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  • Congress Passes Bill to Avert Cuts, Extend Cap Exceptions Process

    Yesterday, the House and Senate passed legislation to bring the nation back from the "fiscal cliff" that includes 5 important provisions for physical therapists. The bill has been sent to President Obama for his signature.

    The American Taxpayer Relief Act of 2012 (HR 8) freezes the Medicare conversion factor for 2013 at the 2012 level, averting a 26.5% cut to physical therapists and other providers under the physician fee schedule, and continues the 1.0 GPCI work value floor through 2013. The legislation also extends the current 2-tier therapy cap exceptions process ($1,900 automatic KX modifier process, $3,700 manual medical review, and application of the therapy cap to hospital outpatient department) for 1 year. Additionally, in a provision that APTA has called "unjustified, capricious, and poor public policy," the bill applies the multiple procedure payment reduction (MPPR) to therapy services at 50%, up from 20% for office settings and 25% for facility settings, beginning April 1. APTA estimates the application of a 50% MPPR policy will reduce payments by approximately 6-7%. This reduction will be partially offset by a 4% increase that resulted from the Centers for Medicare and Medicaid Services' (CMS) use of new survey data of practice expenses conducted by APTA. Coupled together, APTA expects the net overall decrease for outpatient therapy services to be between 2%-3% beginning April 1. APTA will update the MPPR calculator on its website in the coming days. APTA will advocate to stop the implementation of the MPPR provision.

    HR 8 also postpones sequestration cuts until March 1. Under these cuts Medicare providers would see a 2% reduction in payment. The National Institutes of Health and other federal agencies would see reductions of 7%-8%.  

    Read this statement by APTA President Paul A. Rockar Jr, PT, DPT, MS, on HR 8. A summary of the legislative provisions and offsets (savings) to HR 8 is available on APTA's website.    

    Several other policies of importance to physical therapists went into effect January 1. Under the functional limitations reporting requirement for Medicare Part B services, physical therapists must include nonpayable G-codes and modifiers on claim forms to capture data on the beneficiary's functional limitations at the outset of the therapy episode, at a minimum of every 10th visit, and at discharge. To ensure a smooth transition, the Centers for Medicare and Medicaid Services has set forth a testing period from January 1 until July 1. After July 1 claims submitted without the appropriate G-codes and modifiers will be returned unpaid.

    In addition, physical therapists who successfully participate in the Physician Quality Reporting System in 2013 can obtain a 0.5% bonus payment in 2013 and 2014 and will avoid penalties of 1.5% in 2015. 

    APTA will continue to provide updates and post resources to help members comply with 2013 Medicare policies.  

    Call for Applications: USBJI Young Investigators Initiative

    Early-career physical therapist investigators are encouraged to apply for the United States Bone and Joint Initiative (USBJI) Young Investigators Initiative Program. This distinctive and well-regarded career development and mentoring program pairs promising new musculoskeletal investigators with experienced researchers who offer counsel on securing funding and other survival skills required for pursuing an academic career.

    This grant mentoring workshop series is open to promising junior faculty, senior fellows, or postdoctoral researchers nominated by their department or division chairs. It also is open to senior fellows or residents who are doing research and have a faculty appointment in place or confirmed and have a commitment to protected time for research. Basic and clinical investigators, with or without training awards (including K awards), are invited to apply.

    Participants, who will be assigned mentors, attend 2 workshops, 12 to 18 months apart. The next workshop for new participants will take place April 26-28 in Chicago. Participants will receive a solid grounding in proposal writing and have a chance to watch as experienced researchers review grant proposals in a mock study section. They also will meet 1-on-1 with their mentors over the course of the workshop.

    When the group reconvenes for the second workshop, participants are expected to have submitted a grant proposal for government, foundation, military, or industry funding. For the second workshop, participant-mentor activities are built around responding to summary statements and study section comments, and strategizing to address other issues relating to performing and funding research. Participants are encouraged to take advantage of ongoing consultation with mentors through the remainder of the application process, until funding is secured.

    The deadline to apply for the April workshop is January 15. Visit USBJI's website for application information.

    APTA is a founding member of USBJI.