AHCA/NCAL Joins Therapy Coalition in Joint Letter on Physician Fee Schedule Reform

Medicare; Part B; AHCA/NCAL Updates

AHCA/NCAL, along with six other organizations representing rehabilitation therapy professionals and facility-based providers, recently submitted a joint letter to the U.S. Senate Finance Committee on Medicare Part B Physician Fee Schedule (PFS) reforms. The intent of the letter was to identify specific policy options impacting outpatient physical and occupational therapy and speech-language pathology services paid under the Medicare Part B PFS payment system to “…support stable and sufficient payments…”  The letter highlights how the current PFS policies have disadvantaged non-physician therapy providers for more than a decade and, in particular, how the PFS incentive payment program policies block most outpatient therapy providers including SNFs, from being eligible for Part B quality incentive payments.   

The coalition recommended the following policies be considered and included in PFS reforms being considered by Congress to ensure patient access to care and the financial stability of outpatient therapy providers: 

  • Eliminate the Multiple Procedure Payment Reduction (MPPR) policy. 
  • Provide flexibility in the supervision of assistants and determine challenges facing the therapy workforce in rural and underserved areas. 
  • Reform the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to allow broader participation (including SNFs) in the Merit-based Incentive Payment System (MIPS). 
  • Reduce the impact of inflation on providers and the patients they serve via Medicare Economic Index (MEI) annual updates. 
  • Reduce administrative (certification signature] burden for therapy services provided under Medicare Part B. 
    • Legislation has been introduced on this matter as H.R. 7279, the Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act. 
  • Enact a permanent Medicare policy for therapy services delivered via telehealth. 
    • The coalition organizations support the Expanded Telehealth Access Act (H.R. 3875). 

Organizations signing on to the coalition letter​ include: 

  • ADVION (formerly the National Association for the Support of Long Term Care) 
  • American Health Care Association/National Center for Assisted Living (AHCA/NCAL) 
  • American Occupational Therapy Association (AOTA) 
  • American Physical Therapy Association (APTA) 
  • American Physical Therapy Association Private Practice 
  • American Speech-Language-Hearing Association (ASHA) 
  • National Association of Rehab Agencies and Providers (NARA)