Originally posted to the American Speech-Language-Hearing Association. Headlines e-mail list on October 26, 2005.
A 1-year moratorium on the implementation of the Medicare therapy caps is among several provisions that are important to ASHA members in the budget reconciliation bill to be considered this week by Senate Finance Committee Chairman Charles Grassley (R-IA). A summary of the chairman's proposal can be found at finance.senate.gov/sitepages/leg/102005lsumm.pdf.
Other key issues include a 1% increase in 2006 payments under the Medicare physician fee schedule that would prevent a projected 4.3% cut in fees. The chairman's reconciliation package would also freeze implementation of the so-called "75% Rule" on inpatient rehabilitation hospitals at the 50% level while Congress and the Department of Health and Human Services study the impact of the restriction.
The legislative package includes provisions on pay-for-performance or "value-based purchasing" where acute-care hospitals, physicians, other practitioners (speech-language pathologists are specifically cited in the legislation), managed care plans, end-stage renal disease providers, and home health agencies would receive 1% of pooled provider payments, growing to 2% over five years based on quality performance measures. ASHA is working with the Centers for Medicare and Medicaid Services (CMS) and Congress to gain recognition of ASHA's National Outcomes Measurement System (NOMS) as the data collection and benchmarking tool for speech-language pathology services. Data collected from NOMS could potentially be used by CMS in the development of a pay-for-performance payment methodology for speech-language pathology services.
It is unclear whether the SLP direct billing provision met the budget threshold requirements (costing or saving at least $45 million) to qualify for consideration in the reconciliation package and is included in the Senate reconciliation legislation.
Senator Grassley's proposal is the first step in a lengthy and uncertain process for Congress to act on an omnibus budget reconciliation bill that will also include short-term Medicaid reforms. On the House side, the Energy and Commerce Committee and the Ways and Means Committee leaders are only expected to take up Medicaid reform measures and Hurricane Katrina relief provisions as part of their budget reconciliation bills.
For further information, please contact Reed Franklin, ASHA's Director of Federal and Political Advocacy, via e-mail at rfranklin@asha.org or at 800-498-2071, ext. 4473.
Reprinted by permission of the American Speech-Lanuage-Hearing Association.
