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  • Supreme Court Upholds Health Care Law; APTA Reiterates Priorities

    In a historic and long-awaited decision, the Supreme Court today upheld the Affordable Care Act (ACA). APTA, which has remained neutral on ACA and the subsequent Supreme Court case, announced that its current legislative and regulatory strategies will continue, and reiterated its philosophy that the nation's health care system must address several fundamental patient-centered issues: coverage, access, quality, and costs.

    "APTA has for years been an advocate for a health care system that includes rehabilitation as a core benefit, demonstrates the value of physical therapy to patients, embraces innovation in reforms that are patient centered, and provides a solution to a system that for too long has been high in costs and disparate in outcomes and quality," APTA President Paul Rockar Jr, PT, DPT, MS, said in a statement. "We will continue to work with legislators, policy makers, insurers and other decision makers to ensure that these priorities are addressed in this law and future health care reforms—whether at the national or state level, or through individual private payment systems."

    APTA's Government Affairs staff is currently reviewing the Supreme Court decision and will provide a more detailed analysis to members in the coming days and weeks as more information becomes available.

    "We are committed to providing our leaders, members, and components with the information they need to advocate effectively for these priorities nationally and at the state level," added Rockar.

    Members should continue to follow News Now, Twitter, Facebook, and APTA's health care reform webpage for the latest information and updates.

    Version 5010 Enforcement Discretion Period Ends June 30

    The Version 5010 enforcement discretion period ends June 30. As of July 1, all noncompliant providers and entities, including physical therapists, will be subject to enforcement action under the existing HIPAA transaction and code set enforcement process. Providers still experiencing issues regarding use of the new electronic standards in their transactions should refer to their respective vendor, clearinghouse, payer's website, or provider service department for assistance.

    All HIPAA-covered entities were required to upgrade to the new ASC X12 Version 5010 (Version 5010) and NCPDP Versions D.0 and 3.0 by January 1. However, the Centers for Medicare and Medicaid Services (CMS) initiated an enforcement discretion period to give the industry additional time to upgrade to the new transaction standards. 

    Physical therapists who have not completed their Version 5010, D.0 or 3.0 implementation should consider the following steps:

    • Reach out to clearinghouses for help and take advantage of any free or low-cost software that may be available from payers.
    • Check with payers now to see what plans they will have in place to handle incoming claims.
    • Contact financial institutions to establish lines of credit to cover any temporary interruptions in claims reimbursement as a result of not being Version 5010 compliant.

    For more information regarding the updated standards, visit the Versions 5010 and D.0 & 3.0 section on the CMS' website. APTA also provides resources to help physical therapists transition to HIPAA Version 5010. Go to CMS' ICD-10 website for the latest news and resources to help in preparations for the transition to ICD-10.

    Bemis-Dougherty Elected Secretary of USBJI

    Anita Bemis-Dougherty, PT, DPT, MAS, lead clinical practice specialist in APTA's Public Policy, Practice, and Professional Affairs Unit, recently was elected secretary of the United States Bone and Joint Initiative (USBJI). Bemis-Dougherty joins APTA members Jan K. Richardson, PT, PhD, OCS, FAPTA, and Paul A. Ullucci Jr, PT, DPT, ATC, SCS, LAT, CSCS, C-DSc, who serve on the USBJI board of directors. Richardson and Ullucci represent the American College of Rheumatology and the National Athletic Trainers' Association, respectively.

    USBJI is a global, multi-disciplinary initiative targeting the care of people with musculoskeletal conditions. Its focus is on improving quality of life as well as advancing the understanding and treatment of those conditions through research, prevention, and education. APTA is a founding member of USBJI.  

    New in the Literature: Early Rehabilitation Exercise Program for Acute Exacerbation of COPD (J Cardiopulm Rehabil Prev. 2012;32:163-169.)

    Preliminary evidence from a randomized controlled trial (RCT) conducted in Australia shows that it is safe and feasible to implement an exercise program for patients during an acute exacerbation of chronic obstructive pulmonary disease (COPD), say authors of an article published in Journal of Cardiopulmonary Rehabilitation and Prevention.    

    Patients with an acute exacerbation of COPD admitted to the hospital were randomly assigned to 1 of 3 groups—a low-intensity exercise group that participated in twice-daily aerobic and resistance exercise sessions and physical therapy, a moderate- to high-intensity exercise group that participated in twice-daily aerobic and resistance exercise sessions and physical therapy, or a control group that participated only in physical therapy. Primary outcomes were the number and classification of adverse events and program adherence.

    In 174 exercise sessions, there was 1 serious adverse event of arrhythmia in the low-intensity exercise group that resolved within 1 hour. There were 12 other minor adverse events involving 5 patients with no significant differences between groups. Patients completed an average of 80% of their scheduled sessions with no significant between-group differences. The exercise groups improved significantly in walking distance. However, no significant between-group differences were observed.

    Ethics in Practice Series Examines Reimbursement, Confidentiality, Gifts, and More

    APTA's revised Code of Ethics for the Physical Therapist (Code) and Standards of Ethical Conduct for the Physical Therapist Assistant (Standards) went into effect in July 2010. Since then, numerous Ethics in Practice articles have appeared in PT in Motion that explore a variety of ethical scenarios on topics such as reimbursement, confidentiality, discharging patients, gifts, professional integrity, and professional behavior. View these and other recent articles titled "Shop Treatment," "On the Road Again," "No Vacation," "Seeking a Continuance," "When Is More Too Much?" and "Attitude at an Altitude" on APTA's Ethics Decision-Making Tools webpage.

    USPSTF Releases Recommendations on Obesity Screening, Lifestyle Counseling

    Clinicians should screen all adults for obesity and offer or refer patients with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions, says a recommendation issued Tuesday by the US Preventive Services Task Force (USPSTF). When selecting interventions, clinicians should consider other risk factors for cardiovascular disease, a patient's readiness for change, social support and community resources that support behavioral change, and other health care and preventive service priorities. The task force further recommends that health care professionals offer or refer people who are obese to a comprehensive weight loss and behavior management program with 12 to 26 sessions in the first year.

    Supporting documents and related items on the recommendation, which include a clinical summary, consumer fact sheet, news bulletin, and evidence synthesis, are available on USPSTF's website.  

    In a separate recommendation, USPSTF determined that for people who have low risk for heart disease, counseling to encourage healthy lifestyle choices, such as a healthful diet and physical activity, offers only small benefits in reducing the risk for cardiovascular disease. The task force also states that this counseling may be beneficial to some people, depending on their individual risk factors, including known cardiovascular disease, high blood pressure, and high cholesterol.

    These recommendations are available in the Annals of Internal Medicine and on the task force website.

    Photo Contest Deadline Extended to August 15

    APTA has extended the deadline for this year's photography competition to August 15. Association members are encouraged to participate in the competition by submitting entries that reflect physical therapy practice, education, or research. Winning entries should:

    • Reflect the full scope and depict the strides that contemporary physical therapy practice, education, or research has helped to achieve.
    • Depict models of excellence in a variety of settings.
    • Portray a diverse population of physical therapists, physical therapist assistants, patients, researchers, faculty, or students.
    • Reflect high quality in terms of aesthetics, composition, and technical standards. 

    Winners will be selected by a distinguished panel of judges. Winning entries will be displayed at association headquarters, may appear in APTA's online or print publications, and on APTA's website.

    The first-place winner will receive $500. The second and third place winners will receive $250 each. No cash prizes will be awarded for honorable mentions. Winners will be announced in a future issue of PT in Motion. Complete contest rules and additional details are available on APTA's website. All entries must be received by August 15. Winners will be notified by December 14.