Deconstructing the sausage - Analyzing provisions for therapy assistant payment differentials

It is commonly stated that the process of legislating is like making sausage - you generally don ' t want to see how it happens.The therapy community was recently disappointed with the announcement that facilities would have to code their Medicare B claims with a modifier and would receive payment at 85% of the standard rate whenever that therapy was delivered in whole or in part by an OTA or PTA.  This is hard coded into legislation - and is not a rule or regulation.  For reference, this is included in the legislation that has been called "The Bipartisan Budget Act of 2018."The addition of this requirement was included in the recent legislation as an offset to the cost of repealing the Medicare therapy caps.Professional associations like AOTA have stated that they were surprised by a ' last minute ' inclusion of payment differentials that they report to have learned about on  February 5, 2018.  Since the AOTA employs a professional staff of lobbyists and legislative policy experts it is reasonable to wonder how they could have been surprised at this very late stage in the process.When bills are being created, they are passed through ' committees ' of the House and Senate.  These committees are composed of legislators who are responsible for ' fine tuning ' legislation to the point that it is ready for a vote on the floor of the legislative body.  It is common practice for legislation to be passed to theCongressional Budget Office where it can re...
Source: ABC Therapeutics Occupational Therapy Weblog - Category: Occupational Health Tags: health insurance OT practice Source Type: blogs