Therapy Cap

On Wednesday, February 1, 2017, both the House and the Senate introduced bills that would repeal the Therapy Cap.  The bill numbers are H.R. 807 and S. 253. The text of the bills it not yet available.

H.R. 807 was introduced by Rep. Paulsen, Erik (R-MN) and has been referred to the House - Energy and Commerce; Ways and Means.  There are currently 46 co-sponsors of the Bill (click here for the full list).  NARA will continue to update you on this Bill.
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NARA Spring Conference 2016 May 4 - 6, 2016 Renaissance Washington DC Hotel - Dupont Circle Major changes are in store for the health care sector which will have a profound effect on providers and their patients. The elections in November will bring a new President, determine which party will control the House and Senate, and usher in new leadership for regulatory agencies such as HHS and CMS. Federal agencies will take significant steps to implement new payment methodologies to replace the physician... Read More

The National Association of Rehab Providers & Agencies will conduct its Spring Conference May  4 - 6, 2016 at the Renaissance Dupont Circle hotel in Washington DC.  The program will kick off Wednesday, May 4th with an introduction and big picture overview as to what is currently happening from a regulatory, policy, and legislative perspective.  Over the course of the 2 1/2 day conference, attendees will be educated and updated by key industry speakers on the hot topics making up the big picture... Read More

On April 14th, by a vote of 92-8, the Senate passed H.R. 2, the Medicare Access and CHIP Reauthorization Act, which had passed the House over two weeks ago by a wide margin. Eight Republicans voted against the bill: Senators Cruz, Lee, Perdue, Rubio, Sasse, Scott, Sessions, and Shelby. Six amendments were offered to the bill and all were defeated, including Sen. Cardin’s amendment to repeal the outpatient therapy caps. The bill will now be sent to the President who has already stated that he will... Read More

One of the hot-button issues in the rehabilitation industry, as far as legislation is concerned, is the ongoing battle to get a full repeal of the Medicare Therapy Caps introduced as a result of the Balanced Budget Act (BBA) in 1997.  This act has caused headaches for providers and patients alike. In part-one of this two-part series, we gave a big-picture view of the Therapy Cap and what it all entailed.  In part-two, we plan on giving a little more insight into what that actually means and the... Read More

As almost everyone in the rehabilitation industry is well aware, there was legislation enacted back in 1997, under the Balanced Budget Act, that placed an annual cap on rehabilitation services under Medicare.  While this legislation was intended to prevent organizations from taking advantage of the system, the harmful effect of denying patients the care they desperately need has more than overshadowed the “good” of that original intent. Therapy Cap Background The Balanced Budget... Read More

CMS Announces Educational Call for Providers on Functional Testing Requirement  

December 12, 2012 1:30 - 3:00pm EST

The transcript and audio file for the October 22, 2012 Manual Medical Review of Therapy Claims Special Open Door Forum is available on the Special Open Door Forum web page: http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html . Thank you for your continued interest in the CMS Open Door Forums. http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html Read More

CMS Special Open Door Forum Summary Manual Medical Review Process for Part B Therapy Claims Effective October 1, 2012  

Effective October 1, 2012, CMS will implement a phased Therapy Cap Exception (TCE) process. The implementation schedule is provided below. During this period, the 2012 therapy cap amounts will be $1880 for occupational therapy services and $1880 for the combined services for physical therapy and speech-language pathology. All requests for therapy services above $3,700 which are provided by a speech language therapist, physical therapist, or physician shall be approved or disapproved in advance. Settings... Read More