By Robert (Bob) Weiss, MS, LE Legislative Advocate
Implementation of the “75% Rule” and deletion of the therapy cap exception process were both delayed by Congress until June 30, 2008 when, on December 29, 2007, President Bush signed the Medicare, Medicaid and SCHIP Extension Act of 2007 (Act) into law, extending the State Children's Health Insurance Program (SCHIP).
The Act extends the Medicare therapy cap exception process through June 30, 2008. If Congress had not acted to extend the exception process through June 30, 2008, the Medicare Physician Fee Schedule Final Rule for 2008 would have imposed a combined therapy cap of $1,810 per beneficiary for OPT and OSP, and a separate cap of $1,810 for OOT, beginning January 1, 2008. Unless Congress repeals the therapy caps or further extends the therapy cap exception process prior to July 1, 2008, the therapy caps will take effect when the Act's extension expires on June 30, 2008.
The Act also contains a number of other provisions impacting Medicare providers and suppliers, such as provisions freezing the inpatient rehabilitation facility compliance threshold at 60% instead of 75% and allowing certain co-morbidities to count toward that threshold.
California Assembly Bill No. 1214 Emmerson Waiver of benefits that would have made current healthcare mandates optional was withdrawn from consideration by its author after it became apparent it would not pass the Health Committee.
The New York State Breast Cancer Network has agreed to actively support NY A.07077 Maisel/S.01544 Fuschillo lymphedema diagnosis and treatment bills. They are drafting a letter of support on behalf of their member organizations that will be used as part of their legislator briefings on Advocacy Day on in Albany. The NLN has sent letters of support to the Chairmen of the Insurance and Health Committees urging favorable action on these bills.
Assembly Bill A.05889 Maisel passed the full Assembly last June and is now being considered in the Senate as S04266 Golden. This legislation, sponsored by the Lymphatic Research Foundation, would establish a lymphedema and lymphatic disease research grants program. Grants, not to exceed fifty thousand dollars, would be awarded on a competitive basis to biomedical research institutions that are conducting direct research related to lymphedema and lymphatic disease.
Robert "Bob" Weiss, M.S.
NLN LE Legislative Advocate