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  • CMS Issues FAQ on Manual Medical Review

    CMS has added a frequently asked questions (FAQ) document to its Therapy Cap webpage regarding manual medical review for outpatient therapy claims that exceed $3,700. This document provides responses to questions regarding the process that the Recovery Audit Contractors (RACs) will use to review claims under the manual medical review process in 2013.

    CMS also has established an e-mail box to which providers can submit additional questions, which is therapycapreview@cms.hhs.gov.

    Report on National Debt Recommends 'Narrowing' In-office Ancillary Services Exception

    Included in a new report that addresses the US national debt and deficit is the recommendation to restrict physician self-referrals and narrow the "in-office ancillary services" (IOAS) exception to the Stark self-referral laws.

    The Simpson-Bowles deficit commission today released its final report on the national debt and the deficit. The 60-page document outlines principles, a 4-step process that includes $2.5 trillion in deficit reduction, and steps to sustain the lower levels of spending, even with other spending priorities on the horizon. Within the deficit reduction proposals is yet another suggestion to close the IOAS exception. APTA applauds this news, which shows continued momentum in our efforts to reform this policy. APTA is reviewing the report for any additional proposals that may impact APTA and its members.

    The report specifically says that "physician self-referrals should be further restricted and better monitored, including narrowing the 'ancillary service exception.'" This recommendation follows a similar recommendation in the president's Fiscal Year 2014 Budget, released last week, that suggested therapy services should be removed from the IOAS exception.

    For more news on this and other APTA related advocacy efforts continue to monitor APTA's federal advocacy page.

    Texas Chapter Advocates for Patient Access to PT Services, Title Protection for DPT

    Legislation to improve patient access to physical therapist services in Texas took an important step on Thursday, April 11, when Texas HB 1039, Patient Access to Physical Therapy, was considered in the Texas House Committee on Public Health. Texas Chapter members provided excellent oral testimony to the committee in support of the legislation, including physical therapists Michael Connors, PT, DPT, OCS, Cynthia Fisher, PT, DPT, MS, PCS, Nick Patel, PT, DPT, CSCS, CCP, Mike Geelhoed, PT, DPT, OCS, MTC, Jennifer Kish, PT, DPT, SCS, Kathleen Manella, PT, PhD, Matt Walk, PT, FAAOMPT, Allan Besselink, PT, Dip.MDT, Ben Keene, PT, OCS, FAAOMPT, and Jarod Carter, PT.

    Opposition testimony to HB 1039 was provided by the Texas Orthopaedic Association and a physical therapist employed in a physician-owned clinic. The Texas Association of Acupuncture and Oriental Medicine also provided testimony against the bill, expressing concern about the ability of physical therapists to perform dry needling.

    Improving patient access in the Lone Star state has been an important goal for the Texas Chapter.

    The legislation awaits action by the House Public Health Committee; the deadline for house bills to be reported out by house committees is Monday, May 6. Meanwhile, the chapter is also advocating for House Bill 2357 and Senate Bill 1099, legislation that would provide title protection for the doctor of physical therapy (DPT) and master of physical therapy (MPT). The senate bill passed the Texas Senate on Thursday, April 18; the house version has passed through committee and is awaiting a vote by the Texas House.

    CA Joint Manipulation Bill Voted Down, But Reconsideration Granted

    Physical therapists (PTs) from across California descended on the state capitol in Sacramento on Monday to show their opposition to Senate Bill 381, legislation aimed at prohibiting physical therapists from performing joint manipulation. California SB 381, authored by state Sen Leland Yee and sponsored by the California Chiropractic Association, was heard on April 15 in the California Senate Business, Professions, and Economic Development Committee.

    The legislation would prohibit anyone other than a chiropractor, physician, or osteopath from performing joint manipulation in the state and make the term "joint manipulation" synonymous with "joint adjustment." Under SB 381, any health care practitioner other than a chiropractor, physician, or osteopath who performs a joint manipulation in California would be considered to be engaged in the unlawful practice of chiropractic and result in the possible revocation or suspension of the health care practitioner's license.

    While SB 381 was voted down 6-1, the bill was granted "reconsideration," meaning that the Senate committee could reconsider the legislation at a future date. California Chapter members are encouraged to continue contact their state legislators and the members of the Senate Business, Professions, and Economic Development Committee to oppose SB 381, as the bill may be reconsidered as early as this Monday, April 22.

    Watch the hearing at: www.youtube.com/watch?v=lx_hD1udS4c. (The first part of the video shows testimony from supporters of SB 381; testimony from PTs in opposition to SB 381 begins at the 21:15 mark.)

    New in the Literature: Physical Therapy Effective for Atraumatic Full-Thickness Rotator Cuff Tears, Study Says

    A specific nonoperative physical therapy program was effective for treating atraumatic full-thickness rotator cuff tears in nearly 75% of patients, say authors of a multicenter prospective cohort study published by the Journal of Shoulder and Elbow Surgery in March.

    For this study, the authors enrolled patients with atraumatic full-thickness rotator cuff tears. Using questionnaires, the patients provided data on demographics, symptom characteristics, comorbidities, willingness to undergo surgery, and patient-related outcome assessments, including Short Form 12 score, American Shoulder and Elbow Surgeons score, Western Ontario Rotator Cuff score, Single Assessment Numeric Evaluation score, and Shoulder Activity Scale.

    The authors designed a physical therapy program based on a systematic review of extant literature and evaluated patients at 6 and 12 weeks. During these evaluations, patients chose from 3 courses of action: cured with no formal follow-up scheduled; improved with subsequent therapy and a scheduled evaluation in 6 weeks; and unimproved/optional surgery. At 1 and 2 years, patients were called and asked whether they underwent surgery after their last evaluation. The authors used a Wilcoxon signed rank test with continuity correction to compare initial, 6-week, and 12-week outcome scores.

    Among the 452 patients included in the study, patient-reported outcomes improved significantly at 6 and 12 weeks, say the authors. Patients had surgery less than 25% of the time and elected to do so between 6 and 12 weeks, with few undergoing surgery between 3 and 24 weeks.

    2012-2013 Pittsburgh-Marquette Challenge Deadline

    The deadline for the Foundation for Physical Therapy's Pittsburgh-Marquette Challenge is closing in fast. Check here to see if your school is on the list of schools that have already contributed to this year's challenge!

    The deadline for sending in contributions is this Monday, April 22. Contribute today! For late donations, please notify Erica Sadiq at EricaSadiq@foundation4pt.org.

    Student Led Advocacy Effort on Physical Therapist Workforce Legislation

    To engage physical therapy students in advocacy to advance the physical therapist profession, the Student Assembly Board of Directors (SABoD) and APTA have teamed up to implement a Flash Action Strategy (FAS) to initiate student support for the Physical Therapist Workforce and Patient Access Act (HR 1252/S 602), legislation reintroduced in the 113th Congress to include physical therapists in the National Health Service Corps. The FAS is a student-driven strategy to send letters to Congress on this issue during a 72-hour period April 23-25. Education programs across the country have been asked to RSVP that they will send a letter through APTA's Legislative Action Center or Patient Action Center during this time, with the goal of producing 16,000 letters to Congress. The FAS affords a unique opportunity for students to participate in advocacy and unite with fellow peers on a national scale on a single issue.

    More information can be found at www.apta.org/FAS.