Some of the biggest parts of health care reform launch today. Are you ready?

Get up to speed fast with 10 Things You Need to Know for October 1, an APTA resource document that highlights some of the main issues affecting physical therapists in practice. The guide provides relevant information on how reform elements such as Health Insurance Marketplaces and Medicaid expansion may impact you.

"10 Things You Need to Know for October 1" is the first in a series of many new resources that will be posted on our Health Reform: Expansion of Coverage page. Coming soon: A feedback form that will allow you to share how health reform implementation is working in your area and the challenges you are facing in this changed landscape. Until the form is posted, please e-mail your questions and concerns to advocacy@apta.org.

If you need help creating a Notice of Privacy Practice to comply with the HIPAA privacy rules, the federal government has developed model notices that you can customize, reproduce, and distribute either in print or electronically to patients.

The Health Portability and Accountability Act (HIPAA) give patients a right to be informed of the privacy practices of their health care providers and health plans and of their privacy rights regarding their personal health information. HIPAA requires providers and plans to notify patients of these rights. By using a model notice, you will know you are providing the information in compliance with the regulations and that the notice reflects recent regulatory changes to the HIPAA privacy and security rules.

You can download the model notice as a booklet, as a multipage document, as a single page presentation, or as text only.

APTA includes this and many other resources on its HIPAA webpage.

APTA's Education Leadership Institute (ELI) Fellowship, a collaborative with the American Council of Academic Physical Therapy (ACAPT), Education Section, Physical Therapist Assistant Educators Special Interest Group, and APTA, now is accepting applications for 2014. Submission deadline is December 20, 2013. This yearlong invitational blended learning (online and onsite components) fellowship program includes mentorship and is designed to develop emerging and novice (0-7 years) physical therapist and physical therapist assistant education program directors with leadership skills to facilitate change, think strategically, and engage in public discourse to advance the physical therapy profession.

Applicants are selected based on the strength of their application and meeting all eligibility criteria. To learn more about the Education Leadership Institute Fellowship, go to the ELI webpage.

Applicants to physical therapist residency and fellowship programs now can complete 1 comprehensive application and submit it to the participating program(s) of their choosing.

APTA has launched the new centralized application system for residency and fellowship programs. The news RF-PTCAS is being administered through the same vendor that oversees Physical Therapist Centralized Application Service (PTCAS) for professional physical therapist education.

To learn more about residency and fellowship education for physical therapists, as well as RF-PTCAS and the participating programs, please visit the ABPTRFE website at www.abptrfe.org/RFPTCAS or e-mail APTA at resfel@apta.org.

Want to access APTA news as it posts, in the palm of your hand?

The free APTA News app, available for download in Apple and Google Play app stores, allows quick access to APTA'sPT in Motion: News Now, as well as national events and advocacy opportunities, among other features.

It's a terrific option for those who want to stay connected but don't follow APTA on Facebook or Twitter.

Activity on physician self-referral, in particular efforts regarding the exceptions to the
in-office ancillary services (IOAS) exception to the Stark self-referral laws, has ramped up this year, and APTA has new online resources to help members understand federal self-referral efforts and get involved.

New on APTA's Self-Referral webpage:

• "Take AIM" video alert features APTA President Paul Rockar Jr, PT, DPT, MS.
• Prezi presentation visually walks you through the issue.
• "Self-Referral 101" takes a more textual approach to explaining the issue.

You’ll also find APTA's position paper on self-referral, news items, and links to the Government Accountability Office reports that implicate financial incentive in physical self-referrals to prostate cancer radiation therapy, advanced imaging, and anatomic pathology services. (A fourth report, on self-referral in physical therapy, is due this fall and will be posted here as well.)

If you visit WebMD's page describing physical therapy, thank some of your member colleagues who over the last month notified APTA that the content describing the role of the physical therapist included inaccuracies and omissions. APTA contacted WebMD requesting they revise their content, and staff provided them with suggested revisions. The page now provides a more accurate description of physical therapists.

The therapy cap and its application to critical access hospitals, PQRS, incident-to billing, MPPR, functional claims-based data collection, and OPPS adjunct bundling services are among the issues APTA addressed in comments last week to the Centers for Medicare & Medicaid Services (CMS). The comments were in response to Medicare's 2014 payment proposals for the physician fee schedule (View APTA comments.), clinical laboratory fee schedule, other revisions to Medicare Part B payment, and the hospital outpatient prospective and ambulatory surgical center payment systems (OPPS) (View APTA comments.).

The full comments are posted on www.apta.org and highlights are summarized below.

For the physician fee schedule, clinical laboratory fee schedule, and other revisions to Part B for 2014, which were announced July 19, APTA made these recommendations:

Critical Access Hospitals (CAHs)

CMS should not permanently apply the therapy cap to critical access hospitals. CMS can and should continue to interpret congressional intent to treat hospitals and CAHs in the same manner in the application or nonapplication of the therapy caps.

Multiple Procedure Payment Reduction (MPPR)

CMS should mitigate the impact of the MPPR cuts, including no longer applying the MPPR across multiple therapy disciplines and working with Congress on long-term reform of the payment system.

Incident-to Billing Provisions

CMS should ensure that its proposal requiring individuals who perform incident-to services to meet state requirements is included in the final rule.

Physician Quality Reporting System (PQRS)

• CMS should not increase the number of required individual measures for successful reporting in 2014 from 3 to 9.
• Medicare should continue to allow measures groups, such as the back pain measure group, to be reported via claims-based reporting.
• CMS should not eliminate claims-based reporting in 2017.
• Medicare should allow measures 126 and 127 (diabetic foot and ankle care measures) to continue to be reported via claims-based reporting.

Qualified Clinical Data Registry Requirements

• CMS should extend the deadline for registries to qualify for 2015 data collection from January 1, 2014, to April 1, 2014.
• A registry should not have to publically report detailed descriptions on measures under development, as the details might not yet be final.
• For new registries, the number of measures required for reporting should be 3 instead of 9.
• Public data reporting should not be required at the outset and should be vetted through a validation process prior to public release.

Functional Limitation Data Reporting Recommendations

• APTA expressed concerns about the absence of 1 standardized tool to measure patient function.
• Providers should be able to demonstrate patient complexity via use of a modifier such as “low,” moderate,” or “high.”
• In the future CMS should consider permitting providers to report functional limitation data through other mechanisms, such as registries or electronic health records, in addition to claims.
• In the acute care hospital setting, CMS should consider exempting from reporting observation status patients and Part A patients rebilled under Part B, as these patients do not exemplify the typical outpatient therapy episode of care.
• For patients who did not have a formal discharge, CMS should change the episode definition from 60 days from the last date of service to 30 days.
• ICF categories should be expanded in future years.
• CMS, APTA, and other key stakeholders should collaborate to develop a standardized core data set for functional limitation reporting.
• Ultimately, CMS should reform the payment system for outpatient therapy to a per-session system based on severity and intensity.

For OPPS, APTA recommended that CMS remove physical therapy services provided by qualified physical therapists and physical therapist assistants from the list of potential adjunctive services included in the new 29 comprehensive APCs. APTA also recommended the removal of the direct supervision requirement for outpatient therapeutic services in CAHs under OPPS because it is burdensome, unnecessary, and not based on clinical need.

Check out APTA's National Physical Therapy Month webpage at www.apta.org/NPTM, where you can see a video announcement by President Paul Rockar Jr, PT, DPT, MS, about this year's exciting media initiative, the "Top 10 Fittest Baby Boomer Cities in America." Download the members-only 2013 NPTM Event Planning Guide for all the ideas, tools, and resources you will need to promote healthy lifestyles for boomers in your city!

Qualified physical therapists in jurisdictions H and L, under the Medicare Administrative Contractor (MAC) Novitas Solutions, now can perform and bill for both the technical and professional components of electromyography (EMG). The MAC's policy revision, which brings it into alignment with national Medicare policy, is the result of APTA's advocacy efforts.

Jurisdiction L covers Pennsylvania, New Jersey, Maryland, Delaware, the District of Columbia, and certain counties of Virginia (Arlington, Alexandria, and Fairfax); Jurisdiction H covers Arkansas, Louisiana, Mississippi, Colorado, New Mexico, Oklahoma, and Texas. The revisions are to local coverage determinations (LCDs) L29547 and L32723 for nerve conduction studies and EMG.

Previously, the LCD policies stated that physical therapists could bill only for the technical component of EMG services. However, APTA sent a reconsideration letter expressing our concerns with the policies and urging Novitas Solutions to revise the language so that it would be consistent with national Medicare policy. APTA staff received correspondence from Novitas Solutions that these LCDs will be revised shortly to allow qualified physical therapists to perform and bill for both the technical and professional components of EMG services.

Novitas Solutions has indicated that the updated LCDs will be on its website soon. For questions or more information, please e-mail advocacy@apta.org.