"APTA applauds the proposed legal settlement of the nationwide class action lawsuit directed toward ensuring Medicare coverage of reasonable and necessary therapy and nursing services for people with chronic and degenerative health conditions," says APTA President Paul A. Rockar Jr, PT, DPT, MS, in a statement issued today regarding the lawsuit Glenda Jimmo, et. al vs. Kathleen Sebelius. Plaintiffs in the lawsuit alleged that the US Department of Health and Human Services, Medicare contractors, and administrative review boards were arbitrarily limiting coverage for patients who did not show long-term improvement in their conditions, even though official Centers for Medicare and Medicaid Services rules state these services should be covered.
Under this proposed agreement, Medicare would pay for skilled therapy and nursing services if they are needed to maintain the patient's current condition or prevent or slow further deterioration.
The New York Times
highlighted how the policy change will result in significant cost savings in the long term by allowing patients to receive physical therapy and other services in community-based settings and avoiding expensive care in hospitals and nursing homes.
APTA will continue its efforts to ensure access to appropriate physical therapy services. The association also will work with the Centers for Medicare and Medicaid Services and its contractors to ensure accurate and fair incorporation of revisions to the current Medicare manuals and regulations that reflect this significant change. In addition, the association will continue to analyze the proposed settlement for potential impact on Medicare policies regarding the reporting of functional limitations on the claim for outpatient therapy and the requirement to complete a functional reassessment at defined intervals under the Home Health Part A benefit.
APTA plans to actively educate members to ensure proper understanding and application of the newly revised Medicare regulations.
66% of online American adults use social networking sites, according to a 2012 Pew Internet Project study, many users remain skeptical
about using social media for professional purposes. To demonstrate some of the
potential benefits of social media, APTA hosted an online roundtable discussion Monday with 5 physical
therapists and 1 student of physical therapy, all of whom actively use Twitter
and other social media tools to network about physical therapy issues.
53-minute discussion, conducted using Google+ Hangouts and archived via
YouTube, covers the weekly #SolvePT tweetchat, ways that social media are
effective in advocacy efforts, benefits of social media for physical therapy
educators and students, and the challenges of discussing critical issues in a
social media environment, among other topics.
in the panel were Allan Besselink, PT,
Dip MDT, Christopher Bise, PT, DPT,
MS, OCS, physical therapist student Matt
DeBole, Selena Horner, PT, MS, GCS,
Eric Robertson, PT, DPT, OCS, and
Ann Wendel, PT, ATC, CMTPT.
roundtable is available on the Social Media Tips & Best Practices
webpage of APTA.org, which includes links to APTA's policy on social media, a new video tutorial for Twitter,
and other resources.
National Physical Therapy Month ends, take the time to acknowledge your
colleagues or students with an APTA 2013 Honor or Award nomination. By
nominating the person or people you feel are most deserving of an honor or
award, you can help APTA celebrate their many contributions to the physical
Your participation in the nominating process is
extremely important. It's quick, easy—and in keeping with APTA's green
initiative, all APTA national Honors and Awards applications are available for
Go to APTAs Honors and Awards page and submit your nominations
online. All submissions must be received by December 1.
E-mail questions to firstname.lastname@example.org or call
800/999-2782, ext 3233, for more information.
running out to nominate yourself or an APTA-member colleague to national office.
The online Nomination Form (NC 1) is
available on APTA's website under "Leadership and Governance" and
then "Elections and Nominations." The APTA Nominating Committee is
seeking recommendations for the 2013 Slate of Candidates for the following
positions: secretary, vice speaker, 3 directors, and 2 Nominating Committee
value of gathering information on body mass on patients or clients is the focus
of a new podcast in the recently launched series titled Extracting Hidden Gems
from Simple Clinical Measures: The Why, How, and Then What?
Excess body mass or obesity has been identified as a critical health
issue in the United States and around the world. Learn what data physical therapists should gather
and what to do with it, and find additional resources on body mass index, in
this prerecorded podcast that discusses the anthropometric characteristic of
Extracting Hidden Gems from Simple Clinical Measures series can be found on
APTA's recently enhanced vital signs and other patient screenings webpage. This quality-focused web
resource provides information on why and when vital signs and other patient
information should be gathered.
research shows that age, race, employment status, living situation, and education
and income levels are just some of the factors that may play a role in hospital
readmissions. However, the Centers for Medicare and Medicaid Services (CMS) is
not taking these causes into account in its readmissions reduction program,
which started penalizing hospitals October 1 for excessive readmissions, says
an article by Reuters News.
In the study,
published in Journal of General Internal
Medicine, researchers analyzed data from 20 studies on pneumonia and 52 on
For pneumonia patients, among the factors linked to the risk of being
readmitted to the hospital were being older and not white. Having a low level
of education, low income, and being unemployed also were tied to a higher risk
of going back into the hospital.
For heart failure patients, the risk of being readmitted to a hospital was associated
with being elderly, African American, or Hispanic.
The researchers cannot say for certain that the risk factors identified are
what cause a patient to be readmitted to the hospital. But they note in their
report that this kind of information could be used by physicians, case
managers, and discharge planners "to flag patients at high risk of
readmission because of certain nonmedical vulnerabilities," says Reuters.
Visit APTA's hospital readmissions webpage for information
about how physical therapists can help reduce readmissions by providing recommendations for the most appropriate level of care to the health
care team prior to and during care transitions.