APTA along with other therapy stakeholder organizations met with the Centers
for Medicare and Medicaid Services (CMS) to discuss implementation of the
manual medical review (MMR) process for outpatient therapy claims exceeding
$3,700. As reported March 22 in News Now, recovery audit
contractors (RACs) will complete 2 types of review for claims processed on or
after April 1, 2013—prepayment review for states within the Recovery Audit
Prepayment Review Demonstration, and immediate postpayment review for the
assured stakeholders that the agency would have the necessary safeguards in
place to ensure appropriate and fair medical review by RACs. Prior to the
meeting, the therapy organizations sent a detailed list of questions to CMS
regarding the use of the advanced beneficiary notice (ABN), RAC administration,
and outreach education to Medicare contractors, providers, and patients. CMS
indicated that it plans to issue a written FAQ of the questions submitted in
the coming weeks.
the meeting, CMS clarified the following:
the coming days, APTA will provide additional resources to members on the application
of the 2013 MMR process. Resources and the latest information on the therapy
cap can be found on APTA's 2013 Medicare Changes webpage.
address the public health problem of physical inactivity, the Department of
Health and Human Services is accepting comments on walking as an effective way
to be sufficiently active for health. The information collected will help frame
an anticipated Surgeon General's call to action on this issue.
will submit comments by the April 30 deadline. APTA members are encouraged to send
their recommendations to APTA to be included in the association's submission to
information on ways to increase walking and community walkability on the
following 2 topics:
to walking for youth, adults, seniors, people with developmental injury and
chronic disease-related disabilities, racial and ethnic minorities, and
strategies for overcoming those barriers and their reach and impact to increase
physical activity at the population level and among the above-mentioned
your comments by COB April 26 to Lisa Culver, PT, DPT, MBA,
senior specialist, APTA department of clinical practice.
A recent $50,000 donation by the
Section on Geriatrics to the Foundation for Physical Therapy will be allocated
toward the Marilyn Moffat Endowment Fund for Geriatric Research ($25,000) and
the Center of Excellence for Health Services/Health Policy Research ($25,000).
Established in 2007, the Marilyn
Moffat Endowment Fund for Geriatric Research supports emerging investigators
examining methods to facilitate the translation of research into current
physical therapy practice with aging adults.
The Center of Excellence is a new
initiative with a goal to provide health services and health policy research
training to prepare physical therapist scientists to examine physical therapy
resource utilization, costs, and quality. The purpose of the research is to
identify the most effective ways to deliver, organize, finance, and assess
outcomes of health care services.
more about the donation in the Foundation's press release.
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