On Monday, the therapy cap with an exceptions process went into effect for outpatient hospitals. In addition, the manual medical review exceptions process for claims exceeding $3,700 became effective for phase I providers. Originally, the Centers for Medicare and Medicaid Services (CMS) had announced that providers would know the dollar amount that their patients accrued toward the therapy cap on October 1. Due to some systems challenges, this information was not available. CMS announced this week that the information will be available October 8 through eligibility inquiries. Physical therapists (PTs) should check with their Medicare Administrative Contractors to determine the best way to obtain the dollar amounts accrued. When the data is available on October 8, PTs can then determine whether there is a need to seek an exception to the therapy cap.

To help PTs with the implementation of the cap and the manual medical review exceptions process, APTA has created a Medicare Therapy Cap Resources webpage. This webpage compiles relevant information available from APTA and CMS in 1 place.

In this month's Heard on the Hill podcast, Mike Matlack, APTA director of grassroots and political affairs, breaks down the races for the United States Senate and House of Representatives and discusses the toss-up states in the Senate and competitive seats in the House. He also explains how the Electoral College looks as the candidates head into the debates.

Source: National Journal 

Researchers at the European Association for the Study of Diabetes 2012 Meeting reported this week that higher levels of leisure-time physical activity cut the risk of cardiovascular and all-cause mortality in people with type 2 diabetes, says an article by Heartwire. People with diabetes who did little or no exercise at baseline and then substantially increased their leisure-time physical-activity levels over approximately 5 years cut their risk of death by almost two-thirds.

The researchers used data on leisure-time physical activity, recorded yearly, from more than 15,000 men and women with type 2 diabetes included in the Swedish National Diabetes Register. Participants were grouped as either "low physical activity" (no regular exercise or exercise once per week) or "regular exercise" (between 3 times per week and daily exercise). If patients died during the course of the study, their last recorded physical-activity level was used for the analysis.

Over a 5-year period, regular exercisers were significantly less likely to have a cardiovascular event or to die either from cardiovascular disease or any other cause.

The investigators also looked at patients who reported doing little or no physical activity at baseline but who increased their regular exercise to at least 3 times per week by the end of the study period (a mean of 4.8 years). Cardiovascular deaths among these patients dropped by 67% compared with patients who did not improve their exercise habits. Rates of all-cause mortality were reduced by almost the same degree.

Session moderator Nick Wareham, MD, stressed that the data "… should encourage us to focus on encouraging physical activity as part and parcel of medical care."

Researchers at King's College London have identified a gene linked to age-related degeneration of the intervertebral discs, a common cause of lower back pain.

Back pain costs the United Kingdom an estimated £7billion ($11 billion in US dollars) a year due to sick leave and treatment costs. Lumbar disc degeneration (LDD) is inherited in 65%-80% of people with the condition, suggesting that genes play a key role. Until now, the genetic cause of lower back pain associated with LDD was unknown, says King's.

For this study, scientists compared MRI images of the spine in 4,600 individuals with genome-wide association data, which mapped the genes of all the volunteers. They identified that the gene PARK2 was implicated in people with degenerate discs and could affect the speed at which they deteriorate.

The researchers say the results show that the gene may be switched off in people with LDD. Although it is still unclear how this might happen, it is thought that environmental factors, such as lifestyle and diet, could trigger this switch by making changes known as epigenetic modifications to the gene.

The study was published online September 19 in Annals of Rheumatic Diseases.  

The Marquette Challenge is an annual student-led grassroots fundraising effort that supports physical therapy research. Over the past 24 years, students participating in the Marquette Challenge have raised more than $2.3 million in support of the Foundation and its mission.

To learn how your school can help advance physical therapy research and gain national recognition check out the interactive Challenge kit. 

At the population level, diabetes is a stronger risk factor for new heart failure (HF) than 4 other modifiable risk factors, namely smoking, dyslipidemia, obesity, and hypertension, suggests the latest analysis from the Atherosclerosis Risk in Communities (ARIC) study cohort.

ARIC is a longitudinal study of more than 15,000 African American and Caucasian men and women in 4 communities across the United States, who were recruited during the 1980s when they were aged 45 to 64. The current analysis included 14,709 of the participants followed an average of 17.6 years.

According to the authors, the lifetime risk of incident heart failure was about 1 in 3 for its African American participants and reached 1 in 4 in Caucasians. In both groups, that risk was higher than the lifetime risk of new coronary heart disease or stroke in the same population. 

In addition, they found that a percentage drop in diabetes prevalence would avert more cases of new HF than the same percentage decrease of any of the 4 other studied modifiable risk factors. Specifically, a 5% proportional reduction in the prevalence of diabetes in ARIC African American participants would result in approximately 53 fewer HF cases per 100,000 person-years and 33 fewer HF hospitalizations per 100,000 person-years for Caucasians.

Free full-text of the article is available in Journal of the American College of Cardiology.