Potential 9% therapy cut worries LTC providers - SpecialtyRx
August 10, 2020
Potential 9% therapy cut worries LTC providers

CMS proposes shocking 9% decrease in Medicare rehab payments

How industry advocates are fighting back in your favor


On August 3rd, the Centers for Medicare & Medicaid services published its proposed changes to Medicare payment policy under the Physician Fee Schedule (PFS). Also covering Medicare Part B concerns, the rule—if approved—would take effect in January.

While long-term care providers were happy to learn of newly expanded allowances for telehealth, the news comes with a potentially devastating blow. For fiscal year 2021, CMS will cut 9% from Medicare payments for both physical and occupational therapies under the PFS. Senior advocates are referring to the move as a ‘deep disappointment,’ as our nation’s most vulnerable citizens will surely suffer.

“If implemented in its current form, these cuts could drive physical therapy providers out of business, particularly those who deliver care to underserved minority communities and older Americans,” said Nikesh Patel, executive director at the Alliance for Physical Therapy Quality and Innovation. “[These are] two populations that have already been disproportionately impacted by the public health emergency.”

Cms covid-19 relief

Learn more at McKnight’s LTC News and cms.gov


LTC critics speak

Officials explained that the therapy cuts were designed to offset payment increases for primary care physicians as CMS strives to achieve budget neutrality. But operators and senior advocates know—the impact will be highly disadvantageous to patients.

“A reduction in payment of this magnitude is misguided under typical circumstances, but is truly damaging to patient access during a global pandemic. Upon discharge from the hospital, many COVID-19 patients require therapy for their long-term recovery,” read a group statement from the APTA, AOTA and ASLHA.

Providers are also reeling.

“Many audiology and speech-language pathology practices are fighting to stay afloat due to the challenges posed by COVID-19,” said Theresa Rodgers, president of ASHA. “If these practices are shuttered due to the additional financial stress from these cuts, patients ultimately stand to suffer.”

On a brighter note

While public backlash has been loud and clear, providers are encouraged to share their questions, comments, and concerns regarding proposed rule CMS-1734-P by October 5, 2020.

For now, administrators, caregivers, residents, and families can celebrate the measure’s 2021 telehealth expansions. This includes continued coverage for virtual PT, OT, and SLP services. Patients will also see a huge allowance increase from one visit every thirty days to every three days. Finally—some healthcare news we can all get behind.


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