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  • Anticipating Patch Legislation, CMS Puts Hold On Claims Processing

    While a proposed "patch" to scheduled reductions in the 2014 Medicare Physician Fee Schedule (MPFS) may be imminent, the Centers for Medicare and Medicaid Services (CMS) is implementing a 10-business-day claims-processing hold just in case Congress doesn't take action to prevent the reductions before a March 31 deadline.

    In an e-mail alert sent to various groups, CMS states that it is "hopeful that there will be congressional action to prevent the negative update from taking effect on April 1, 2014. CMS has instructed the Medicare Administrative Contractors to hold claims containing services paid under the MPFS for the first 10 business days of April (ie, through April 14, 2014)."

    The hold would only affect MPFS claims with dates of service of April 1, 2014, and later. CMS believes that the hold will have minimal impact on provider cash flow, because under current law, clean electronic claims are not paid any sooner than 14 calendar days after the date of receipt. All claims for services delivered on or before March 31, 2014, will be processed and paid under normal procedures, regardless of any congressional actions.

    LPGA’s Natalie Gulbis Calls PTs ‘Huge Part to Our Success’

    Now in her 12th season on the LPGA Tour, golfer Natalie Gulbis believes that daily in-season treatment by physical therapists (PTs) played a major role in her ability to stay in the game for so long. “I don’t know how long my career would have been" without physical therapy, Gulbis told Move Forward Radio this week. “I don’t want to think about it.”

    Gulbis credited laser surgery on her back for saving her career in 2010, but she cited treatment by PTs as a key component in battling the ongoing physical demands of the LPGA Tour.

    In the Move Forward Radio interview, Gulbis described the transformations she has witnessed as golfers unsure of their ability to play in a tournament receive physical therapy that allows them to participate and even thrive. "I’ve seen them win," Gulbis said. "I’ve seen them play well. And here they were earlier in the week not sure if they could even swing a golf club. So [physical therapists] are a huge part to our success.”

    Gulbis was joined on Move Forward Radio by Al Casini, PT, who has treated Gulbis and other professional golfers.

    Gulbis called her relationship with Casini “a great partnership” and made it clear that her interest in fitness and health goes far beyond golf. “I do a lot of different active sports,” Gulbis said. “I want to make sure that I keep my back strong because I only get one back for my life, so I want to keep it healthy.”

    Move Forward Radio airs approximately twice a month. Episodes are featured and archived at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online via Blog Talk Radio or downloaded as a podcast via iTunes.

    APTA members are encouraged to share this episode via social media and to alert their patients to the Move Forward Radio series and other MoveForwardPT.com resources to help educate the public about the benefits of treatment by a physical therapist. Ideas for future episodes and other feedback can be e-mailed to consumer@apta.org.

    New CPG Requirements Will 'Raise the Bar' at Federal Clearinghouse

    The federal government's official clearinghouse for practice guidelines will adopt more stringent standards for acceptance in the coming months. The new standards, adopted from the Institute of Medicine (IOM), include requirements for content, authorship, methodology, format, accessibility, and currency.

    The Agency for Healthcare Research and Quality's National Guideline Clearinghouse (NGC) will implement the new standards beginning June 1. The changes result from a 2008 directive from the federal government for IOM to identify best practice for developing clinical practice guidelines (CPGs). A full report, titled Clinical Practice Guidelines We Can Trust, is available at the IOM website.

    According to a recent article in JAMA, the journal of the American Medical Association, "The major changes from the older criteria are that documentation must be provided showing that a guideline is based on a systematic review of the evidence and an assessment of the benefits and harms of the recommended and alternative care options." The JAMA article described the change as one that is "raising the bar" for CPGs at the NGC.

    Need more information on practice guidelines and other evidence-based practice resources? Check out APTA's new Resources for the Development of Evidence-Based Documents webpage designed to help you find current guidelines and research and learn how to contribute to the growing pool of evidence-based physical therapy research.

    Autism Rates Show a 30% Rise in 2 Years

    In a report that could inform how physical therapists (PTs) and physical therapist assistants (PTAs) approach their work with children, the US Centers for Disease Control and Prevention (CDC) has cited a nearly 30% rise in autism spectrum disorder (ASD) rates in the US since 2008. Current CDC estimates raise the prevalence of ASD from 1 in 88 children to 1 in 68 children, with a growing number of children diagnosed with ASD who have average or above-average intellect.

    The CDC findings were widely reported in major media outlets including the Washington Post,New York Times, Los Angeles Times, and the Associated Press, each highlighting different features of the report, which pointed out variations in prevalence among ethnicities, sex, and geographic location.

    While the new rate "exceeds that of all previous surveillance years," authors of the CDC report said the "most notable change" was the prevalence rates among children with average or above-average intelligence—from 38% of all ASD diagnoses in 2006 to 46% in 2010, the year the study was conducted. The rise was accompanied by a decline in the number of children with co-occurring intellectual disabilities, from 41% to 31%.

    The CDC report called for more standardized measures to document ASD severity and functional limitations, improved recognition and documentation of symptoms of ASD, and lowering the age at which children are first assessed.

    For more information on ASD and its relationship to physical therapist services, check out a 2014 Physical Therapy article on Physical Activity and Exercise Recommendations for Children and Adolescents With ASD, as well as a 2011 article on Motor Functioning in Infants, Children, and Adults with ASD. Additionally, the association offers a 2-part continuing education primer (part 1; part 2) on ASD available through the APTA Learning Center.