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  • Inconsistent and Burdensome Documentation Rules Removed From NY, CT LCD Policy

    New York and Connecticut physical therapists no longer have to follow certain burdensome documentation requirements that were in conflict with national Medicare policy.

    Thanks to efforts by APTA and the New York and Connecticut chapters, the Medicare administrative contractor (MAC) for those states removed 2 requirements from its local coverage determination policy: (1) for progress reports to jump from a frequency of every 10 treatment days to every 5 treatment days after services exceeded the therapy cap, and (2) for documentation of a physician reexamination for services that exceeded either 90 days or the therapy cap. Both requirements directly conflicted with national Medicare policy.

    APTA sent a letter on May 6 to the MAC, National Government Services Inc (NGS), expressing concerns about the documentation requirements and urging NGS to make them consistent with national Medicare policy. In response, NGS is removing these requirements in a revised policy that is effective for dates of service on or after August 1, 2013.

    For questions or more information, please e-mail advocacy@apta.org.

    New Publication Explains Key EHR Contract Terms

    A new resource gives physical therapists and other health care providers explanations of key terms and provisions used in contracts with EHR technology developers.

    The new EHR Contracts: Key Contract Terms for Users to Understand from the Office of the National Coordinator for Health Information Technology (ONC) provides an overview of commonly used contract provisions and technical insight. The guide defines and explains such terms as "indemnification and hold harmless," "limitation of liability," and "termination and wind down," which ONC says can help providers choose an appropriate EHR system and help protect practices from safety risks that may arise from EHR adoption.

    The guide notes, however, that it is not legal advice, and it's wise to have an experienced attorney review the terms of any specific contract and situation.

    More resources are available on APTA's EHR webpage.

    New and Updated Resources on Functional Limitation Reporting Under Medicare

    FAQ updates and new podcasts offer members the latest information on issues most top-of-mind related to functional limitation reporting (FLR).

    The FAQ lists on APTA's FLR webpage now reflect items from recent call-in discussions. In addition, 3 new podcasts address hot topics within functional limitation reporting: the involvement of physical therapist assistants in FLR, reporting on patients in "observation status," and reporting on patients with multiple diagnoses and plans of care. The first podcast on PTAs is available today on the FLR webpage. Look for the release of the next 2 podcasts in upcoming weeks.

    To see all of APTA's member resources on functional limitation reporting, visit www.apta.org/FLR.

    APTA Summary of Final Rule on Medicaid and CHIP Posted

    APTA has reviewed the final rule on Medicaid and the Children's Health Insurance Programs (CHIP) that was released July 5 as a supplement to the final rule on health care exchanges. Among other things, under this rule CMS clarifies that any individuals eligible to enroll in Alternative Benefit Plans (ABPs) must be provided the 10 mandatory benefits that the Accountable Care Act deemed "essential health benefits," one of which includes rehabilitative and habilitative services.

    A summary of the ruling is available to members on the APTA website on both the Medicaid and the Health Insurance Exchanges webpage.