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  • Ernest A. Burch Jr. Dies at 91

    Ernest Burch, PT

    The former APTA vice president helped lead the way in the establishment of autonomous physical therapist practice in Maryland.

    Ernest A. Burch Jr., PT, FAPTA, considered a pioneer in physical therapy, died April 28 at age 91.

    Originally from Swedesboro, New Jersey, Burch received his undergraduate degree from Western Maryland College (now McDaniel College) in 1950. He began his career in physical therapy after serving time in the U.S. Army during the Korean War and then completing his PT education in 1956 from the University of Pennsylvania on a G.I. bill that paid his tuition.

    He spent 10 years as chief therapist at Union Memorial Hospital in Baltimore before leaving to open a private practice, Burch, Rhoads & Loomis, focusing on orthopedic and home health services. The practice eventually expanded to 10 offices. While at Union Memorial, Burch spent an afternoon each week observing Henry O. and Florence P. Kendall perform muscle testing and posture analysis with nurses at Johns Hopkins.

    As successful as Burch’s career was, he was equally well-known for the depth and breadth of his service to APTA. Notably, he and Florence Kendall helped push for autonomous practice legislation in Maryland in the 1970s. Among the long list of positions Burch held are APTA vice president, chair of the APTA Nominating Committee, secretary and then president of the Maryland Chapter, president of the Private Practice Section, and chair of the Maryland State Board of Physical Therapy Examiners. He was named a Catherine Worthingham Fellow, APTA’s highest member category, and he earned several awards, including APTA’s Lucy Blair Service Award and the Private Practice Section’s Robert G. Dicus Award.

    "Ernie was a stalwart for physical therapy advocacy," said APTA CEO Justin Moore, PT, DPT. "In one of my first presentations for APTA more than 20 years ago, I was at a chapter meeting being drilled with questions about direct access, referral for profit, and incident-to billing. After 30 minutes, Ernie stood up and said if everyone in the room was as aggressive on Capitol Hill as in the conference room we’d have solved those problems already. The crowd applauded and my presentation was over. I hadn’t met Ernie yet, but he supported me and I never forgot that. Over the years I got to know him a bit better. He was a gem and a gentleman. APTA is fortunate for having had his leadership."

    New TRICARE Rule Allows for Telephone-Delivered Services, Drops Copays

    Audio-only visits will be allowed when necessary, cost-sharing is lifted, and TRICARE licensing requirements relaxed.

    In this review: TRICARE Coverage and Payment for Certain Services in Response to the COVID-19 Pandemic (interim final rule with comment period)
    Effective date: May 12, 2020

    The big picture: TRICARE is expanding the range of remote services it will allow—and is temporarily waiving copays for telehealth.
    TRICARE, the health insurance used throughout the military, will function under a new interim rule that will allow for the use of audio-only remote services for office visits "when appropriate," and eliminate copays and copayments for beneficiaries who receive services delivered via telehealth. The rule, set to go into effect May 12, also relaxes provisions around licensing requirements for providers. The new rule will remain in effect until the COVID-19 public health emergency ends.

    Important to note: The changes — especially the new provisions around the use of audio-only services — come with requirements and shouldn't be seen as blanket permissions.

    Yes, it's possible for TRICARE beneficiaries to receive care through audio-only (telephone) services, but only when appropriate — and documentation is important.
    The U.S. Department of Defense Office of the Secretary (author of the interim rule) has lifted TRICARE's prohibition on telephonic services to enable beneficiaries to have their symptoms evaluated by a provider over the phone. The change applies to any covered illness or injury, including COVID-19 symptoms, for all beneficiaries, but the services must be medically necessary and rendered by an authorized TRICARE provider within the scope of the provider's license.

    The interim rule is clear that the use of audio and visual two-way platforms is preferred, and that audio-only services should only be used when necessary — for instance, when access to broadband may be impossible. TRICARE is counting on its providers to use clinical judgment in deciding when the audio-only option is appropriate, and to carefully document their reasons for choosing the platform used.

    DoD also points out that there are circumstances under which audio-only telehealth is not appropriate — namely, any visit that requires a physical examination.

    Cost-sharing and copays for telehealth service are (temporarily) out.
    To incentivize TRICARE beneficiaries to reduce in-person visits to TRICARE providers, the rule eliminates cost-sharing, including deductibles, for all in-network authorized telehealth services. The waiver applies to TRICARE Prime and Select beneficiaries in all geographic areas but will remain only as long as the national public health emergency is in place.

    Interstate practice in TRICARE will be a little easier — and there could be international implications, too.
    For the duration of the emergency, the TRICARE system will lift its mandate that providers must be licensed in the state in which they're practicing (which could be different from the state in which they reside), even if that license isn't otherwise required. Providers still need to have an equivalent license to practice, however, and DoD acknowledges that individual states retain the authority to manage the licensing of all providers in that state's jurisdiction. The change allows TRICARE providers to make full use of relaxed interstate licensing requirements adopted by state or federal government.

    The interim rule around licensing also has implications beyond the U.S.: According to DoD, the change could also allow TRICARE providers in other countries to practice beyond that nation's borders, so long as permitted by the host nation.

    The change applies to services delivered both in person and via telehealth.

    FSBPT to Host Webinar on NPTE Amid COVID-19

    Testing center closures are preventing administration of the National Physical Therapy Examination.

    [Editor's note: an earlier version of this story reported the webinar date as May 15; that session is intended for faculty only. The May 18 session is open to students and others.]

    For thousands of would-be PTs and PTAs, the National Physical Therapy Examination stands between them and licensure. Amid COVID-19, the hardest part isn’t passing the exam – it’s having the opportunity to take it.

    The Federation of State Boards of Physical Therapy, which oversees the NPTE process, uses Prometric to administer the exam in testing facilities across the country. In normal circumstances, Prometric supports millions of test takers annually around the world. But the COVID-19 pandemic has closed buildings where exams are usually conducted and made it unsafe for test-takers to sit near each other – problems not unique to the NPTE.

    Aware of the challenge, FSBPT is hosting a free webinar on Monday, May 18, at 3:10 pm ET, to provide updates and answer questions. Advance registration is required.

    Last week Prometric sent a letter acknowledging the challenges and confusion: “We recognize that our communications to your test takers and other stakeholders has at times been inadequate and may have caused unnecessary confusion and frustration,” the letter said. Prometric also includes status information on a special COVID-19 webpage.