Reimbursement: Legislative and Regulatory Update Following is a summary of Medicare salary equivalency, per hour limits, as of April 15,1997. The regulations were proposed 3/28/97. Public comments were accepted until May 2 7. Implementation is likely to occur in late 1997 or early 1998. Steady and steep increases in speech-language pathology (SLP) and occupational therapy ... Article
Article  |   October 01, 1997
Reimbursement: Legislative and Regulatory Update
Author Affiliations & Notes
  • Mark Kander
    Medicare and Medicaid Branch
    ASHA Director
Article Information
Older Adults & Aging / Articles
Article   |   October 01, 1997
Reimbursement: Legislative and Regulatory Update
SIG 15 Perspectives on Gerontology, October 1997, Vol. 2, 13-18. doi:10.1044/gero2.2.13
SIG 15 Perspectives on Gerontology, October 1997, Vol. 2, 13-18. doi:10.1044/gero2.2.13
Following is a summary of Medicare salary equivalency, per hour limits, as of April 15,1997. The regulations were proposed 3/28/97. Public comments were accepted until May 2 7. Implementation is likely to occur in late 1997 or early 1998.
Steady and steep increases in speech-language pathology (SLP) and occupational therapy (OT) cost-based charges by some rehabilitation services contractors was the main impetus for the Health Care Financing Administration’s (HCFA) decision to implement salary equivalency (SE) per hour limits.
HCFA acknowledged in the 3/28/97 Federal Register proposal that one reason contractors have boosted charges for speech-language pathology and OT services is to compensate for low physical therapy (PT) SE reimbursement limits. Until SE is implemented, HCFA has instructed its fiscal intermediaries to apply the “prudent buyer” principle in deciding reasonableness of speech-language pathology and occupational therapy. SE payments are for the practitioner’s total time in the facility (subject to an unspecified minimum percentage of time per day for patient specific services).
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