FEES and PPS In 1997, Congress enacted the Balanced Budget Act (BBA). This act mandated HCFA to begin a process that has resulted in the most dramatic change in health care reimbursement in 30 years—The Prospective Payment System (PPS). This system will be phased in over a 4-year period and establishes levels ... Article
Article  |   December 01, 1998
FEES and PPS
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Swallowing, Dysphagia & Feeding Disorders / Professional Practice
Article   |   December 01, 1998
FEES and PPS
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), December 1998, Vol. 7, 11-13. doi:10.1044/sasd7.4.11
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), December 1998, Vol. 7, 11-13. doi:10.1044/sasd7.4.11
In 1997, Congress enacted the Balanced Budget Act (BBA). This act mandated HCFA to begin a process that has resulted in the most dramatic change in health care reimbursement in 30 years—The Prospective Payment System (PPS). This system will be phased in over a 4-year period and establishes levels of therapeutic intensity and resulting reimbursement for Medicare A patients. The overall result of PPS will be to sharply reduce reimbursement for therapy. PPS will also greatly shorten the amount of time therapists will be allowed for therapeutic intervention.
A similar scenario applies to Medicare B patients as well. Under the new reimbursement structure, Medicare B patients are subject to a cap of $1,500 per patient/year. In the case of speech-language pathology, this cap is shared with physical therapy. As a result, the amount of money available for therapy is $750 per patient/year. Lobbying efforts are underway to affect change in the above. Despite any success in potential efforts to correct the current legislation, it is abundantly clear that the speech-language pathologist will have to learn to work in a more cost effective (managed) environment that demands objective, measurable outcomes. This IS the way of the future! Certainly in the field of dysphagia therapy, the need for objective, measurable instrumentation has long been accepted as a critical component of dysphagia management. Historically, the MBS has played this role. Additional instrumentation, such as Fiberoptic Endoscopic Evaluation of Swallowing (FEES), emerged as alternative instrumentation in 1988.
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