A proposed rule issued Wednesday includes vital provisions regarding minimum essential coverage as mandated by the Affordable Care Act.

Under the ACA, nonexempt individuals are required to maintain minimum essential coverage or make a shared responsibility payment. This provision is known as the individual mandate.  The ACA specifies the categories of individuals who are eligible to receive exemptions from the shared responsibility payment under section 5000A of the Internal Revenue Code, which provides nonexempt individuals with a choice: maintain minimum essential coverage for themselves and any nonexempt family members or include an additional payment with their federal income tax return.

This proposed rule sets forth standards and processes under which the health insurance exchanges will conduct eligibility determinations for and grant certificates of exemption from the shared responsibility payment.

The proposal also provides standards for determining whether certain other types of health insurance coverage constitute minimum essential coverage and procedures for sponsors to follow for a plan to be identified as minimum essential coverage under section 5000A.

Additionally, it proposes to designate certain types of existing health coverage as minimum essential coverage. Sponsors of a health plan that seek to have such coverage recognized as minimum essential coverage would have to submit information, including the essential health benefits covered, to the Department of Health and Human Services (HHS). Among the essential health benefits required in the ACA are rehabilitation and habilitation services and devices.

This proposed rule, which complements a proposed rule issued the same day by the Internal Revenue Service, is published in today's Federal Register.

Comments on the rule are due March 18. APTA will analyze the proposed rule to determine if it is necessary for the association to submit comments.  

APTA provides a comprehensive summary of a recently proposed rule that has significant importance to the new Medicaid expansion population who must be offered essential health benefits beginning in 2014. In the proposed rule, the Centers for Medicare and Medicaid Services recommends that states define the habilitative services category under Medicaid and requests comments on whether the habilitative services should be offered in parity with rehabilitative benefits, as contemplated in previously released guidance to states on essential health benefits. In addition, the summary outlines proposals related to eligibility and enrollment, cost sharing, and eligibility appeals.

The summary is available on APTA's Medicaid webpage.  

Kick off American Heart Month by attending the third Annual State of Women's Heart Health webinar February 5, 4:00 pm ET. This informative discussion with some of the nation's health leaders, including Department of Health and Human Services Secretary Kathleen Sebelius, Food and Drug Administration Commissioner Margaret Hamburg, and Million Hearts initiative Director Janet Wright, MD, will highlight advances in women's heart health, actions to reduce risk factors, and ways to help raise awareness about heart disease in women. 

For more information and to register, visit the American Heart Association's You're the Cure website.

The annual review and revision of the association strategic plan conducted in late 2012 by the APTA Board of Directors has resulted in a revised plan for 2013. Members can access the plan and related materials on the website at this link. The strategic plan represents the highest priorities of the Board of Directors as it manages the work of the association and was informed by member and external stakeholder input.

In a follow-up of a randomized controlled trial, a strategy of rehabilitation plus early acute anterior cruciate ligament (ACL) reconstruction did not provide better results at 5 years than a strategy of initial rehabilitation with the option of having a later ACL reconstruction. Results did not differ between knees surgically reconstructed early or late and those treated with rehabilitation alone. These results should encourage clinicians and young active adult patients to consider rehabilitation as a primary treatment option after an acute ACL tear, say the authors in their article published this month in BMJ. 

This study included 121 young, active adults (mean age 26 years) with acute ACL injury to a previously uninjured knee. All patients received similar structured rehabilitation. In addition to rehabilitation, 62 patients were assigned to early ACL reconstruction and 59 were assigned to the option of having a delayed ACL reconstruction if needed. One patient was lost to 5-year follow-up.

The main outcome was the change from baseline to 5 years in the mean value of 4 of the 5 subscales of the knee injury and osteoarthritis outcome score (KOOS₄). Other outcomes included the absolute KOOS(4) score, all 5 KOOS subscale scores, SF-36, Tegner activity scale, meniscal surgery, and radiographic osteoarthritis at 5 years.

Thirty (51%) patients assigned to optional delayed ACL reconstruction had delayed ACL reconstruction (7 between 2 and 5 years). The mean change in KOOS₄ score from baseline to 5 years was 42.9 points for those assigned to rehabilitation plus early ACL reconstruction and 44.9 for those assigned to rehabilitation plus optional delayed reconstruction (between group difference 2.0 points after adjustment for baseline score). At 5 years, no significant between-group differences were seen in KOOS₄, any of the KOOS subscales, SF-36, Tegner activity scale, or incident radiographic osteoarthritis of the index knee. No between-group differences were seen in the number of knees having meniscus surgery or in a time-to-event analysis of the proportion of meniscuses operated on. The results were similar when analyzed by treatment actually received.

If you are interested in leadership development, collaborating with colleagues, and lending your expertise to APTA, then you need to join the Volunteer Interest Pool. Current opportunities include all awards subcommittees: Advocacy, Catherine Worthingham Fellows, Education, Lecture, Practice and Service, Publications, Research, and Scholarship. 

To answer the call for these opportunities, you must first complete a volunteer interest profile. Creating this profile allows you to include your preferred level of involvement, willingness to travel, current availability, and interest/experience in a variety of areas. You only need to create the volunteer profile once. It can be updated at any time. Once you have created a profile, you will need to review the current opportunities and answer the questions specific to each committee.

Deadlines will vary by group, so don't delay in checking out these opportunities! To learn more about the Volunteer Interest Pool, please contact Angela Boyd.