Congress Passes 1 Year Fix for SGR and the Medicare Therapy Cap

The following was posted by the APTA.

Congress passed a 12-month patch for the sustainable growth rate (SGR) formula today, which avoids a scheduled 24.1% payment cut to Medicare providers, and provides for a 0.5% payment update through December 31, 2014.  January through March 31, 2015, providers will receive a 0% payment update.  This patch was approved by the Senate today, after passing the House of Representatives on March 27.  The Protecting Access to Medicare Act of 2014 (H.R. 4302), will now be sent to the President for his signature.

In addition to preventing the payment cut, H.R. 4302 also extends the therapy cap exceptions process for outpatient therapy services.  Providers will continue to use the KX modifier at the $1,920 level and manual medical review at $3,700.  This legislation also delays implementation of ICD-10 for one year.

While APTA is pleased that Congress took action and prevented steep payment cuts to providers and allowed Medicare patients to continue treatment, we believe that Congress must continue to work toward a permanent solution for SGR reform and the Medicare therapy cap.  Providers and patients can no longer endure this system of last minute extensions.

Take advantage of the upcoming Congressional recess, April 14-25, and meet with your members of Congress.  Stress the need for continued bipartisan, bicameral efforts to reform the SGR and repeal the Medicare therapy cap once and for all.

Call your legislator’s district scheduler this week and request a meeting.  You can find the phone number for each district office by entering your zip code here, clicking the info link, and then clicking the Contact tab.  You can also view upcoming town hall events on the Grassroots Resources tab of the Legislative Action Center.  After your meeting is scheduled, email APTA at lindsaystill@apta.org.  We will help you prepare for the meeting by providing talking points and tips before you meet with your legislator.

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Kristi Fredieu

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