A new year started mere days ago, but the long term care profession faces the exact same challenges that the end of 2011 offered when Congress could not resolve a permanent solution to the so-called "doc fix" for paying doctors in the Medicare program, which was instead folded into the emergency passage of a temporary two-month extension of the payroll tax cut.

Greg Crist, vice president of public affairs at the American Health Care Association (AHCA), said the battle in Congress for long term care providers is “shaping up a lot like the end of 2011,” with AHCA advocating that skilled nursing facilities and long term care in general not be used as a “pay-for” to ensure the resolution of the larger tax cut issue.

This rehash of what transpired before the holiday break is extremely important to providers already beaten down by severe cuts in Medicare and Medicaid reimbursement rates in recent months, Crist says.

In addition to the fix on paying doctors in Medicare, Congress must address a permanent solution to the therapy cap exceptions process. In a statement released after the temporary extension bill was passed, AHCA President and Chief Executive Officer Gov. Mark Parkinson said, “Thousands of seniors receiving critical therapy should have the peace of mind that even past February they will have access to the care they need.”

A permanent extension of the therapy cap exceptions process for medically necessary Medicare Part B outpatient therapy services would help ensure tens of thousands of beneficiaries receive the critical therapy services they need for their recovery, providers argue.

Therapy caps of $1,870 for physical therapy and speech-language pathology combined, and a separate $1,870 cap for occupational therapy, will place significant hardships on thousands of Medicare beneficiaries if Congress and the Obama administration are unable to reach an agreement and extend an exceptions process to the existing limitations. ​