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  • SGR Patch Now In Place – Congress Gives Itself 12 Months To Develop Permanent Repeal

    With a vote taken just in time to avoid a March 31 deadline that would have triggered a 24% cut in payment via the flawed sustainable growth rate (SGR) formula, the US Senate has passed House-drafted legislation that will provide a 12-month temporary fix. In addition to the patch, the final bill still includes a delay on Medicare's implementation of the ICD-10 codes that had been set for an October 1 launch.

    The final bill replaces the cut with a .5% provider payment update through the end of the year and no update from January 1 to April 1 in 2015. In addition to the SGR fix, the legislation also continues extender provisions, including the therapy cap exceptions process and Geographic Pricing Cost Index (GPCI), until March 31, 2015.

    Congress had given itself until March 31, 2014, to finalize details of a proposal to repeal the SGR, but hit political road bumps that prevented the chambers from agreeing on the final shape of that legislation and how it would be paid for. As the deadline loomed, the Centers for Medicare and Medicaid Services (CMS) announced that it was prepared to put a temporary hold on claims processing to avoid implementing the SGR reductions while lawmakers scrambled to approve a patch. With that patch now in place before the deadline, CMS can drop the hold.

    The approximate $20 billion cost of the bill will be paid for through a combination of cuts and programmatic changes that include reductions to clinical labs, radiology services, a delay on oral-only drugs for end-stage renal disease bundles, the establishment of a new value-based purchasing program for skilled nursing facilities based on performance around hospital readmissions, and a tightening up of code valuation under the fee schedule. Additional funds are identified through the use of SGR "transitional fund" money and an extension of Medicare sequester provisions.

    The legislation also contains a provision that delays the implementation of the International Classification of Diseases, 10th revision (ICD-10) for all HIPAA-covered entities.

    APTA continues to work with legislators toward a permanent end to the SGR and therapy cap and will keep member advocates updated through PTeam alerts.

    New Tool Demystifies Security Risk Assessments

    Physical therapists (PTs) and other health professionals looking for help on how to conduct HIPAA security risk assessments have a new free tool to make the process more understandable.

    The US Office of the National Coordinator for Health Information Technology (ONC) is now offering a downloadable Security Risk Assessment (SRA) Tool that it says "lets you take a self-directed tour of HIPAA standards and helps you conduct a risk assessment at your own pace." The tool was developed in collaboration with the US Department of Health and Human Services' Office for Civil Rights and the Office for the General Counsel.

    Under HIPAA, PTs who are considered covered entities or business associates are required to conduct risk and vulnerability assessments of electronic personal health information (PHI) to evaluate the potential for the confidentiality, integrity, and availability of that information to be compromised.

    The tool is designed to lead users through each HIPAA requirement through a series of yes or no questions. In addition to providing space for documentation, the tool offers other features including "context sections" that explain threats and vulnerabilities, examples of safeguards, a glossary, and report charts that display the user's risk levels. The report can also be exported as a Microsoft Excel file or PDF document. The tool is available for both Microsoft and iOS (iPad only).

    Recent costly settlements for violations of HIPAA PHI requirements have made headlines, and underscore the importance of understanding the rules and assessing security risks. APTA offers multiple resources on health information technology, HIPAA requirements, and electronic health records.

    Capt. Mark Kelly To Speak At NEXT; Discounted Registration Ends April 2

    APTA members need to act by April 2 if they want to get in on early registration discounts for the inaugural NEXT Exposition and Conference featuring Captain Mark Kelly. A space shuttle commander and husband of former US Representative Gabrielle Giffords, Kelly will deliver the opening keynote address for the event June 11-14 in Charlotte, North Carolina.

    Kelly is an American astronaut, retired US Navy captain, bestselling author, prostate cancer survivor, and experienced naval aviator who flew combat missions during the Gulf War. He has served as his wife's partner and most ardent supporter during her continuing recovery from a traumatic brain injury. Kelly's presentation will also include a special video message from Giffords.

    NEXT evolved from the meeting formerly known as the Annual Conference and Exhibition. Though the focus and tone of NEXT will be on what's ahead for the profession, the event will also feature many of the popular elements of past annual conferences including the McMillan and Maley lectures and the Oxford Debate. As with past annual conferences, NEXT will occur immediately after APTA's House of Delegates.

    Registration and housing information can be found on the NEXT webpage along with a schedule of presentations and preconference sessions.