Call to slash therapy caps

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The chairman of the Medicare Payment Advisory Commission has urged a House committee to set lower Medicare Part B therapy spending caps.

He also urged Congress to halve the certification period for outpatient therapy plans to 45 days from 90. Doing so should reduce the amount of unwarranted therapy that occurs since the average term of therapy is just 33 days, said Glenn M. Hackbarth.

He submitted recommendations and testified at a January hearing of the House Energy and Commerce Committee.

Hackbarth asserted that lowering current therapy caps from $1,920 per year to $1,270 would mean that about two-thirds of patients would still never reach them. One cap applies to occupational therapy while the other is for physical and speech therapies combined.

Therapy charges that would go beyond a cap should enter a streamlined, standardized manual review process, Hackbarth added. This new system would counteract the current “limited physician oversight to determine” the propriety of continuing therapy. 


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