Efforts to protect Medicare beneficiary access to therapist services received a boost yesterday when the Senate voted 52 to 47 to adopt a 1-year extension of the moratorium on implementation of the Medicare Therapy Cap as part of its budget reconciliation package (S 1932). The House version of the budget bill, which won committee approval this week and is expected to be voted on by the full House next week, does not include therapy cap provisions or any Medicare policy changes. The lack of Medicare provisions in the House could complicate negotiations to resolve differences between its bill and the Senate version of the budget bill in the coming weeks.

The Senate bill also includes a 1 percent increase in 2006 payments under the Medicare physician fee schedule —as opposed to the 4.4 percent cut announced by the Centers for Medicare & Medicaid Services (CMS) and an extension of the 50 percent admissions criteria threshold for inpatient rehabilitation facilities (IRFs) through June 30, 2007. Other provisions would establish "pay for performance" standards in Medicare and allow families with children with disabilities and incomes up to 300 percent of the federal poverty level to "buy in" to Medicaid coverage. The Senate bill also prohibits the establishment of new physician-owned specialty hospitals.

Without congressional action, CMS will implement the $1,740 cap in fewer than 60 days.

Source: APTA