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  • APTA Recommends Interim Revisions to HH PPS; Calls for Alternative Payment System

    APTA illustrates several ways that the home health prospective payment system (HH PPS) can be revised to better reflect the role of physical therapists in home health, as well as bolster clinically appropriate practice patterns that improve quality of care and lower growth in expenditures, in comments submitted on September 4 to the Centers for Medicare and Medicaid Services (CMS). 

    APTA's remarks focus heavily on therapy coverage requirements. While calling on CMS to begin the work of developing an alternative payment system for therapy services under the Medicare home health benefit, the association makes specific interim recommendations to alleviate the burdens associated with missed reassessment visits and alter provisions regarding coverage of compliant therapy disciplines and visit ranges.

    In response to CMS' quality reporting proposal, APTA advocates for the alignment of HH measures with current measures under the inpatient prospective payment system. Specifically, the association asks that CMS apply consistent measures regarding emergency department use and readmissions.

    Recognizing CMS' commitment to ensuring that home health payments are accurate and are not unduly influenced by practices not associated with changes in the patient's condition, APTA recommends that the agency find alternative ways to account for these nominal case-mix changes that do not impose further cuts to HH PPS.

    Finally, APTA urges CMS to finalize its proposal to provide more flexibility in the physician face-to-face requirement. 

    VA to Provide Veterans With Mobility Impairments Assistance for Service Dogs

    The Department of Veterans Affairs (VA) has amended its regulations to provide veterans with mobility, visual, or hearing impairments benefits to support the use of a service dog as part of the management of these impairments. The benefits include assistance with veterinary care, travel benefits associated with obtaining and training a dog, and the provision, maintenance, and replacement of hardware required for the dog to perform the tasks necessary to assist the  veterans.

    APTA will provide a summary of the final rule on service dogs on its website shortly.

    Call for Participants: PTs Needed for Pain Study

    Researchers from McMaster University are seeking physical therapist (PT) participants for an 18-month study on Pain PLUS, a new free information service for evidence-based pain management. The purpose of this study is to compare 2 different methods of sharing pain research evidence, as well as the knowledge and decisions made by 4 different types of professionals—physicians, nurses, rehabilitation professionals, and psychologists—involved in pain management. One method of sharing will be sending e-mail alerts. The other method will be providing web-based resources. All participants will have access to both services for 9 months each.

    For more information on Pain PLUS and how you can participate in this study, contact Margaret Lomotan at lomotam@mcmaster.ca or 905/525-9140, ext 27328, or visit http://plus.mcmaster.ca/PainPLUS/.

    Patients With Cancer Not Discussing Exercise With Oncologists

    Despite evidence of the positive effect that exercise can have on cancer care and recovery, many patients with cancer are reluctant to exercise and few discuss it with their oncologists, according to a Mayo Clinic study published in the Journal of Pain and Symptom Management.

    The study is part of a series of investigations looking at exercise habits among patients with cancer. For this investigation, researchers qualitatively analyzed semistructured interviews with 20 adults (half male and half aged 65 years or older) with Stage IIIB or IV nonsmall cell lung cancer. Participants were questioned about their levels of activity, the influence of their symptoms on their activities, perceived barriers and facilitators for exercise, and exercise-related instructions received from their professional caregivers.

    "Participants overwhelmingly cited usual daily activities as their source of 'exercise,'" say the authors. Symptoms, particularly treatment-related, discouraged participation, with fear of harm being a significant concern only among younger women. Participants recognized exercise as important for physical and mental well being but seldom as a means to mitigate symptoms. Although respondents said they preferred to receive guidance from their oncologist, none reported receiving more than general encouragement to "stay active." Participants accepted a lack of direction as approval of their current activity levels. Additionally, participants appeared less receptive to guidance from ancillary health professionals, say the authors.