Reliant Reveal Policy Series – Telehealth; Therapy Cap Repeal; President’s Proposed Budget…
The Medicare Telehealth Parity Act of 2015 (H.R. 2948) (https://www.congress.gov/bill/114th-congress/house-bill/2948/ ) sponsored by Representative Mike Thompson (D-CA), Diane Bland (R-TN), Gregg Harper (R-MS) and Peter Welch (D-VT), expands telehealth coverage under Medicare in three phases and allows the services to be administered in several metropolitan areas. The proposal goes on to authorize reimbursement for OT, PT and SLP services in originating sites and as additional covered telehealth providers.
The Bipartisan Chronic Working Group of the Senate Committee on Finance has issued a range of policy options aimed at coordinating and improving the quality of care for individuals with chronic disease and increasing efficiency in the Medicare program. The policy would permit Medicare Advantage plans to include certain telehealth services in their annual bid amount as well as allow MA plans to include rehabilitation therapy telehealth services furnished by PTs, OTs, SLPs and certified OTAs. NASL has commented that a “bridge” program would help providers that are subject to alternative payment models required under Medicare Access and CHIP Reauthorization Act (MACRA) transition or “bridge” to the new system. The Connect for Health Act (S. 2484/H.R. 4442) (http://populationhealthinsights.careinnovations.com/h/i/211710537-connect-for-health-act-introduced-into-u-s-congress) promotes cost savings and quality under the Medicare program through the use of telehealth and remote patient monitoring services (RPM). However, there are multiple limitations in this Act including originating site restrictions, geographic limitations and other technical issues.
Therapy Cap Repeal
No legislative vehicle exists at this moment to aggressively attack the ever coveted Therapy Cap Repeal at this time. However, NASL spent time on the Hill thanking Senator Cardin for his amendment and efforts to repeal the arbitrary cap. Messaging included caution concerning pre-authorization without extreme modernization of claims processing. Some wonder if other reimbursement change efforts won’t simply trump the need for a therapy cap repeal. Time will tell and NASL and Reliant Rehabilitation stay focused on the efforts. Cardin Amendment or Medicare Access to Rehabilitation Service Act can be found here. https://www.congress.gov/bill/114th-congress/senate-bill/539
The President’s Budget
Most say the President’s Budget proposal is “dead on arrival” but NASL caution Board of Governor members that Congress can take up pieces of the Budget and run with it. Positives were the Administration’s efforts to explore more transparency with the Medicare Advantage program and efforts to modernize Medicare and Medicaid through improving quality and efficiency. Negatives exist in the duplicative post-acute care bundled payment proposal that is identical to previous years with post –acute providers suffering a near 3 percent reduction in a short 5 years-AHCA argues this is “merely a rate cut, not a meaningful reform of our payment and delivery system”. And once again the budget proposes another cut to the bad debt reimbursement reduction. For more go to http://www.pressreleasepoint.com/ahcancal-reacts-president-obamas-proposed-budget