House Passes Temporary Fix for SGR and the Therapy Cap; Senate Action to Come

The APTA recently sent out this update that we wanted to share with you.

The House passed the Protecting Access to Medicare Act of 2014 (H.R. 4302) today, which would avoid the scheduled 24.1% payment cut to Medicare providers and extend the therapy cap exceptions process for 12 months.  The short-term fix provides a 0.5% payment update for providers through December 31, 2014, followed by a 0% update in the first quarter of 2015.  The legislation also delays implementation of ICD-10 for one year.

The House passed H.R. 4302 this morning by an unexpected voice vote on the floor, which angered some Representatives who wanted Congress to continue to focus on a permanent repeal package.  The Senate is expected to vote on the legislation by Monday.

The approximate $20 billion cost of the temporary fix approved in the House will be paid for through a combination of cuts and programmatic changes that include reductions to clinical labs, radiology services, a delay on oral-only drugs for end-stage renal disease bundles, the establishment of a new value-based purchasing program for skilled nursing facilities based on performance around hospital readmissions, and a tightening up of code valuation under the fee schedule. Additional funds are identified through the use of SGR “transitional fund” money and an extension of the Medicare sequester provisions.

Although members of both the House and Senate have recognized the need for permanent repeal, progress stalled when legislators were unable to agree on how to pay for the SGR reform package.  APTA continues to work with legislators for a permanent solution to the SGR formula and Medicare therapy cap. 

APTA members can stay up-to-date on the latest SGR reform and therapy cap news by joining the PTeam or downloading the APTA Action app.

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Kristi Fredieu

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