am so excited by the December issue and these 10 articles that I'm really
considering changing my path and going out to see if I can help develop acute
care specialization and become a practicing clinician again," says PTJ Editor in Chief Rebecca Craik, PT, PhD, FAPTA, at the conclusion of the latest Craikcast.
Craik this month in discussing the articles that complete the 2-part PTJ Special Series on Rehabilitation for
People With Critical Illness are coeditors Patricia
Ohtake, PT, PhD, Dale Needham, MD, and Dale Strasser, MD. The group also
discusses quality improvement research, a key topic of the articles in the
February edition of the critical care special series. The first part of the
series was published in the December 2012 issue.
part of APTA's strategic plan, one of the goals for 2013 is to better enable
physical therapists to consistently use best practice to improve the quality of
life of their patients and clients. To achieve this goal, APTA is supporting
the development of clinical practice evidence-based documents. This initiative
aims to provide structure, process, and resources for the development of
Clinical Practice Guidelines (CPG) and Clinical Practice Appraisals (CPA) that
enable the translation of research into physical therapist practice. In order
to facilitate the development of clinical practice documents and other high
quality evidence summaries, APTA is offering financial and training support to sections
for this purpose.
for CPG/CPA development must focus on clinical practice areas that are
important and relevant to the practice of physical therapy. The proposal must
be supported and submitted by an APTA section. Each proposal will be considered
individually and will be awarded in part or in full depending on the priorities
of the association and the strength of the proposal.
for the current review cycle are due on March 18. For more information or for a
copy of the proposal submission document, contact Anita Bemis-Dougherty, director,
Practice Department, at email@example.com or 800/999-2782,
In a retrospective cohort obtained
from electronic medical records and insurance claims data, initial physical
therapy management following a new primary care low back pain (LBP)
consultation was not associated with increased health care costs or utilization
of specific services. The authors of this article, which appears
online in Archives of Physical Medicine
and Rehabilitation, write that additional research is needed to examine the
cost consequences of initial management decisions made following a new
consultation for LBP.
Records and data were examined on 2,184 patients aged 18 and older with a
new consultation for LBP from 2004-2008 in single health care delivery system
in the United States. Patients were categorized as receiving initial physical
therapy management if care occurred within 14 days after consultation.
Total health care costs for all LBP-related care received in the year
following consultation were calculated from claims data. Predictors of
utilization of emergency care, advanced imaging, epidural injections,
specialist visits, and surgery were identified using multivariate logistic
regression. Generalized linear model was used to compare LBP-related costs
based on physical therapy utilization and identify other cost determinants.
Initial physical therapy was received by 286 of 2,184 patients (13.1%) and
was not a determinant of LBP-related health care costs or utilization of
specific services in the year following consultation. Older age, mental health
or neck pain comorbidity and initial management with opioids were determinants
of cost and several utilization outcomes.
member Julie M. Fritz, PT, PhD, ATC,
is the article's lead author. APTA members Gerard
P. Brennan, PT, PhD, Stephen J.
Hunter, PT, DPT, OCS, and John S.
Magel, PT, DSc, OCS, FAAOMPT, are coauthors.
February 11, is the deadline to submit nominations for the Federal Government Affairs Leadership Award and the APTA Public Service Award.
Federal Government Affairs Leadership Award is presented annually to an active
APTA member who has made significant contributions to APTA's federal government
affairs efforts, and has shown exemplary leadership in furthering the
association's objectives in the federal arena.
Public Service Award is presented annually to individuals who have demonstrated
distinctive support for the physical therapy profession at a national level.
Individuals from the following categories are eligible for nomination of this
award: members of Congress, congressional staff members, members of a state
legislature, federal agency officials, health and legislative association
staff, and celebrities or other public figures.
Board of Directors will select award recipients during its March 2013
conference call. Awards will be presented at the Federal Advocacy Forum to be
held April 14-16 in Washington, DC. Submit nominations by February 11 to Stephanie Sadowski.
APTA's summary of a recently released HIPAA final rule
includes important information for physical therapists related to modifications
of the Privacy, Security, and Enforcement Rules embedded in the HITECH
Act, changes to the HIPAA Enforcement Rule to incorporate the increased
and tiered civil money penalty structure, the adoption of breach notification
requirements for unsecured data, and adjustments to the HIPAA Privacy Rule as
required by the Genetic Information Nondiscrimination Act to increase privacy
protections for genetic information.
members can access the document on the Health Information Technology webpage under
"APTA Summaries" and the HIPAA webpage.
a meeting with APTA yesterday, the Centers for Medicare and Medicaid Services
(CMS) clarified the impact of the therapy cap on patients who receive
outpatient therapy services in critical access hospitals (CAHs). CMS stated
that for 2013, when a patient receives outpatient therapy services from a
critical access hospital, the services will count toward dollars accrued toward
the therapy cap. For example, if a patient receives $2,000 of outpatient
therapy services in a CAH and upon discharge goes to a private practice to
continue therapy services, the private practice would need to obtain an
exception (in this case use the KX modifier).
CMS clarified that for 2013 the therapy cap does not apply to outpatient
therapy services provided within CAHs themselves. This means that if the
patient continued treatment in the critical access hospital, after exceeding
$1,900 in therapy services, there would be no need to seek an exception through
the automatic process. That is, the CAH would not need to submit the claim with
a KX modifier. Also, if the patient exceeds $3,700 and continues care in CAH,
the hospital would not need to obtain an exception through the manual medical
had been seeking clarification on this issue from CMS since the January 1
passage of the American Taxpayer Relief Act of 2012 (HR 8), which extended the
current 2-tier therapy cap exceptions process through 2013. The agency advised
APTA last month that it was working with its general counsel for interpretation
of the legislative language.
APTA's comments to the Senate
Finance Committee's May 2012 request for input from health care stakeholders on
3 areas critical to Medicare and Medicaid reforms—program integrity, payments, and enforcement—have
been included in the committee's recently released report
titled "Opportunities to Curb Waste, Fraud and Abuse in Medicare and
the Senate Finance Committee writes about eliminating self referral in 2
sections of the report. Under the Beneficiary Protection section, the committee
notes "concern that over-broad application of the Stark law exception for
physician in-office ancillary services compromises patient care by
incentivizing overutilization." The committee references "increasing
enforcement of existing laws, such as the Stark law" under the area titled
than 160 stakeholders in the health care community submitted comments to the
Senate Finance Committee's request. During the 113th Congress, 6 Senators plan to work
with key committees of jurisdiction, the Government Accountability Office, the
Department of Health and Human Services Office of the Inspector General, and
interested stakeholders to develop a more detailed list of administrative
recommendations and potential legislative actions.
comments can be found on the association's Self Referral webpage.
than 530 physical therapists, physical therapist assistants, and physical
therapy students from Indiana gathered at the statehouse on January 30 to show
their support for HB 1034, which would provide direct access to physical
therapists. Over 50 legislators joined the members of the physical therapy
profession for lunch and to discuss the bill.
Sen Pat Miller and state Reps Dave Frizzell and Matt Ubelhor spoke to the crowd
and confirmed their commitment to passing direct access legislation. Indiana is
1 of only 3 states with no form of direct access to physical therapy treatment,
and the only state without direct access to a physical therapy evaluation. Many
Indiana Chapter members held signs with the messages: "49 states allow you
to see your PT directly … not Indiana" and "Hoosiers deserve direct
access to physical therapists."
House Public Health Committee hearing for HB 1034 will be held February 6. The
chapter is coordinating a team of chapter members to speak in support of the
bill. If it is approved by the committee, the bill would then go to the full
House of Representatives for consideration.
of the January 30 event are available here.