Despite APTA's urging for continued Medicare coverage of TENS for chronic low back pain (CLBP) and additional research regarding the circumstances when the use of TENS for CLBP is effective, the Centers for Medicare and Medicaid Services (CMS) finalized the requirement of enrollment in an approved clinical study to receive coverage for TENS for CLBP.
In its final decision memo, CMS said that the clinical study requirement is to support additional research on the use of TENS for CLBP, and this requirement will expire in 3 years. CMS says in the memo that based on its review of the evidence, "… we have determined that TENS is not reasonable and necessary for CLBP under 1862(a)(1)(A) of the Act. Neither the comments we received, nor the discussions that we have had with industry and investigators, have provided us with the persuasive scientific evidence to reach a different conclusion." Thus, at the expiration of the 3-year clinical study requirement, TENS for CLBP will not be covered, as it will be considered not reasonable and necessary.
Links to APTA's comments and summary on the National Coverage Analysis Tracking Sheet for TENS for Chronic Low Back Pain can be found on APTA's Medicare Coverage Issues webpage.
APTA members commented extensively on CMS's proposal memo in News Now coverage posted March 14 and April 3.
A week of cognitive and physical rest—which included taking time off from school or work and avoiding talking on the phone, exercising, watching TV, socializing, or working at a computer—alleviated symptoms of concussion in 49 high school and college athletes, according to a Reuters Health article based on a study in The Journal of Pediatrics.
To measure the effect of "an intensive bout of rest" after a concussion, researchers evaluated the athletes between April 2010 and September 2011 and assigned them to groups based on the time elapsed between sustaining a concussion and the onset of rest. Fourteen of the patients started the rest within a week of their injuries. Another 22 patients began resting within a month of the concussion, and 13 patients began the week of rest between 1 and 7 months after the concussion.
At the beginning of the study, all of the patients had symptoms related to the injury, such as headaches and trouble concentrating.
After the week of rest, all groups saw their symptoms improve regardless of the time between concussion and onset of rest. Among the athletes who started the rest within a week of their concussion, their symptoms improved from a score of 22 on a 132-point scale down to 7, says the article.
APTA's new Joining Forces Initiative (JFI) webpage includes background on this comprehensive national initiative, launched by First Lady Michelle Obama and Jill Biden, EdD, to mobilize all sectors of society to give service members and their families the opportunities and support they have earned. JFI is designed to bring attention to the unique needs and strength of America's military families while showcasing the skills and dedication of America's veterans and military spouses. The initiative will highlight employment, education, and wellness as issues of special importance to military families across the country.
As an invited participant in JFI, APTA has made several commitments to ensure that the nation's military personnel and their families receive the care they deserve and that physical therapists have the best, most up-to-date information on traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and postcombat depression.
Access the webpage to learn more about APTA's commitment to JFI and find education, advocacy, and related resources on TBI and PTSD.
UnitedHealth Group Inc will maintain several health coverage protections included in the Affordable Care Act (ACA) regardless of the Supreme Court's ruling on the law, says an article by Reuters.
UnitedHealth will continue to provide coverage for dependents up to age 26 under their parents' plan and offer certain preventive health care services, such as annual check-ups, screenings for high blood pressure and diabetes, and immunizations without requiring a copayment. The company also will continue to forgo lifetime dollar coverage limits on policies.
The other provisions to be maintained include providing clear ways for members to appeal coverage claim decisions and eliminating rescissions, which are generally considered to be retroactive policy cancellations, except in the case of fraud, says the article.
UnitedHealth, which is the largest US health insurer by market value and serves more than 38 million members, said the protections are effective immediately and will be available to current and future plan members.
ACA also bars insurers from denying coverage to children up to age 19 with preexisting medical conditions. UnitedHealth said that while it recognized the value of this provision, the company "cannot take that step" alone, but is "committed to working with all other participants in the health care system to sustain that coverage," says Reuters.