The Medicare Part B therapy caps went into place on January 1, 2010 making action to repeal the therapy caps or extend the exceptions process necessary immediately, to prevent the rationing of care for patients in dire need of our services. It is imperative for the profession and our patients, who truly need these essential services that we act now.
AOTA's federal affairs staff is aggressively working to repeal the cap or extend the exceptions process and your help is needed to force Congress to address this important issue.
Click here to learn more and contact your Senators and Representative today.
Therapy Cap Exceptions Process Expired!
The therapy cap exceptions process expired December 31, 2009, which means that claims filed as of January 1 are subject to the $1,860 cap on occupational therapy services. AOTA has learned that CMS and contractors are advising providers to discontinue use of the KX modifier.
Medicare Tranmittal Update-QOU
Download the What's New Page-October 2008 here!
AOTA Comments about Trailblazer Draft LCD DL30533
Download the document in pdf format here.
Alert: OIG Work Plan for FY 2010 Released
The Department of Health and Human Services (HHS)recently released
its Office of Inspector General (OIG) Work Plan for fiscal year (FY)
2010. This publication describes activities that the OIG plans to
initiate or continue with respect to the programs and operations of
HHS in the next year.
AOTA is closely reviewing the work plan for implications for OT advocacy;
however, occupational therapy is specifically mentioned with regard
to Medicaid in the following excerpt:
Medicaid Physical and Occupational Therapy
Services: Appropriateness of Payments:
We will review the appropriateness of payments for Medicaid
physical and occupational therapy services. Pursuant to 42 CFR § 440.110,
states may provide physical and occupational therapy services to Medicaid
beneficiaries. Previous OIG studies found that some physical and occupational
therapy services provided under Medicare were medically unnecessary,
were billed incorrectly, or were rendered by unqualified providers.
Through a medical review, we will determine whether Medicaid has similar
program integrity issues.
You can access the report at: http://oig.hhs.gov/08/Work_Plan_FY_2010.pdf
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