Tuesday, May 6, 2014

CMS Report on Part B Therapy Payment Alternatives Released

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) recently released an extensive and long-awaited report on Medicare Part B therapy payment alternative options.

The Developing Outpatient Therapy Payment Alternatives (DOTPA) project began in 2007 and had two main identified purposes: 1) to identify, collect, and analyze therapy-related information tied to beneficiary need and the effectiveness of outpatient therapy services, and 2) to explore payment method alternatives to the current financial caps on Medicare outpatient therapy services. AHCA members participated in this project as volunteer study data collection facilities, as well as through representatives participating in DOTPA Technical Expert Panels (TEPs).

The following DOTPA reports are currently available are on the CMS website—the DOTPA Payment Alternatives Report and DOTPA Final Report. The Payment Alternatives Report details results of the exploration of payment alternatives for Medicare outpatient therapy services. The Final Report summarizes the overall results, lessons learned from the DOTPA project, and possible directions for future research. In addition, the DOTPA CARE-C and CARE-F Assessment Forms used to collect items of information on the DOTPA patient sample are also available. Find these reports and additional information on the DOTPA web page.

The Payment Alternatives Report introduction states that "The research presented here does not aim to provide a completed, finalized model for a new payment system. Instead, selected characteristics that exist for an alternative payment system are discussed within the context of this diversity." AHCA staff and members are currently reviewing the reports and will integrate the report findings and conclusions within our ongoing efforts at repealing the Part B therapy caps and reforming the overall payment policy. 

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