• Wednesday, September 26, 2012RSS Feed

    Private Market Required to Provide Clear, Comparable Information on Health Plans

    Under the Affordable Care Act (ACA) insurance companies and employers now are required to provide consumers in the private health insurance market with a brief summary of what a health insurance policy or employer plan covers, called a Summary of Benefits and Coverage (SBC). Additionally, consumers will have access to a uniform glossary that defines insurance and medical terms in standard, consumer-friendly terms.

    These tools also will help employers find the best coverage for their business and employees.

    SBC includes a new comparison tool that helps consumers compare coverage options by showing a standardized sample of what each health plan will cover for 2 common medical situations. The comparison tool is modeled on the nutrition facts label required for packaged foods.

    SBC will include information about the covered health benefits, out-of-pocket costs, and the network of providers. The glossary defines terms commonly used in the health insurance market, such as "deductible" and "copay," using clear language.

    Starting this fall, consumers will receive SBC free of charge and in writing from their insurance companies or employers. This information can be requested at any time, but it will also be made available when shopping for, enrolling in, or renewing coverage. It also will be provided whenever information in SBC changes significantly.

    SBC now is available for consumers in the individual health insurance market. For enrollees in group health plans enrolling during an open enrollment period, it will be available during the next open enrollment period that started on or after September 23, 2012. For enrollees who enroll outside of an open enrollment period, it will be available at the start of the next plan year that began on or after September 23, 2012.

    The Center for Consumer Information and Insurance Oversight provides examples of SBC, an SBC template, and the uniform glossary

    Additional information for consumers is available at healthcare.gov


    Wednesday, September 26, 2012RSS Feed

    Sign Up for Foundation's Monthly E-newsletter

    If you're not receiving the Foundation for Physical Therapy's monthly News & Events  e-newslettersign up today and stay current with the latest information on research supported by the Foundation, funding and awards, and events. The newsletter also provides quick links to information about the Foundation's Trustees and staff; scholarships, fellowships, and grants; and how to make a donation.


    Wednesday, September 26, 2012RSS Feed

    Infographic: Visualizing Health Care Costs

    September's Visualizing Health Policy, a new monthly feature in JAMA, illustrates how health care costs in the United States have surged over the past 50 years. The infographic, created by the Kaiser Family Foundation (KFF), shows how health care spending is unevenly distributed within the US population, with only half the population accounting for more than 97% of health care costs; how health care costs are putting pressure on US families; how the United States spends more per person for health care than other countries; and how the cost of health insurance premiums has increased in the past decade for both workers and employers.

    Archived infographics are available on KFF's website


    Wednesday, September 26, 2012RSS Feed

    New NIH Resource Teaches Kids About Sports Injuries

    A free booklet available in English and Spanish from the National Institutes of Health (NIH) aims to teach children and teens how to avoid sports injuries. Suitable for active kids, parents, and coaches, the story features teen soccer player Ana, who sprains her knee during a pick-up game at a family picnic. Ana and her family learn the best way to treat a sports injury promptly to avoid future complications. This new resource also offers specific tips on how to keep sports safe for kids and prevent injuries, such as warming up before exercise and staying hydrated.

    Ana's Story is NIH's second fotonovela, a comic-book style publication popular in the Hispanic/Latino culture that has been used effectively as an educational tool. Isabel's Story, also available in English and Spanish, teaches about osteoporosis and bone health. 

    Free copies of both Ana's Story and Isabel's Story are available to anyone upon request. To order, contact NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases' information clearinghouse at 877/ 226-4267 or http://catalog.niams.nih.gov/.


    Tuesday, September 25, 2012RSS Feed

    Open Door Forum Tomorrow on Manual Medical Review of Therapy Claims

    Tomorrow the Centers for Medicare and Medicaid Services (CMS) will hold a special open door forum, ­­3:00 pm-4:00 pm ET (conference call only), on the manual medical review of therapy claims. Physical therapists are encouraged to participate in the call, which will provide an opportunity to ask questions about the mandated manual medical review of therapy services October 1-December 31, 2012, which was enacted by the Middle Class Tax Relief and Job Creation Act of 2012. 

    CMS will discuss therapy documentation requirements. The therapy cap applies to all Part B outpatient therapy settings and providers including:

    • private practices,
    • Part B skilled nursing facilities,
    • home health agencies (TOB 34X),
    • rehabilitation agencies (outpatient rehabilitation facilities), and
    • comprehensive outpatient rehabilitation facilities.

    Beginning this year, the therapy cap also will apply to therapy services furnished in hospital outpatient departments October 1-December 31, 2012. Before 2012, therapy provided in hospital outpatient departments did not count toward the therapy cap.

    Participants may submit questions prior to the special forum to therapycapreview@cms.hhs.gov.

    To participate, call 866/501-5502 and enter conference ID 34261274. (TTY Communications Relay Services are available for people with hearing impairments. For TTY services dial 7-1-1 or 800/855-2880. A relay communications assistant will help.)

    A downloadable transcript and audio recording of the forum will be posted to CMS' website.


    Tuesday, September 25, 2012RSS Feed

    Visualize, Customize, and Share State-level Data From RWJF

    The Robert Wood Johnson Foundation's (RWJF) new Data Hub tracks state-level data and allows users to visualize, customize, and share facts and figures on key health care topics. Users select a category and an indicator to create a map or rankings report, and can modify reports as appropriate by payer, income, educational attainment, race/ethnicity, or timeframe. Data Hub is part of RWJF's commitment to providing timely, accessible information and evidence to inform health policies and practices. The online resource establishes a system of priority measures for monitoring state-level progress toward improving the nation's health and health care.


    Tuesday, September 25, 2012RSS Feed

    Military Leaders Call for Less Junk Food in Schools, Fitter Youths

    Being overweight or obese is the leading medical reason that young adults cannot join the military, with 1 in 4 too overweight to enlist, says a report issued today by Mission:Readiness, a group of more than 300 retired generals and admirals.

    Schools are selling 400 billion calories of junk food every year—the equivalent of nearly 2 billion candy bars—says Still Too Fat to Fight, which calls for stronger standards for foods and beverages sold at schools.

    According to the report, the military spends over a billion dollars a year on weight-related diseases. "Because our country has failed to improve fitness and reduce obesity among our youth, the military has had to work much harder than in the past to recruit and retain enough qualified men and women who can effectively serve our country," the authors say.

    This month the Centers for Disease Control and Prevention (CDC) is highlighting the critical role that schools play in improving the physical activity and dietary and behaviors of children and adolescents. CDC has synthesized research and best practices related to promoting healthy eating and physical activity in schools, culminating in 9 guidelines.

    Each of the guidelines is accompanied by a set of implementation strategies developed to help schools work toward achieving each guideline. For example, strategies to achieve guideline 4, which calls for the implementation of a comprehensive physical activity program with high-quality physical education as the cornerstone, include requiringstudents in grades K-12 to participate in daily physical education that uses a planned and sequential curriculum and instructional practices that are consistent with national or state standards for physical education, providing a substantial percentage of each student's recommended daily amount of physical activity in physical education class, and using instructional strategies in physical education that enhance students' behavioral skills, confidence in their abilities, and desire to adopt and maintain a physically active lifestyle.


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