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  • CMS Releases Medicare Home Health Final Rule for 2014

    The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System for 2014. The rule affects services provided by home health agencies under Medicare Part A beginning January 1, 2014.

    The national standardized 60-day episode payment for 2014 is set at $ 2,869.27, and the national per-visit rate for CY 2014 for physical therapy services is $132.40. CMS projects that Medicare payment to home health agencies in calendar year 2014 will be reduced by $200 million.

    The rule finalizes the following policies:

    • Home health payment rates will see an updated market basket increase of 2.3% that is in turn reduced through home health rebasing.
    • As a result of rebasing, a $80.95 (3.5%) reduction will be applied to the national standardized 60-day episode payment rate each year from 2014 - 2017.
    • Three Low-Utilization Payment Adjustment (LUPA) add-on factors will be used in calculating the LUPA. This affects skilled nursing, physical therapy, and speech-language pathology when that discipline is the first skilled visit in a LUPA episode—either as the only episode or an initial episode among adjacent episodes.
    • A total of 170 ICD-9-CM diagnosis codes will be removed within home health PPS Grouper diagnosis groups.
    • Two claims-based measures will be adopted: Re-hospitalization during the first 30 days of home health and emergency department use without hospital readmission during the first 30 days of home health.
    • Payments to rural home health areas will be increased by 3 percent and applied to the national standardized 60-day episode payment rate.

    The policies in the final rule will become effective January 1, 2014. APTA will provide a full summary of the final rule in the coming days.

    Ask Congress to Add Therapy Cap Repeal to SGR Legislation on December 2

    Legislation that would end the sustainable growth rate (SGR) will soon be discussed in a Senate committee, and grassroots efforts could play a big role in how that discussion takes shape. The Senate Finance Committee will be considering the proposed legislation on December 12, making the next 2 weeks a crucial time for communicating physical therapy's position on both SGR and the therapy cap to lawmakers and the public.

    The advancement of the SGR legislation provides an opportunity for addressing the importance of also ending the therapy cap. APTA is calling on all physical therapists (PTs), physical therapist assistants (PTAs), students, patients/clients, and others to contact their legislators on Monday, December 2, and ask them to include a full repeal of the cap in the SGR legislation.

    APTA recommends 2 ways to get involved in the efforts to fix these flawed policies that harm patients and restrict access to therapy services:

    • E-mail your legislators. APTA members can e-mail their legislators by logging in to the Legislative Action Center, while patients and clients can reach their legislators via the Patient Action Center. Both constituencies can also download the APTA Action app and use the “Take Action” button to contact their members of Congress.
    • Get involved on social media. APTA is encouraging supporters to change their Facebook and Twitter profile pictures to the “Stop the Therapy Cap” logo on December 2 and then share APTA’s Facebook posts or tweet their legislators using prewritten messages provided by APTA. Legislators' Facebook pages and Twitter handles can be easily found through the Congressional Directory button on the APTA Action app. Appropriately-sized images can be downloaded from the therapy cap grassroots campaign webpage.

    For more information about the grassroots campaign on December 2, e-mail advocacy@apta.org.

    Not Much Time Left to Share Your NPTM Activities

    There's still time to share your National Physical Therapy Month celebration and recognition photos and stories with colleagues all over the world, but you'd better hurry: The APTA public relations staff is now making its last call for submissions to its NPTM celebration page.

    The page is a great way to show how physical therapy restores and improves motion in people’s lives. Submissions could include a wide range of activities, including photos of state recognitions of NPTM, or local facility events. E-mail a brief description and at least 1 photo (300 dpi) to the APTA public relations staff.