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 Doc Fix Should Also Fix Therapy Caps For Good, AHCA Says

 

 

In a letter to the House Ways and Means and Energy and Commerce Committees, the American Health Care Association (AHCA) urged the chairman to include a permanent therapy cap fix in whatever legislative vehicle is created to permanently fix the formula for Medicare physician payments.

“We appreciate and strongly support your effort to find a permanent fix to the Sustainable Growth Rate” (SGR), which drives the update in physician rates, said the letter from Gov. Mark Parkinson, AHCA’s president and chief executive officer. “The medical directors of the 15,000 skilled nursing centers in the U.S. are doctors, and we appreciate your efforts to ensure that they are reimbursed at reasonable levels.”

Year after year, the therapy cap fix has been tied to the annual SGR fix. As a result, AHCA said it was concerned that if lawmakers enacted a permanent SGR resolution without doing the same for therapy caps, it would “leave millions of elderly patients without the care they require.”

Currently, Congress must pass an annual extension of the therapy cap exceptions process, “or face the consequence of residents in our centers not having access to necessary medical treatment,” Parkinson wrote. In the absence of an exceptions process, the cap imposes a limit of $1,900, “which does not come close to adequately covering the cost of needed treatment,” AHCA said.

The letter further asked lawmakers not to fund the permanent SGR fix with cuts to other providers.
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