Wednesday, November 1, 2017

Bipartisan Framework to Repeal Therapy Caps Announced

Drew Thies

The House Ways and Means and Energy and Commerce Committees announced last week that their members have reached a bipartisan agreement permanently repealing annual limits on Medicare payments for therapy policy. The per-patient limits, commonly referred to as “therapy caps” were an annual nuisance for lawmakers, who previously had to repeal the policy on a yearly basis.

A joint statement from Ways and Means Committee Chairman Kevin Brady (R-TX), Ranking Member Richard Neal (D-MA), Energy and Commerce Committee Chairman Greg Walden (R-OR), and Ranking Member Frank Pallone (D-NJ) praised the agreement as “a major breakthrough” and avoids a similar situation to “the days of SGR patches.”

In 2006, Congress passed an exceptions process allowing patients to exceed the cap based on medical necessity and the temporary legislation has been renewed on a case-by-case basis. The cap was addressed most recently in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and expires on January 1st.

Though the policy framework has been agreed to, lawmakers still do not have agreement on how to offset the package. Negotiations continue as the committees seek to pass legislation before the year-end deadline on the current therapy cap suspension law.

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