MedPAC Cites Need for SLP Provider Numbers, Reviews ASHA Assessment Tool A Medicare commission has recognized the importance of a Medicare provider number for speech-language pathologists (SLPs) and reviewed an assessment tool developed by ASHA as part of the commission’s call for better data collection by the Centers for Medicare and Medicaid Services (CMS) in order to assess a beneficiary’s need ... Policy Analysis
Free
Policy Analysis  |   July 01, 2006
MedPAC Cites Need for SLP Provider Numbers, Reviews ASHA Assessment Tool
Author Notes
  • Ingrida Lusis, is the director of health care regulatory advocacy. Contact her at ilusis@asha.org.
    Ingrida Lusis, is the director of health care regulatory advocacy. Contact her at ilusis@asha.org.×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   July 01, 2006
MedPAC Cites Need for SLP Provider Numbers, Reviews ASHA Assessment Tool
The ASHA Leader, July 2006, Vol. 11, 1-30. doi:10.1044/leader.PA.11092006.1
The ASHA Leader, July 2006, Vol. 11, 1-30. doi:10.1044/leader.PA.11092006.1
A Medicare commission has recognized the importance of a Medicare provider number for speech-language pathologists (SLPs) and reviewed an assessment tool developed by ASHA as part of the commission’s call for better data collection by the Centers for Medicare and Medicaid Services (CMS) in order to assess a beneficiary’s need for outpatient rehabilitation services.
In a June report to Congress, the Medicare Payment Advisory Commission (MedPAC) cited ASHA’s National Outcomes Measurement System (NOMS) as one of four assessment tools the commission reviewed in developing its report titled “Increasing the Value of Medicare.” The other three tools were predominantly oriented to physical and occupational therapy and used patient-self reports. MedPAC recognized that patient self-report tools would be clinically inappropriate for beneficiaries receiving speech-language pathology services.
MedPAC stated that a unique Medicare provider number for SLPs could be used to improve accountability related to resources and outcomes, especially if CMS links payment to outcomes. Currently only physical therapists and occupational therapists have provider numbers. Throughout the report, MedPAC recognized speech-language pathology as a distinct and separate profession in its referencing of the three major outpatient rehabilitation services.
The MedPAC report also outlined possible next steps for CMS to take in developing alternatives to the therapy caps including the selection of outcomes measurement tools, conducting pilot studies on the feasibility of using such tools, and the design of a new payment system that utilizes outcomes measurement systems. Two options presented by MedPAC include episode-based payments and value-based purchasing.
Under an episodic system, a clinician would be paid a set amount for speech-language pathology services associated with treating a patient from the evaluation to the end of treatment. The payment amount would vary by diagnosis and complexity. A value-based purchasing model would pay providers based on patient outcomes and resource use. Under both payment scenarios outcomes measurement would be necessary.
NOMS is a speech-language pathology assessment tool developed by SLPs. NOMS utilizes Functional Communication Measures (FCMs) which are a series of disorder-specific rating scales designed to describe the change in an individual’s functional communication ability over time, from admission to discharge, in various speech-language pathology treatment settings. Each scale contains seven discrete gradations of change designed to gauge progress in the areas most commonly addressed by SLPs. Each scale ranges from a least functional (level 1) to most functional (level 7). Visit ASHA’s Web site for additional information on NOMS.
ASHA will continue to work with both CMS and Congress to ensure that NOMS is utilized in the assessment of speech-language pathology services and work to pass legislation that would allow SLPs to obtain a Medicare billing number. ASHA members can support this effort by taking 5 minutes to request that their federal lawmakers co-sponsor H.R. 3795 and S. 657.
MedPAC is an independent federal body established in 1997 to advise Congress on issues affecting the Medicare program. ASHA provided extensive comments and feedback to MedPAC in the development of the outpatient rehabilitation chapter. MedPAC’s June report can be found at http://www.medpac.gov/publications/congressional_reports/Jun06_Ch06.pdf.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
July 2006
Volume 11, Issue 9