Therapy payment bills supported during AHCA/NCAL fly-in

Sen. Benjamin Cardin (D-MD) told AHCA that lawmakers support a full repeal.
Sen. Benjamin Cardin (D-MD) told AHCA that lawmakers support a full repeal.

National long-term care industry advocates and numerous facility representatives made the rounds in the halls of Congress on Wednesday in support of legislation designed to permanently end nearly two decades-old therapy caps and improve short-term data collection efforts they say have caused undue administrative burdens on providers and patients.

Versions of the Medicare Access to Rehabilitation Services Act are currently under review in both houses (S.539 and H.R.775). Providers also seek major changes to improve the present manual medical review (MMR) process for therapy claims, which has caused unnecessary burdens on beneficiaries and providers.

The American Health Care Association and National Center for Assisted Living sponsored the provider visits this week on Capitol Hill to both endorse the legislation and explain to more than 50 senators and representatives why and how the current manual claims review process should be improved, Mark Parkinson, AHCA/NCAL president and CEO said in a statement Thursday.

AHCA/NCAL and providers are proposing a plan to improve the present manual medical review process for therapy claims, which expires March 31.

“Our goal was to set clear markers of support for the dual therapy issues – ending therapy caps and restoring efficiencies and commonsense program integrity practices to claims review,” Parkinson said.

He added that AHCA/NCAL and providers want to ensure a new therapy payment system will include safeguards to ensure compliance and that any MMR fixes will be retroactive.

Senate co-sponsor Benjamin Cardin (D-MD) told AHCA that lawmakers support a full repeal of the existing caps on therapy services, noting their sole purpose when imposed 18 years ago “was to help balance the federal budget.”

Both bills in Congress also have been fully endorsed by the Therapy Cap Coalition, an organization of 23 entities including consumer groups, professional therapy associations, vendor groups, and trade associations, AHCA/NCAL noted.