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  • Summary on Proposed Rule for Acute, Long-term Care Hospitals Posted

    APTA's summary of Medicare's proposed rule for general acute care hospitals and long-term care hospitals, which includes quality measures for readmissions relating to hip and knee replacement procedures, now is available on the Medicare Payment and Policies for Hospital Settings webpage. (See related article posted April 26)

    Final Rule Provides States Flexibility to Offer Home and Community-based Services

    Yesterday, the Centers for Medicare and Medicaid Services (CMS) released the final rule on the Medicaid program’s Community First Choice (CFC) option as mandated under the Affordable Care Act (ACA) establishing a new option for states to provide home and community-based attendant services and supports for beneficiaries.

    With the additional flexibility to finance home and community-based services and support, the provision is expected to increase state and local accessibility to services that augment the quality of life for beneficiaries through a person-centered plan of service and various quality assurances—at a potentially lower per capita cost relative to institutional care settings.

    According to the rule, states that elect this option must make available home and community-based attendant services and supports to assist in accomplishing activities of daily living, instrumental activities of daily living, and health-related tasks through hands-on assistance, supervision, and/or cueing. Additionally, the following services may be provided at the state’s discretion—transition costs, such as rent and utility deposits; first month's rent and utilities; purchasing bedding, basic kitchen supplies, and other necessities required for transition from an institutional setting; and the provision of services that increase independence or substitute for human assistance to the extent that expenditures would have been made for the human assistance, such as nonmedical transportation services or purchasing a microwave.

    The final rule sets forth the requirements for CFC, however, requirements pertaining to "setting," under §441.530, will be addressed in future rulemaking.

    APTA Meets With Members of Congress From All 50 States

    More than 250 physical therapists, physical therapist assistants, and students who participated in this year's Federal Advocacy Forum, held April 22-24 in Washington, DC, met with members of Congress from all 50 states to discuss the repeal of the therapy cap, the physical therapist's role in managing patients with traumatic brain injury, and student loan repayment. 

    On Monday, an interactive town hall session that  featured APTA health quality and financing staff informed attendees  about regulatory hot topics such as therapy cap implementation, payment, quality, and accountable care organizations. Forum participants also attended a session on direct access and received updates on APTA's legislative and regulatory activities.

    APTA presented Sen Susan Collins (R-ME) with this year’s Public Service Award for her work on therapy cap repeal and access to physical therapy for military members and veterans. APTA member Eva Norman, PT, DPT, was awarded the 2012 Federal Government Affairs Leadership Award for her continued leadership and dedication to APTA's federal legislative issues. 

    This year's Federal Advocacy Forum was held in conjunction with APTA's Leadership Forum, which included APTA's Board of Directors meeting and Leadership Symposium.

    Kaiser Health Highlights Excessive Copays for Physical Therapist Services

    An April 22 article by Kaiser Heath News highlights the growing number of insurers and employers who classify physical therapy visits as specialty care, resulting in higher copayments for patients that often are equal to a specialist visit. The article quotes Matthew Hyland, PT, PhD, MPA, CSCS, president of the New York Chapter, and Justin Elliott, APTA director of state government affairs.  

    APTA's Fair Physical Therapy Copays webpage offers a variety of legislative resources, such as APTA model legislation and a sample letter to legislators, to help chapters in their fight against excessive copays. Examples of state strategies used by the Kentucky, Missouri, New Jersey, and New York chapters also are available.