• Wednesday, July 31, 2013RSS Feed

    CMS Clarifies Functional Limitation Reporting Requirements

    The Centers for Medicare and Medicaid Services (CMS) clarified various elements of functional limitation reporting in its July 24, 2013, edition of MLN Matters.

    The article includes definitions of a "reporting episode" and a "reporting period" for the purposes of functional limitation reporting, details the importance of submitting claims in sequence, and provides further clarity on unique reporting scenarios that include multiple plans of care.

    The MLN Matters article is among the many resources that can be accessed at APTA's functional limitation reporting webpage, which includes a downloadable toolkit, multiple case scenarios, and FAQs.

    The reporting of functional limitation data is required for therapy services claims under Medicare Part B for dates of service on or after July 1, 2013.


    Tuesday, July 30, 2013RSS Feed

    Study: Back Pain Treatment Increasingly Ignores Clinical Guidelines

    Despite published guidelines that call for physical therapy or medications such as ibuprofen or acetaminophen for first-line management of most back pain, other treatments such as imaging, narcotics, and referrals to other physicians have increased, according to a study published online yesterday in JAMA Internal Medicine.

    Because more than 10% of visits to primary care physicians relate to back and neck pain, and the treatments recommended by guidelines generally are less costly than those being used increasingly, the financial implications in the health care market are significant. "With health care costs soaring, improvements in the management of back pain represent an area of potential cost savings for the health care system while also improving the quality of care," the study concludes.

    The study identified 23,918 visits to primary care physicians for spine problems. Average age of the patients increased from 49 to 53 years during the study period, January 1999 through December 2010, and 58% of the patients were female.

    According to the results, physical therapy referrals remained unchanged at about 20%, but physician referrals increased from 6.8% to 14%. Nonsteroidal anti-inflammatory drug or acetaminophen use per visit decreased from 36.9% to 24.5%, while narcotic use increased from 19.3% to 29.1%t. The number of radiographs remained at about 17%, but the number of computed tomograms or magnetic resonance images increased from 7.2% to 11.3% during the study period.


    Tuesday, July 30, 2013RSS Feed

    Maine Law Further Protects Health Care Providers in Preferred Provider Arrangements

    A new Maine law will give physical therapists and other health care providers additional protections when they enter into contracts for preferred provider arrangements. Public Law 399 (LD 1466) will require health plans to disclose certain information and materials to providers at the time a preferred provider arrangement contract is offered.

    The legislation will prohibit contracts that allow health insurance companies to make changes to key terms, such as reimbursement rates, without the provider's written consent after the agreement has been entered.

    LD 1466 was sponsored by Maine Senate Majority Leader Seth Goodall (D-19) and supported by the Maine Chapter of APTA. The new provisions will take effect October 8.


    Tuesday, July 30, 2013RSS Feed

    New FAQ Provides Guidance on Coding for Patient Education

    APTA answers members' most-often-asked questions about coding for patient education services in a new APTA.org resource. The members-only FAQ addresses questions such as "How do physical therapists report (bill) time spent delivering patient education" and "What should be included in documentation about patient education?"


    Tuesday, July 30, 2013RSS Feed

    CMS Wants You to Rate Your MAC

    As APTA reported on July 9, physical therapists and other health care providers have a chance to rate their Medicare Administrative Contractors (MACs), and the Centers for Medicare and Medicaid Services (CMS) is still seeking registrants for this opportunity.

    CMS's new provider satisfaction measuring tool, the MAC Satisfaction Indicator (MSI), will ask participants to rate their Medicare administrative contractors (MACs) in areas such as claims processing, Medicare enrollment, education offerings, and responsiveness to inquiries.

    CMS will choose participants at random from registered Medicare fee-for-service providers. APTA encourages members to join the registry and if selected provide feedback-CMS and the MACs will use the results of the MSI to improve their service to all Medicare fee-for-service providers.

    Click here to go directly to the registration form, or visit the Medicare Contractor Satisfaction Indicator webpage for more information.


    Monday, July 29, 2013RSS Feed

    Updated MMR Complaint Form, Proposed Rule Summaries Now on APTA.org

    New APTA web resources will help members stay up-to-date on Medicare policies and proposals:

    • To help members navigate the 2 types of manual medical review (MMR) of Medicare claims for patients whose annual therapy costs exceed $3,700, APTA has created an MMR State Resources page, including a map and a detailed explanation of the process. As of April 1, recovery auditor contractors (RACs) complete either prepayment review or postpayment review of applicable claims, depending on the state of the provider.
    • An updated Medicare Therapy Cap information page includes a link to the MMR State Resources page as well as to a revamped Manual Medical Review Complaint Form. APTA encourages members to complete this complaint form if they are experiencing problems with MMR. APTA staff will contact members within 2 business days of receiving the complaint form.
    • APTA has posted a summary for the proposed rule released by the Centers for Medicare and Medicaid Services (CMS) for the home health prospective payment system for 2014. The rule proposes to remove 2 categories of ICD-9-CM codes from the HH PPS Grouper; reduce the national, standardized 60-day episode rate of 3.5% annually 2014–2017; increase each of the per-visit payment rates for low-utilization payment adjustments of 3.5% annually 2014–2017; and add 2 claims-based quality measures. This proposed rule is open for comment until August 26.
    • APTA has posted a summary of the CMS proposed rule to revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for 2014. Among other changes, the rule proposes to expand the categories of related items and services packaged into a single payment for a primary service under the OPPS, to make the OPPS more of a prospective payment system. Specifically, the proposed rule would add 7 categories of supporting services and create 29 comprehensive ambulatory payment classification groups (APCs) to replace 29 existing device-dependent APCs. This proposed rule is open for comment until September 6.

    Monday, July 29, 2013RSS Feed

    APTA Member Benefit: Car Rental Discounts

    If your summer travel plans include driving a rental car, your APTA membership can save you up to 25% with Avis and Budget. Be sure to look for additional savings coupons when making your reservation online.

    To make a reservation with Avis, click here, or call 800/331-1212 and mention AWD Number T031200.

    To make a reservation with Budget, click here, or call 800/455-2848 and mention BCD Number X570900. Budget also offers Budget Bucks Payback: rent with Budget twice through December 31, 2013, and receive a $25 Budget Bucks gift certificate toward your next rental. To start earning Budget Bucks, register your Fastbreak RapidRez number at www.budget.com/bucks. If you aren't a Fastbreak member, click here for free enrollment.

    Your APTA member discount is good for any occasion, not just APTA business. Use it on your summer vacation, next business trip, or when you need sofree enrollmentme extra wheels.


    Friday, July 26, 2013RSS Feed

    Concussion Webinar Can Prepare PTs for Fall Sports Season

    For youth football players, more contact drills in practice don't result in less exposure to head hits during games, according to a July study in the Annals of Biomedical Engineering that was reported in the The New York Times. The study calls for further research to determine how reducing exposure in practice affects actual concussion risk for the young athletes.

    This and other news on concussions as youth and high school teams begin practice for the fall season keep this topic hot for athletes, their parents, and health care providers. "It's not surprising that there's a youth concussion epidemic," said Ann Mucha, PT, DPT, NCS, in her presentation at APTA Conference in June.

    As a follow-up to her presentation, on August 22 Mucha will explore concussion and outline effective multidisciplinary team approaches in APTA's webinar "Managing Concussions With an Interprofessional Team." The webinar also will cover how the physical therapist's role on core teams is quickly evolving, and why physical therapists are uniquely qualified to address some of the most prevalent brain injury challenges, including balance dysfunction, dizziness, motion sensitivity, cervical dysfunction, and deconditioning.


    Friday, July 26, 2013RSS Feed

    2013 ELI Fellows Graduate From APTA Education Leadership Institute Fellowship

    The second class of ELI Fellows graduated from APTA's Education Leadership Institute (ELI) Fellowship on July 11. Fourteen ELI Fellows completed a yearlong higher education leadership program that consisted of:

    • 9 online modules provided by nonphysical therapy content expert faculty;
    • 3 face-to-face mentorship sessions with ongoing mentorship provided by experienced physical therapy program directors;
    • higher-education mentorship provided by administrators within participants’ institutions or organizations; and
    • implementation of a personal leadership plan and an institution-based leadership project.

    In addition, the ELI Fellows cultivated a shared learning community and network with opportunities to integrate curriculum content within their current and future education leadership roles and responsibilities.

    The ELI Fellowship strives to develop physical therapist and physical therapist assistant education program directors with the leadership skills to facilitate change and improvement in the academic environment of the 21st century, think strategically to creatively implement solutions in education that respond to changes in health care and society, and engage in public discourse that advances the physical therapy profession.

    Partners who help promote and support the ELI Fellowship include the American Council of Academic Physical Therapy, the Education Section, and the PTA Educators Special Interest Group. More information about the ELI Fellowship is available on APTA's website.


    Thursday, July 25, 2013RSS Feed

    APTA Member James Buskirk Examines Today Show Host for Balance Issues

    This morning’s airing of the Today show featured a segment with APTA member James Buskirk, PT, SCS. Show host Savannah Guthrie, who notes at times that she tends to be accident prone, traveled to Illinois to be evaluated by Buskirk. He performed a series of tests to track her vision, equilibrium, and spatial location, and he explained how he can design a rehabilitative program to help her with deficits in these areas.


    Thursday, July 25, 2013RSS Feed

    Registration Now Open for 2013 APTA State Policy & Payment Forum

    Registration is now open for the 2013 APTA State Policy & Payment Forum to be held September 15-17 at the Hilton in Omaha, Nebraska. This event is designed to increase your involvement in and knowledge of state legislative issues that have an impact on the practice and payment of physical therapy, and to improve your advocacy efforts at the state level.

    Programming will focus on physical therapy payment and legislative issues at the state level. Among the presentation topics are implementation of health care reform in the states, physical therapy copay legislation, telehealth, emerging scope of practice issues, strategies for negotiating with insurance companies, and infringement issues. To learn more about this year's forum and to register online, go to: www.apta.org/StateForum/.


    Wednesday, July 24, 2013RSS Feed

    Specialist Certification Exam Applications Due July 31

    Physical therapists who plan to take the 2013 American Board of Physical Therapy Specialties (ABPTS) exam for certification in Geriatrics, Neurology, Orthopaedics, Pediatrics, or Sports must turn in their applications by July 31. Application forms and information are available on the ABPTS website.

    Individuals who successfully achieve board certification in 2013 will be recognized during the 2014 Combined Sections Meeting in Las Vegas.

    (The application deadline for specialist certification in Cardiovascular and Pulmonary, Clinical Electrophysiology, and Women's Health was July 1.)

    If you need additional information contact the specialist certification department.


    Monday, July 22, 2013RSS Feed

    DMEPOS Competitive Bidding Program Launched in 91 US Regions

    Physical therapists in 91 metropolitan statistical areas (MSAs) need to know which suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) have been selected by the Centers for Medicare and Medicaid Services (CMS) under its competitive bidding program. As of July 1, these are the only suppliers from which Medicare beneficiaries in these MSAs may obtain certain DMEPOS items, such as wheelchairs, hospital beds, walkers, and oxygen.

    The Medicare.gov website provides a supplier directory under the "Resource Locator" tab for finding a Medicare contract supplier in your region. A Medlearn Matters article (SE1244) and a Fact Sheet from CMS provide more information on this program for physical therapists, physicians, and other providers.

    Under the competitive bidding program, DMEPOS suppliers compete to become Medicare contract suppliers. CMS awards contracts to the suppliers that offer the best prices and meet applicable quality and financial standards. As a result, some DMEPOS suppliers from which your patients have obtained items from in the past may no longer provide these items to Medicare beneficiaries.

    Providers, DMEPOS suppliers, and consumer groups are concerned that the increased emphasis on price competition under this program could produce unsustainably low prices, limit the number of DMEPOS suppliers in the program, and, as a result, reduce beneficiary access to high-quality, brand name, and customizable equipment, and other effective supplies.

    If you experience problems accessing DMEPOS items for your patients, we encourage you to contact APTA by e-mailing advocacy@apta.org. Also, the People for Quality of Care and the American Association for Homecare have set up a hotline at 800/404-8702 for patients and providers to report problems with access to DMEPOS items as a result of this program. The information provided on the hotline will be aggregated and presented to CMS and Congress with the beneficiaries' permission.

    Congress has introduced 2 bills regarding this program: legislation to stop the program altogether and replace it with a market pricing program (HR 1717); and legislation to delay the program for 6 months until various problems can be fixed (HR 2375).


    Friday, July 19, 2013RSS Feed

    Online Nomination Form for 2014 Elections Available

    It may seem as if the 2013 elections for APTA offices were just completed, but APTA encourages members to begin considering candidates for the 2014 elections—including self-nominations—early to ensure time to complete the process by the November 1, 2013, deadline.

    The online Nomination Form (NC 1) is available on the APTA website under Elections and Nominations. The APTA Nominating Committee is seeking recommendations for the 2014 Slate of Candidates for the following positions: treasurer, speaker of the House of Delegates, 3 directors, and 2 Nominating Committee members.


    Friday, July 19, 2013RSS Feed

    New Video Resources Help Bring Evidence-Based Practice to Clinics

    Three new APTA videos feature members talking about programs at their facilities that encourage clinicians to incorporate evidence-based practice into their patient care.

    In Using Research in Clinical Practice-Steps to Success, Beth Crowner, PT, DPT, NCS, MPPA, associate professor at Washington University at St Louis, provides practical steps to starting a program that increased the use of evidence in a teaching facility, including starting a journal club and developing common examination items and outcome measures to collect.

    In Major Projects at a Health System Level, Jenni Moore, PT, DHS, NCS, of the Rehabilitation Institute of Chicago (RIC), describes several projects that encouraged evidence-based practice across the large RIC health system.

    In Applying Lessons Learned From a Large Health System to Your Clinic, Moore continues, outlining a process that can be applied in smaller settings, highlighting how to address barriers and leverage facilitators for success.


    Friday, July 19, 2013RSS Feed

    Find Your Colleagues and Yourself in APTA Conference Photos

    Nearly 600 photos were taken at APTA Conference and the 2013 House of Delegates—want to see if you and your colleagues are in any of them?

    To view and purchase images from APTA Conference, please go to www.nowpicturethis.zenfolio.com/p850501073, password "apta." Images are displayed in order of occurrence. To purchase prints, click on any photo, then look for the Buy tab in the upper righthand corner of your screen. Please contact Jennifer Rondon at jenniferrondon@apta.org with any questions.


    Thursday, July 18, 2013RSS Feed

    APTA Provides Highlights of 2014 Proposed Physician Fee Schedule

    A new APTA document provides highlights of the provisions in the 2014 proposed physician fee schedule rule that will affect physical therapy.

    Available to members on APTA's Medicare Physician Fee Schedule webpage, the highlight summary document covers changes that will affect payments, the proposed addition of critical access hospitals to the therapy cap, changes to the Physician Quality Reporting System, claims and registry reporting, and more.


    Thursday, July 18, 2013RSS Feed

    APTA to Host Third Call-In on Medicare's Functional Limitation Reporting Requirements

    Due to continued high demand, APTA will host a third Q&A call for members to answer questions about functional limitation reporting requirements. The next call-in will be Tuesday, July 23, 2:00 pm-3:00 pm (ET). Participants will need access to a computer and the Internet. Space is limited, so secure your spot soon. To register please e-mail advocacy@apta.org with "July 23 Call" in the subject line.

    All providers who bill outpatient therapy services under Medicare Part B must submit functional limitation data (G-codes and appropriate modifiers) for any Medicare beneficiary, or claims will be returned unpaid. Therapists must report functional limitation data on the beneficiaries' current functional status and on the projected goal at scheduled intervals throughout the episode of care, including at the outset of the therapy episode, no less frequently than every 10th visit, and at discharge.

    If you can't make any of the call-in sessions, APTA will add questions posed during these calls to its existing FAQ documents on the Functional Limitation Reporting webpage.


    Thursday, July 18, 2013RSS Feed

    WCPT Partners With PEDro and Physiopedia

    Saying that they share many of the same objectives and values, the World Confederation for Physical Therapy (WCPT) has agreed to promote 2 physical therapy knowledge resources: the Physiotherapy Evidence Database (PEDro) and Physiopedia.

    Produced by the Centre for Evidence-Based Physiotherapy at The George Institute for Global Health, PEDro provides online access to over 24,000 randomized trials, systematic reviews, and clinical practice guidelines in physical therapy. Physiopedia is a free online wiki for physical therapists.

    Hooked on Evidence is another free physical therapy research resource. APTA's database of current research evidence on the effectiveness of physical therapy interventions was opened to public access last year.


    Wednesday, July 17, 2013RSS Feed

    Foundation Releases 2012 Annual Report

    The Foundation for Physical Therapy posted its 2012 Annual Report, highlighting $580,500 awarded in research grants and scholarships to leading and emerging researchers, clinicians, and academicians who are advancing effective innovations in the field of physical therapy.


    Tuesday, July 16, 2013RSS Feed

    Self-Referral of Anatomic Pathology Cost Medicare $69 Million, Says GAO

    A new report from the Government Accountability Office (GAO) concludes that when physicians performed biopsies in their own facilities instead of referring the service to an outside lab, the number of procedures increased, and costs went up. GAO released "Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer" yesterday.

    This second of 4 reports in GAO's self-referral investigation covered anatomic pathology services between 2004 and 2010. Among the findings are that self-referred services more than doubled, while services referred externally increased far less (116% vs 38%); and spending was higher for self-referrals than for non-self-referral services (164% vs 57%). GAO estimated that the higher rate of procedures and higher number of services per biopsy by self-referrers cost Medicare $69 million. Additional findings and conclusions are in the report.

    "There is more than enough evidence that self-referral leads to over-utilization," stated the Alliance for Integrity in Medicare (AIM) today in response to the report. GAO recommended that the Centers for Medicare and Medicaid Services (CMS) track self-referred anatomic pathology services, create policies to ensure appropriateness of biopsy procedures, and develop new payment approaches. AIM said that while it applauds GAO's findings, it disagrees with these recommendations. "It's time to get at the root of the problem and close the self-referral loop." APTA is an AIM member.

    In its first report, GAO investigated self-referral in advanced imaging services, also concluding that financial incentives were a likely factor driving the increases in referrals and spending.

    APTA anticipates the last 2 reports in the series, on radiation oncology and physical therapy, later this year.


    Tuesday, July 16, 2013RSS Feed

    2013 Call for Proposals: CPG/CPA Development

    As part of APTA's strategic plan, one of the goals for 2013 is to better enable physical therapists to consistently use best practice to improve the quality of life of their patients and clients.

    To achieve this goal, APTA is supporting the development of clinical practice evidence-based documents. This initiative aims to provide structure, process, and resources for the development of Clinical Practice Guidelines (CPG) and Clinical Practice Appraisals (CPA) that enable the translation of research into physical therapist practice. In order to facilitate the development of clinical practice documents and other high quality evidence summaries, APTA is offering financial and training support to sections for this purpose.

    Proposals for CPG/CPA development must focus on clinical practice areas that are important and relevant to the practice of physical therapy. The proposal must be supported and submitted by an APTA section. Each proposal will be considered individually and will be awarded in part or in full depending on the priorities of the association and the strength of the proposal.

    Proposals for the current review cycle are due on September 15. For more information or for a copy of the proposal submission document, contact Anita Bemis-Dougherty, director, Practice Department, at anitabemis-dougherty@apta.org or 800/999-2782, ext 3176.


    Monday, July 15, 2013RSS Feed

    Walking for Arthritis Pain Is Topic of Free Dial-in Presentation July 17

    Jennifer Hootman, PhD, ATC, FACSM, FNATA, epidemiologist with the Centers for Disease Control and Prevention (CDC) arthritis program, will outline research findings on the benefits of walking to ease arthritis pain this Wednesday, July 17, in a free dial-in presentation.

    The 30-minute lunchtime presentation, hosted by the Osteoarthritis Action Alliance (OAA), will discuss a recent CDC Morbidity and Mortality Weekly Report on the prevalence of walking among adults with arthritis.

    To participate, call 866/487-9460 just before 12:00 pm ET, and enter conference code 5760233526#. The event also will be recorded and archived at OAAction.org.

    View a preview of the presentation slides.

    APTA is a member of OAA.


    Friday, July 12, 2013RSS Feed

    2013 Post-House Packet Available Online

    A Post-House Packet containing draft final language for all motions acted on at the 2013 House of Delegates (House) in Salt Lake City is posted at the 2013 House of Delegates webpage and on the House of Delegates community.

    Official language for new and amended positions will be updated on the APTA website by September 23, in conjunction with the posting of the official House minutes to the House community archive.

    In the meantime, the position that was rescinded at the 2013 House (Direct Access and Attainment of “Physician-Status” as Applied Under the Medicare Program HOD P06-05-16-08) has been removed from the APTA website.

    A summary of the 2013 House has been prepared in Word and PowerPoint to serve as foundational elements for newsletter articles and presentations to educate members and nonmembers on the actions taken by the House. Those summary resources can be found along with other post-House content in the House community within the 2013 archive documents.

    The livestream of the entire 2013 House remains available to APTA members here.


    Friday, July 12, 2013RSS Feed

    NY Physical Therapy Association Pledges $125,000 to Foundation for Physical Therapy

    The New York Physical Therapy Association has pledged $125,000 toward the Foundation for Physical Therapy's Center of Excellence for Health Services/Health Policy Research.

    The Center of Excellence will train the next generation of physical therapist investigators who will gain skills necessary to examine effective delivery, organization, financing, and analysis of outcomes.

    "We are extremely pleased that the New York Physical Therapy Association has made this generous pledge to help support the largest grant in the Foundation's history," stated Foundation President William G. Boissonnault, PT, DPT, DHSc, FAPTA, FAAOMPT.

    Six months into the yearlong fundraising campaign for this initiative, the Foundation has surpassed the half-way mark with more than $1.9 million raised toward the goal of $3 million.


    Wednesday, July 10, 2013RSS Feed

    Second Call-in Q&A Can Answer Your Questions on Functional Limitation Reporting

    Because of high demand for its first Q&A call-in, APTA will host a second Q&A call for members on Tuesday, July 16, 2:00 pm-3:00 pm (EST) to answer questions about the functional limitation reporting requirements that became effective July 1.

    All providers who bill outpatient therapy services under Medicare Part B must submit functional limitation data (G-codes and appropriate modifiers) for any Medicare beneficiary, or claims will be returned unpaid. Therapists must report functional limitation data on the beneficiaries' current functional status and on the projected goal at scheduled intervals throughout the episode of care, including at the outset of the therapy episode, no less frequently than every 10th visit, and at discharge. Participants in this second Q&A will need access to a computer and the Internet. Space is limited. To secure a spot, please e-mail advocacy@apta.org with "July 16 Call" in the subject line. Based on demand, APTA will host future calls throughout the month of July.

    For more information and resources on functional limitation reporting, please visit APTA's Functional Limitation Reporting webpage.


    Wednesday, July 10, 2013RSS Feed

    GAO Says 115,000+ Medicare Beneficiaries Affected by Manual Medical Review in 2012

    The Government Accountability Office's (GAO) mandated report on the implementation of manual medical review (MMR), part of the therapy cap exceptions process, estimated that the Centers for Medicare and Medicaid Services (CMS) received more than 167,000 reviews, affecting more than 115,000 Medicare patients, over a 3-month period.

    Between October 1, 2012, and December 31, 2012, CMS-contracted Medicare administrative contractors (MACs) reviewed 110,000 preapproval requests and 57,000 claims for services that were not preapproved. These were the 2 types of MMRs being implemented during the last 3 months of 2012. Of the estimated 110,000 preapproval requests reviewed, the MACs affirmed 80,500 (73%) and did not affirm 29,500 (27%). The MMRs of claims without approvals resulted in 19,500 (34%) claims affirmed for payment and 37,000 claims (66%) not affirmed for payment.

    The GAO report, required by the Middle Class Tax Relief and Job Creation Act of 2012, also looked at the implementation process as carried out during those 3 months. (The report did not review the new MMR process that began April 1, 2013.) CMS did not issue complete guidance at the start of the MMR process in 2012, and so the MACs encountered implementation challenges, said GAO, such as a lack of fully automated systems for tracking the reviews of preapproval requests in the time allotted.

    APTA continues to advocate for a less burdensome and more streamlined approach to manual medical review, including advocating for revisions to the new MMR process that began on April 1, 2013, in which outpatient therapy claims exceeding $3,700 are reviewed by recovery audit contractors.


    Wednesday, July 10, 2013RSS Feed

    What Belongs in an Annual PT Exam - Tell Us

    APTA wants member input on standard elements that should be included in an annual physical therapist examination. Per a House of Delegates charge and goals related to the association's strategic plan, a task force is developing templates for such an exam and seeks comments from the APTA membership at large.

    The deadline for sending comments is July 29, 2013, and member input is valuable, so please review the webpage and consider adding your thoughts to those of your colleagues for this important initiative.


    Tuesday, July 09, 2013RSS Feed

    MACs Want to Know: How's Our Service?

    Physical therapists and other health care providers now have a chance to rate their Medicare Administrative Contractors (MACs).

    The Centers for Medicare and Medicaid Services (CMS) is launching a new provider satisfaction measuring tool, the MAC Satisfaction Indicator (MSI) and in preparation is building a registry of participants. CMS will gather contact information from the registered Medicare fee-for-service providers from which to draw a random sample who will have an opportunity to express their level of satisfaction with their MAC.

    CMS and the MACs will use the results of the MSI to improve their service to all Medicare fee-for-service providers.

    Registration opened yesterday, July 8, and should take less than 1 minute to complete. Please visit the Medicare Contractor Satisfaction Indicator webpage for more information.


    Tuesday, July 09, 2013RSS Feed

    House Adopts New Vision of the Physical Therapy Profession

    The 2013 APTA House of Delegates adopted a landmark new vision of the profession of physical therapy: "Transforming society by optimizing movement to improve the human experience."

    Building on the foundation of APTA's Vision 2020 and working through a collaborative process of literature review, interviews and surveys, meetings, and input from the Board of Directors and others, a Board-appointed task force met the charge of the 2010 House of Delegates to bring a proposed new vision statement to the 2013 House for consideration.

    Most significant about the new vision is its outward perspective. This reflects physical therapy’s maturation from an inward-facing profession that aspired to the elements outlined in Vision 2020—autonomous practice, direct access, doctor of physical therapy, evidence-based practice, practitioner of choice, and professionalism. Now that the profession has largely achieved these aspirations, it can envision the impact that physical therapy can and must have on individuals, communities, and populations. APTA Board of Directors member Lisa Saladin, PT, PhD, the Board liaison for the vision-related motions brought to the House floor, assured delegates that these elements haven’t been lost in the concise, bold new vision. They are addressed in companion Guiding Principles to Achieve the Vision, which the 2013 House also considered and adopted. These 8 principles demonstrate how the profession and society will look when this new vision is achieved:

    Identity explains the importance of validating the movement system along with other body systems and affirming the physical therapy profession’s responsibility to define it, promote it, and evaluate and manage it in patients and clients.

    Quality commits the profession to establish and adopt best practice standards.

    Collaboration charges the profession to join others in solving the health-related challenges that society faces.

    Value includes accountability in demonstrating that services are safe, effective, patient-centered, timely, efficient, and equitable.

    Innovation describes the creativity and proactivity of the profession that will enhance health services delivery and increase the value of physical therapy to society.

    Consumer-centricity indicates that patient/client/consumer values and goals are central to all efforts of the profession.

    Access/equity acknowledges the profession’s obligation to recognize and ameliorate health inequities and disparities.

    Advocacy identifies the profession’s role to advocate for patients/clients/consumers as individuals and as a population. [RC 14A-13, RC 15-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.



    APTA Director Lisa K. Saladin, PT, PhD, discusses the 2013 APTA House of Delegates adoption of a new vision for the profession.

    Watch other dispatches from Salt Lake City.


    Tuesday, July 09, 2013RSS Feed

    Academic Council Designated as an APTA Component

    Amendments to the APTA bylaws have granted component status to the newly named American Council of Academic Physical Therapy (ACAPT). ACAPT, originally established in 2010 as the Academic Council of the Board of Directors, provides leadership and direction for physical therapist academic and clinical education, such as facilitating collaboration across institutions to develop new education models; defining metrics of quality and excellence to enhance academic programs, departments, and schools; and influencing policy and regulation related to academic physical therapy.

    ACAPT's voting members are academic institutions with CAPTE-accredited physical therapist programs, represented by individual APTA members per the bylaws amendments. ACAPT is meant to bridge a gap between APTA and PT education—APTA establishes goals and priorities that impact education, but educational institutions have the authority to change educational policies and practices. As educational institutions, the voting members of ACAPT will both determine and implement policies and practices in collaboration with APTA and other stakeholders.

    As a component, ACAPT will send a representative to the annual House of Delegates as a consultant to respond to inquiries as directed by the speaker of the House. [RC 2-13, RC 3-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    US Health Care System Should Meet Individual, Community, and Population Needs

    APTA updated its policy on principles and objectives for the US health care system, aligning it with the association's outward-facing vision of what’s best for the health of society. The renamed policy, Principles and Objectives for the United States Health Care System, features a higher focus on patient-centered care; conveys that health care providers, including physical therapists, should be able to practice and be paid for their full scope of practice; recognizes the provision of care for maintenance of health; and emphasizes equitable and value-based payment. A new principle, Team-Based Care, reflects current health policy laws, regulation, and culture and calls for health care team leaders to be identified based on the patient's needs, changing as the patient's needs change. [RC 16-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Standards of Practice Recognize Ongoing PT-Patient Relationship

    "Discharge" is being discharged from the physical therapy profession's lexicon as the term to describe conclusion of an episode of care, per revisions to the House of Delegates "Standards of Practice for Physical Therapy." Adopted changes to Section III of the Standards of Practice acknowledge that physical therapists (PTs) develop long-term professional relationships with their patients/clients that may stretch over many years throughout the continuum of the patient's/client's lifespan. Rather than "discharging" a patient, PTs conclude an episode of care, with the possibility of future services and fostering a professional patient/client relationship.

    Specific areas that this culture shift addresses include but aren't limited to:

    • Wellness and prevention visits without the presence of disease or illness
    • Single-visit follow-ups after an episode of care to ensure patient adherence and progress
    • Single visits or a brief series of visits outside the historical pattern of referral for a finite series of visits
    • Intermittent care of patients/clients with chronic conditions

    APTA staff will incorporate "episode of care" and related terms into its publications, documents, and communications as materials go through planned review and revision cycles and will encourage adoption of the terminology as appropriate to members and external constituents.

    Similarly, APTA will consider when to use "physical therapist services" or "physical therapist practice"' as the preferred terms when referring to the provision of physical therapy, as opposed to "physical therapy services" or "physical therapy practice." Staff will incorporate these terms, as appropriate, into materials during planned review and revision cycles. [RC 17-13, RC 18-13, RC 21-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Corresponding Membership Available for Students

    An amendment to the APTA bylaws provides for student rates for APTA student members to join additional state chapters. The cost to be a corresponding student in an additional chapter can't exceed the chapter's student physical therapist or student physical therapist assistant dues. Before the amendment, the only corresponding member rates available were full physical therapist (PT) or full physical therapist assistant (PTA) member rates. The corresponding student member rate offers affordable access when, for example, a student wants to be a member of her or his home chapter, her or his DPT/PTA program's chapter, and the chapter during a clinical affiliation or residency. [RC 1-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Resolution Calls for Broadened Efforts to Reduce Administrative Burdens That Limit Care and Increase Recognition of Value of Physical Therapist Services

    As further evidence that the physical therapy profession is moving away from an internal focus and looking out toward the needs of health care consumers and society, APTA has resolved to focus advocacy efforts on demonstrating to society the value of physical therapist (PT) participation in the health care system and on achieving access for consumers to necessary PT services. At the same time, the association rescinded a House of Delegates policy calling for attainment of "physician status" under Medicare (HOD P06-05-16-08). Because of drawbacks to pursuing "physician status" APTA noted that efforts were better directed toward the goals of the new resolution, Public Policy Efforts to Improve Consumer Access to Physical Therapists. Under this resolution, the association can pursue multiple strategies to improve access to physical therapist services and take any statutory opportunities that present in the current and evolving environment. [RC 19-13, RC 20-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Documentation Should Reflect Clinical Reasoning and Decision Making

    As health care reform evolves, and the profession seeks a new payment system that moves away from fee-for-service and toward recognition of the clinical reasoning and decision making of the physical therapist (PT), the House of Delegates charged APTA to pursue documentation standards that align with this goal, reflecting the PT’s clinical reasoning and decision making. Supporting comments to the House motion argued that PTs should be recognized for (and, therefore, documentation for payment should be based on) the “why”—our unique knowledge and skill set that helps individuals improve movement and function, instead of strictly on the "what" or "how"—the procedures performed. [RC 24-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    APTA Pledges to Support Health Care Access for People With Chronic Disability

    Noting that "the current model of management involving episodic care is not adequate to meet the needs of those living with chronic disability and relying on both Medicare and Medicaid for the reimbursement of physical therapy services," a new APTA position pledges action on the issue.

    The Role of Physical Therapy in Health Management for People With Chronic Disability emphasizes that government agencies are the insurers of "last resort"for most people with chronic or degenerative disabilities who are classified as "dual eligible"(beneficiaries of both Medicare and Medicaid). APTA resolves to "support and advocate"for that population’s "timely and regular"access to physical therapist services, needed equipment, and assistive and adaptive devices.

    A companion motion commits APTA to develop a plan to meet the motion’s intent. An interim report is due to the House of Delegates in 2014 and a final report in 2015. [RC 25-13, RC 26-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    PTs as Prescribers of DME Could Improve Patient Access to Equipment and Related Services

    Recognizing physical therapists (PTs) for their expertise in evaluating for, training in, and prescribing durable medical equipment (DME) will lead to more timely access to appropriate and necessary equipment and services, APTA said in adopting a resolution that supports PTs as authorized prescribers of DME, which is integral to PT patient/client management.

    Even after a PT evaluation has determined that DME is needed, patients often experience delays in getting a prescription by those now authorized to prescribe, the resolution argues. The delays force those individuals to remain immobile or at reduced function and safety while waiting on their DME.

    Our profession would demonstrate its commitment to patient- and client-centered care by advocating for the support of choice, access, quality, and adequate funding for DME and related services, which would include authorizing PTs as prescribers. [RC-27-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Training Program Will Foster Consistent, High-Quality Peer Review

    The House called upon APTA to review current resources and develop needed new resources to provide and promote a process for the training and recognition of physical therapists (PTs) to perform peer review of physical therapist services. APTA’s existing position (HOD P06-04-16-15) that only PTs should review physical therapist services hasn’t yet been realized; the lack of trained and qualified reviewers is partly to blame, supporting comments for the motion indicated.

    A report outlining the process and a timeline for completion is due to the 2014 House of Delegates with plans for implementation due no later than January 1, 2015. [RC 29-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    APTA Announces Other Results of House of Delegates Activity

    In addition to the motions reported on separately today, he House of Delegates debated and resolved several motions related to operations and governance:

    • After a long and mindful debate, a motion to give section delegates voting rights was defeated. [RC 4-13]
    • Delegates referred to the Board of Directors a proposed resolution to support management of pediatric overuse injuries. The Board is expected to review it in terms of potential special interest resolutions in general and look for ways to address these interests other than individual House resolutions. [RC 22-13]
    • Per previous years' progress toward governance review and reform, motions passed that clarify and define the powers of the House, the Board, and the Reference Committee; and codify the election classes for the Board of Directors. [RC 5-13, RC 7-13, RC 8-13, RC 10-13]
    • Responsibilities were clarified for submitting House motions, preparing background papers on motions, and submitting delegate names and information for an upcoming House. [RC 11-13, RC 12-13, RC 13-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates by following this link, or click on July 9 from the News Now calendar.


    Tuesday, July 09, 2013RSS Feed

    Parliamentarian John Stackpole Named Honorary APTA Member

    John Stackpole, PhD, PRP, CPP, became an honorary APTA member on June 26 by a unanimous vote. Stackpole was parliamentarian to the House of Delegates from 1994 to 2011, offering guidance from the dais based on his knowledge of parliamentary procedure. He helped 4 different speakers of the House keep order during the annual proceedings—no small feat. [RC 30-13]

    Draft language adopted by the 2013 House of Delegates will be available on the House Community no later than July 12. Final language for all actions taken by the June 2013 House will be available by September after the minutes have been approved.

    See more results of the 2013 House of Delegates in News Now by following this link, or click on "July 9" from the News Now calendar.


    Monday, July 08, 2013RSS Feed

    Proposed 2014 Physician Fee Schedule Adjusts Payment Rates, Updates PQRS, Applies Therapy Cap to CAHs

    Today, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2014 Medicare physician fee schedule rule that updates 2014 payment amounts and revises other payment policies. Excluding the 24.4% projected sustainable growth rate payment cut, the rule’s aggregate impact on payment is a positive 1% for outpatient physical therapy services. Additional proposed policies that will impact physical therapists include updates to the Physician Quality Reporting System (PQRS) program, application of the therapy cap to critical access hospitals, and changes to the calculation of geographic practice cost indices.

    The law applies an annual beneficiary limit on outpatient therapy services for physical therapy and speech-language pathology services combined and a separate limit for occupational therapy services. Following the passage of the American Taxpayers Relief Act earlier this year, outpatient therapy services provided in critical access hospitals (CAHs) accrued toward the therapy cap amount for the first time. However, in 2013 CAHs are not subject to the therapy cap, meaning they currently do not have to report the KX modifier when the cap is exceeded or undergo manual medical review for services exceeding $3,700. The proposed rule would change this policy to apply the cap to outpatient therapy services furnished in CAHs in 2014 if Congress extends the therapy cap provision to hospitals in 2014.

    CMS proposes to retain the 12-month calendar year reporting period for the PQRS program in 2014 and beyond. The incentive payment for 2014 will remain 0.5%. The 2014 reporting period data will be used to inform both the 2014 incentive payment (0.5%) and the 2016 payment adjustment (-2.0%). CMS is proposing to make the following changes to the successful reporting requirements for 2014:

    • Increase the number of measures that must be reported via the claims and registry-based reporting mechanisms from 3 to 9
    • Change the threshold for reporting individual measures via registry to require that eligible professionals report on 50% of the eligible professional’s applicable patients rather than 80%
    • Eliminate the option to report on claims-based measures groups

    The proposed rule will be published in the July 19, 2013, Federal Register. The public will have until September 6, 2013, to submit comments in response to this rule, and APTA will submit comments on behalf of its members. After reviewing public comments, CMS will publish a final rule on or about November 1, which will become effective for services furnished during calendar year 2014. APTA will provide a more detailed summary of the rule in the upcoming week.


    Monday, July 08, 2013RSS Feed

    Final Rule on Certain ACA Provisions Addresses Medicaid, CHIP

    A final rule on provisions of the Affordable Care Act (ACA) will impact physical therapists (PTs) as providers of services under Medicaid and the Children's Health Insurance Program (CHIP).

    Provisions of the final rule include:

    • New Medicaid eligibility provisions
    • Changes related to electronic Medicaid and CHIP eligibility notices and delegation of appeals
    • Updates that streamline existing Medicaid eligibility rules
    • CHIP revisions related to the substitution of coverage to improve the coordination of CHIP coverage with other coverage
    • Amended requirements to ensure that most alternative benefit plan (ABP) packages include essential health benefits and meet certain other minimum standards
    • Implementation of specific rules for insurance exchanges related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan
    • Updates that simplify the complex Medicaid premium and cost-sharing requirements

    In addition, the rule addresses ACA's new optional eligibility group for low-income adults aged 19 to 64. Effective January 1, 2014, states that implement this new eligibility group must provide medical assistance for these adults through an ABP, except that individuals in the new group who meet the exemption criteria can choose between ABP benchmark benefits as defined by the state under the ACA rules and ABP benchmark benefits defined as the state's approved Medicaid state plan. Adults not meeting exemption criteria must be provided the 10 mandatory benefits that the ACA deemed "essential health benefits," one of which includes rehabilitative and habilitative services.

    States that do not opt for Medicaid expansion to this new group will not have to provide ABPs to this population. However, states have the flexibility to define different benefit packages to meet the needs of disparate populations. For example, states retain flexibility to continue to offer optional benefits, such as outpatient physical therapy services, to their Medicaid beneficiaries.

    APTA will post a summary of this final rule on the APTA website soon.

    • Posted by News Now Staff at 6:15 PM
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    Friday, July 05, 2013RSS Feed

    WCPT Update Highlights World Physical Therapy Day, Calls for Congress Symposia

    The World Confederation for Physical Therapy (WCPT) has new resources available from its website:

    • World Physical Therapy Day is September 8. The World Confederation for Physical Therapy (WCPT) has materials to help you join your global colleagues in raising awareness about the crucial contribution our profession makes to individuals and societies around the world. The theme, Movement for Health, emphasizes staying fit no matter how young or old you are.
    • WCPT is seeking submissions for focused symposia for the 2015 WCPT Congress in Singapore, May 1-4. The deadline for submissions is September 30, 2013. A general call for abstracts for platform and poster presentations will go out January 2014, with a tentative deadline of August 15, 2014.

    Wednesday, July 03, 2013RSS Feed

    Mandate for Employer-Provided Health Insurance Delayed Until 2015

    Businesses with more than 50 employees have an extra year to begin offering health coverage required by the Affordable Care Act (ACA). A post on the US Treasury website announced the deferral yesterday.

    Noting that the vast majority of businesses affected by the requirement already provide health insurance to their workers, Assistant Secretary for Tax Policy Mark Mazur said the delay will allow time to simplify the reporting requirements and enable employers to adapt their reporting systems and health coverage.

    Next year will be a testing and transition period, with employers encouraged to start reporting on their workers’ health coverage in 2014 in preparation for full implementation in 2015.


    Wednesday, July 03, 2013RSS Feed

    APTA Members' Input Welcomed for APTA CEO Search

    As announced last month, APTA hired executive search firm Isaacson, Miller to conduct the search for a new chief executive officer of the association. Suggestions for the position description, candidate recommendations, self-nominations, and questions in general should be sent to 4849@IMSearch.com. The e-mail address is dedicated to this search and consistently monitored by Isaacson, Miller.

    Bonnie Polvinale, APTA's vice president of member relations, is acting as interim CEO while the search is under way. Updates on the search will appear on the APTA Staff page of APTA.org under CEO Transition.

    Editor's Note - July 15, 2013: This item was updated to correct the e-mail address for Isaacson, Miller. Please use: 4849@IMSearch.com.


    Tuesday, July 02, 2013RSS Feed

    Functional Limitation Reporting Under Medicare: Get Answers to Your Questions

    As of yesterday, all providers billing outpatient therapy services under Medicare Part B must begin or continue submitting functional limitation data (G-codes) for any Medicare beneficiary, or claims will be returned unpaid. Therapists must report functional limitation data on the beneficiaries' current functional status and the projected goal to Medicare at scheduled intervals throughout the episode of care, including at the outset of the therapy episode, no less frequently than every 10th visit, and at discharge.

    APTA will host a Q&A call for members on Tuesday, July 9, 2:00 pm-3:00 pm ET, to answer questions about the reporting requirements. Space is limited. To register for a spot please e-mail advocacy@apta.org with "July 9 Call" in the subject line. Based on demand, we will host future calls throughout the month of July.

    For more information and resources on functional limitation reporting, please visit APTA's Functional Limitation Resource Page.


    Monday, July 01, 2013RSS Feed

    CMS: Pioneer ACO Model Participants May Leave Program

    The Centers for Medicare and Medicaid Services (CMS) announced last week that 9 of its 32 Pioneer ACO Model participants may leave the program, with 4 likely to join Medicare's Shared Savings Program. ModernHealthcare.com quoted CMS spokesman Alper Ozinal as saying, "We fully anticipated that as these programs get up and running, some organizations would shift between models."

    The Pioneer ACO model features higher levels of savings and risk than the Shared Savings Program. Pioneer ACO Model participants have until July 31, 2013, to decide how to proceed.

    The Pioneer ACO Model was authorized under the Affordable Care Act and launched in January 2012 by CMS to help accountable care organizations transition from a fee-for-service payment structure to improve patient care, increase Medicare savings, lower costs, and to test alternative program designs to inform future rulemaking for the Medicare Shared Savings Program.

    APTA members can learn more about a physical therapist's role in an ACO by visiting APTA's webpage, FAQ: Accountable Care Organizations (ACOs): Medicare Shared Savings Program and Pioneer Models.


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