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  • Lawmakers Urged to Seize Opportunity to End Therapy Cap

    The Therapy Cap Coalition recently sent a letter to House and Senate leadership urging legislators to add permanent repeal of the therapy cap to the current sustainable growth rate (SGR) reform proposal.

    Sent to House Ways and Means Committee, House Energy and Commerce Committee, Senate Finance Committee, and House and Senate leadership, the February 14 letter from the coalition describes the group's disappointment that the SGR compromise reached in early February did not contain other legislative provisions, specifically language repealing the therapy cap, and suggests that existing proposals could be included in a final package. Specifically, the coalition recommends language in the original Senate version of the bill, which contained a repeal of the cap and replacement policies for the delivery of outpatient therapy.

    The letter emphasizes that lawmakers need to act soon. "The first quarter of 2014 provides an opportunity to end the pattern of yearly extensions that puts patient access to medically necessary therapy services at risk," the letter states.

    The Therapy Cap Coalition, led by APTA, is a group of health care stakeholders that includes patient, consumer, provider, and facility organizations such as the American Heart Association, the American Occupational Therapy Association, the American Speech-Language Hearing Association, the Arthritis Foundation, the National Stroke Association, and the Brain Injury Association.

    APTA's advocacy team is now encouraging grassroots efforts to members and supporters to urge their legislators to include a repeal of the therapy cap in the final bill. Find out how you can take action.

    Post-Mastectomy Physical Therapy 'Widely Improves' Quality of Life

    Postoperative physical therapy that begins as early as 2 days after surgery significantly improves joint mobility and "widely improves the quality of life" for women who underwent mastectomies, according to a new study. Researchers found that women who received physical therapy regained normal glenohumeral function 1 year after surgery and reported less pain, while an untreated control group continued to report limitations.

    Italian researchers focused on women scheduled for Madden's modified radical mastectomy or segmental mastectomy with axillary dissection, dividing a group of 70 women into 2 groups: 1 that received postoperative physical therapy and 1 that did not. Women in the treatment group began physical therapy on the second postoperative day and participated in 40-minute rehabilitation sessions 5 times a week for the duration of the drainage, followed by 20 hour-long sessions after the drainage was removed.

    Researchers observed "considerable" improvements in flexion as early as the fifth postoperative day for the treatment group over the control group, and noted continued progress at 1-month, 6-month, and 1-year evaluations. According to the study's authors, the treated group "regained normal function at 1 year after rehabilitation treatment while [the control group] was unable to do so for flexion, abduction, and internal rotation movements."

    Additionally, the researchers write that physical therapy resulted in "statistically significant differences" in pain perception for the treatment group and even contributed to higher quality-of-life reports from the women who participated in rehabilitation. "Treating and reducing postoperative symptoms, especially pain and functional limitation, helped the patients to have a fast and complete physical and … psychosocial recovery ensuring a significant improvement in terms of quality of life," the report states. The study is e-published ahead of print at the European Journal of Physical and Rehabilitation Medicine.

    The role of the physical therapist (PT) in pre- and postoperative care of women with breast cancer is featured in a Move Forward Radio podcast and is addressed in the Prospective Surveillance Model for breast cancer treatment developed in 2012 by a multidisciplinary group that included APTA members.

    Revised CPT Codes Delayed Until 2016

    The magnitude of proposed changes to an entire family of physical medicine and rehabilitation codes has prompted the editorial panel for the American Medical Association's (AMA) Current Procedural Terminology (CPT) document to postpone finalization of the revisions. Instead, the committee agreed to allow additional time for pilot testing and refinement and has targeted a January 2016 implementation date.

    APTA representatives participated in the most recent editorial panel meeting February 6–8, where the group discussed options for revisions to the 97000 series of the CPT codes (physical medicine and rehabilitation). The panel expressed support for the direction of the coding proposal and made some suggestions for refinements. The codes are set to be pilot tested during the coming weeks.

    APTA is committed to refining the definitions of the new codes and will issue a request for proposals for carrying out the pilot project. Association members can access background information and resources on CPT at APTA's coding and billing webpage, and can also access APTA information on payment reform.