Originally posted to the American Speech-Language-Hearing Association. Headlines e-mail list on November 4, 2005.
Audiologists and speech-language pathologists need to be prepared for potential reductions in Medicare payment under the Medicare Physician Fee Schedule (MPFS) in 2006. Lack of congressional action to date, has pushed forward regulatory implementation of the return of the therapy caps and a significant reduction in Medicare payments on January 1, 2006. ASHA is actively working to prevent these reductions from occurring, but audiologists and speech-language pathologists need to be aware of the potential impact in all health care practice settings.
As reported today in the final rule of the Medicare fee schedule, the new conversion factor is $36.1770. This represents a 4.4% reduction from the current conversion factor of $37.8975 as mandated by the Medicare statute's sustainable growth rate (SGR) formula. Over the next six years, it is anticipated that Medicare payments will be reduced by 26% if the SGR remains in place.
Professional health care and medical associations are unified in advocating that the SGR is a flawed statutory mechanism for controlling the volume growth of Medicare expenditures and that it should be replaced. A pay-for-performance approach is being advocated by professional organizations and key members of Congress as the best alternative for both controlling Medicare expenditures and providing incentives for improving the quality of care.
The Centers for Medicare and Medicaid Services' (CMS) final rule also plans for the return of the rehabilitation therapy caps at an amount of $1,740 for 2006. Unless congress acts to eliminate or delay the caps, CMS will be providing Medicare contractors with instructions on how to implement the $1,740 annual limit. The combined speech-language pathology/physical therapy cap would also include therapy services provided under a chiropractic demonstration project.
A detailed analysis of the Medicare fee schedule impacting ASHA members will be released in the next few days. A copy of the final rule for the 2006 Medicare fee schedule can be found on the CMS Web site at
www.cms.hhs.gov/physicians/default.asp. For more information on the Medicare fee schedule final rule, please contact Mark Kander, Director of Health Care Regulatory Analysis, via e-mail at mkander@asha.org or by phone at 800-498-2071, ext. 4139.
Your Advocacy Needed
Please contact your members of Congress through ASHA's Take Action Web site at
takeaction.asha.org and ask them to repeal the Medicare therapy caps by supporting S. 438 and H.R. 916.
In less than 5 minutes, you can send a letter to the editor by e-mail to your local newspapers based on your zip code. ASHA's Take Action Web site now offers an editable, draft letter that conveys the very real and negative impact associated with the return of the therapy caps. Visit takeaction.asha.org, scroll down, and select "Write a Letter to the Editor on Therapy Caps: With a Small Investment of Time, You Can Have an Impact." Over 700 letters to the editor have been sent to date by ASHA members and consumers.
For more information on congressional action to block the therapy caps, please visit ASHA's Therapy Cap Advocacy Center at
www.asha.org/about/legislation-advocacy/federal/cap/or contact Reed Franklin, ASHA's Director of Federal and Political Advocacy, via e-mail at rfranklin@asha.org or by phone at 800-498-2071, ext. 4473.
Reprinted by permission of the American Speech-Lanuage-Hearing Association.
