient therapy benefit and improve manual medical review process.
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