On Wednesday, President Obama signed the Middle Class Tax Relief and Job Creation Act of 2012 (HR 3630), extending the therapy cap exceptions process for the remainder of 2012. The law mandates consistent use of the KX modifier upon reaching the $1,880 therapy cap and puts in place several reforms to the therapy cap policy.

Starting October 1, claims that meet or exceed $3,700 in annual therapy expenditures will be subject to a manual medical review. The $3,700 threshold will be applied to the combined physical therapy/speech-language pathology cap; a separate $3,700 threshold will be applied to the occupational therapy cap. Also starting October 1, each request for payment must include the national provider identifier of the physician who currently periodically reviews the plan of care. Additionally, HR 3630 designates that the therapy cap along with the exceptions process should apply to the hospital outpatient setting no later than October 1. This provision, along with the full exceptions process, will expire at the end of 2012 unless Congress chooses to extend them into 2013.

An information bulletin, podcast, and FAQs thoroughly outline these new provisions and also address 2 key reports mandated by the law to review methods to improve the outpatient therapy benefit and examine the manual medical review process.

Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for Stage 2 criteria for "meaningful use" for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

In the rule, CMS proposes to specify criteria that eligible health care professionals (EPs), eligible hospitals, and critical access hospitals must meet in order to qualify for an incentive payment, as well as introduce changes to the program timeline and detail payment adjustments. The proposed Stage 2 criteria focus on increasing the electronic capturing of health information in a structured format and the exchange of clinically relevant information between providers at care transitions.

CMS also proposes new objectives that have greater applicability to specialty providers and additional criteria for reporting clinical quality measures.

Physical therapists (PTs) are not defined as EPs at this time; therefore, they are not yet eligible for incentives under Medicare of Medicaid, but, accordingly, they will not be subject to penalties for failure to implement EHR systems. However, physicians and facilities that are included in the program will expect PTs with whom they share patients to use compatible EHR systems. A new APTA resource, Guide to Understanding and Adopting Electronic Health Records, can help PTs make decisions about selecting and implementing EHRs.

Intensive rehabilitative therapy significantly promotes physical and psychological function with pain reduction in older patients, say authors of an article published online in Archives of Gerontology and Geriatrics. 

Researchers enrolled all patients with functional decline after an acute illness admitted to the post-acute care (PAC) unit of a community hospital in Taiwan between July 2007 and December 2010. Patients enrolled before April 2009 received usual rehabilitation (40 minutes per day 5 days per week). Patients enrolled after April 2009 received increased rehabilitation (80 minutes per day 5 days per week). Researchers measured functional improvement by comprehensive geriatric assessment (CGA) at admission and 4 weeks after admission to the PAC unit.

Overall, 458 patients (mean age: 83.4±5.5 years, all males) completed PAC services. Compared with all dimensions in CGA, increased dosage of rehabilitative therapy showed significantly better improvement in daily living activities (Barthel index 28.8±18.4 vs 20.0±14.6), depressive mood (geriatric depression score short form -0.5±1.0 vs -0.1±0.5), and pain reduction (numerical rating scale -2.0±2.2 vs -0.9±2.1), but not in cognitive function (mini-mental status examination 2.9±3.3 vs 3.3.±5.2) and nutritional status (body mass index 0.3±0.9 vs 0.3±2.5).  

A new APTA Web page contains resources to help physical therapists transition to HIPAA Version 5010. In addition to implementation information, the association has designed an online complaint form for members who are having issues transitioning to the new standards. After the form is completed and submitted online, APTA will forward the issue to the Centers for Medicare and Medicaid Services.

The official deadline to adopt Version 5010 was January 1. CMS will begin enforcement of the standards April 1.

As part of its ongoing efforts to educate members about Accountable Care Organizations (ACOs) and the opportunities to become a part of this new model of care, APTA is creating a list of ACOs throughout the country. This listing may not be all inclusive as ACOs develop and change their status through the expiration of contracts, or because APTA has not been notified of their existence. Updates will be added as new information is made available to the association.

If you have information regarding ACOs in your area, or have questions regarding how to participate in an ACO, e-mail advocacy@apta.org.

February 27 is the deadline to submit nominations for 2 advocacy awards that will be presented in April at the Federal Government Affairs Forum.      

The Federal Government Affairs Leadership Award is presented annually to an active APTA member who has made significant individual contributions to APTA's Federal Government Affairs efforts and has shown exemplary leadership in furthering the association's objectives in the federal arena. The Public Service Award is presented annually to 1 or more individuals who have demonstrated unique support for the physical therapy profession at a national level. Individuals from the following categories are eligible for nomination: members of Congress/congressional staff members; members of a state legislature; federal agency officials; health/legislative association staff; and celebrities or other public figures. APTA's Board of Directors will choose award recipients in March. Award presentations will be held at the Federal Government Affairs Forum in Washington, DC. This year's Federal Advocacy Forum will be held in conjunction with a larger event, APTA's Leadership Forum, which integrates APTA's Board of Directors meeting, the Leadership Symposium for New Component President and Executive Teams, and the Federal Advocacy Forum. Participation at other events is not required to attend the Federal Advocacy Forum. Submit nominations by February 27 to Angela Boyd or fax to 703/706-8519. If you need a nomination form or have questions, call Angela Boyd at 800/999-2782, ext 3256.

Register before March 19 and get the best rates for PT 2012, APTA's Annual Conference & Exposition, June 6-9 in Tampa, Florida. PT 2012 offers more than 90 educational programs in 14 tracks, and includes the popular McMillan and Maley lectures and the Oxford Debate. Attendees can earn up to 21 contact hours.

Register today and connect! Join your peers, recognized experts, and leaders for 3 days of valuable, relevant, invigorating professional development and networking.