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AHCA/NCAL Submits Testimony to Congress Regarding Part B Therapy Caps

Dan Ciolek

On July 20, 2017, AHCA/NCAL submitted written testimony for a hearing titled “Examining Bipartisan Legislation to Improve the Medicare Program” conducted by the U.S. House Energy and Commerce Committee, Subcommittee on Health.  The AHCA/NCAL comments focused on a discussion draft of proposed legislation related to the Part B therapy caps exceptions and targeted medical review processes that will expire at the end of December.  Without Congressional action this year , beneficiaries would not be able to receive covered therapy services above the cap limits per year (currently $1,980 for PT/SLP and $1,980 for OT).  AHCA/NCAL has been working with a broad coalition of providers and consumers to repeal the therapy caps, and in the testimony, encouraged Congress to act this year to assure continued beneficiary access.

The following is an excerpt from the five page AHCA/NCAL testimony:

AHCA/NCAL appreciates that the Congress has previously responded to providers and beneficiaries, and has mitigated many therapy cap beneficiary access concerns by extending a cap exceptions process on numerous occasions, and is proposing to do so again with this discussion draft bill. We applaud your attention to addressing this important issue by considering another extension to the current exceptions process policy, which would at least protect the status-quo. However, we ask that the Health Committee consider whether the time is right to consider developing a permanent solution to repeal the therapy caps. We believe that a permanent solution should:

• Ensure timely and uninterrupted beneficiary access to outpatient therapy, 
• Build upon the program integrity success of the current targeted review program established by the MACRA provisions, 
• Align outpatient therapy data collection efforts with IMPACT Act provisions, and 
• Align outpatient therapy policy with various person-centered value-based payment models. 
 
You can find the entire AHCA/NCAL written testimony here.  Contact Dan Ciolek, AHCA Associate Vice-President, Therapy Advocacy, for questions related to the therapy caps.

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