• News New Blog Banner

  • Study: Second Bone Density Test Within 4 Years Has Questionable Value

    A new study suggests that older adults without osteoporosis can wait longer between screenings. The study concluded that when an initial bone-mineral-density (BMD) screening showed no osteoporosis, repeating the test 4 years later didn't necessarily help to predict the risk for bone fracture.

    Medicare pays for BMD screening every 2 years, and on average beneficiaries' screenings are 2.2 years apart. The researchers concluded, among other things, that while a small proportion of the subjects were reclassified upon the second test as high risk for fracture, it was "unclear whether the reclassification justifies the current US practice of performing serial BMD tests at 2.2-year intervals."

    They added, however, that detecting BMD loss would have been "paramount for the … individuals reclassified by a second BMD test who went on to experience a fracture."

    The study, published Tuesday in JAMA and free in full text, included more than 800 men and women with an average age of 75. A summary of the study in MedlinePlus includes interview quotes from study author Sarah Berry, MD, MPH, and National Osteoporosis Foundation President Robert Recker, MD.

    New CUSP Module Helps Clinicians Engage Patients and Families in the Hospital Setting

    A new module in the Agency for Healthcare Research and Quality (AHRQ) Comprehensive Unit-based Safety Program (CUSP) can help clinical teams learn how to engage patients and families in their care. Based on a field-tested guide for engaging patients and families, the CUSP Patient and Family Engagement Module includes PowerPoint slides, speaker notes, demonstration videos and tools to improve communication and patient safety in the hospital setting. This module helps clinicians:

    • Explore the roles and characteristics of patient and family advisors
    • Understand the relationship between communication and patient safety
    • Prepare for the patient’s discharge
    • Communicate adverse events to patients and family members

    Download the CUSP Patient and Family Engagement Module.

    Learn more about CUSP.

    Read the AHRQ Guide to Patient and Family Engagement in Hospital Quality and Safety.

    Insurance Discounts Available to APTA Members

    You're probably aware that your APTA membership could entitle you to savings on your auto, homeowners, renters, condominium, and boater's insurance from GEICO. But did you know that your auto insurance is actually 7 coverages rolled into a single policy? Most of these coverages are required by state law or loan agreements. GEICO explains:

    1. Bodily injury liability provides protection if you injure or kill someone while operating your car. It also provides for a legal defense if another party in the accident files a lawsuit against you. In the event of a serious accident, you want enough insurance to cover a judgment against you in a lawsuit, without jeopardizing your personal assets. Bodily injury liability covers injury to people, not your vehicle, and is required by state law.
    2. Medical payments, no-fault, or personal injury protection coverage usually pays for the medical expenses of the injured driver and passengers in your car. There may also be coverage if you are injured by a vehicle as a pedestrian. It is required in some states.
    3. Uninsured motorists coverage pays for your injuries caused by an uninsured driver or, in some states, a hit-and-run driver. In some states there is also uninsured motorist coverage for damage to your vehicle. It is required only in some states, but given the large number of uninsured motorists, this coverage is important, even in states with no-fault insurance.
    4. Comprehensive physical damage coverage pays for losses resulting from incidents other than collision. For example, comprehensive insurance covers damage to your car if it is stolen or damaged by flood, fire, or animals. A high deductible for this coverage will help keep premiums low. Auto loan agreements typically require comprehensive coverage.
    5. Collision coverage pays for damage to your car when your car hits, or is hit by, another vehicle or other object. A high deductible for this coverage, too, will help keep premiums low. For older cars, consider dropping this coverage, since it normally is limited to the cash value of the car. Auto loan agreements typically require collision coverage.
    6. Property damage liability protects you if your car damages someone else's property. It also provides you with legal defense if another party files a lawsuit against you. It is required by state law.
    7. Rental reimbursement coverage pays for a rental vehicle (usually up to $25 a day) when your vehicle is out of commission as a result of a loss covered under comprehensive or collision coverage.

    Help PTA Education Evolve: Join New APTA Task Force

    Here is your chance to roll up your sleeves and contribute to the future of PTA education. The Educational Programs for the PTA Task Force is ready to enlist volunteers with knowledge and experience in education, the scope of work of the physical therapist assistant (PTA), and data review and synthesis. This new task force continues the work of the PTA Education Feasibility Study Work Group, specifically in the area of data collection and collation.

    Interested members should respond to the call by completing a volunteer interest profile found on the Volunteer Interest Pool webpage. Once your profile is complete, click on the Apply for Current Opportunities button and select Educational Programs for the PTA Task Force.

    The deadline to apply for a position on this task force is October 9.

    US Senate Again Recognizes National Falls Prevention Awareness Day

    The sixth annual National Falls Prevention Awareness Day (FPAD) was observed yesterday, the first day of fall, per US Senate resolution S.248 passed on September 19.

    FPAD is spearheaded by the National Council on Aging (NCOA) to promote and increase public awareness about how to prevent and reduce falls among older adults. This year's theme, Preventing Falls—One Step at a Time, seeks to unite professionals, older adults, caregivers, and family members to play a part in raising awareness and preventing falls. The past few weeks, APTA generated congressional support for the resolution and will continue to work with coalition stakeholders on increasing patient awareness on falls prevention and finding support in Congress for falls prevention initiatives.

    Additional information and resources can be found at the following links:

    2013 House of Delegates Minutes Posted

    Minutes of the 2013 House of Delegates (House) have been posted on the House webpage and within the 2013 Archive folder of the online House community. The minutes provide information on how the House revised and voted on all motions and bylaw amendments brought forward this year.

    Newly adopted or amended House policies, standing rules, and bylaws will be posted to the Policies and Bylaws area of the APTA website by October 11.

    The archived livestream broadcast of the entire 2013 House is still available for viewing by APTA members.

    Manuscripts Sought for Physiotherapy Canada Series on Transitioning Youth

    Physiotherapy Canada is seeking submissions for a special series of journal articles that will consider transitions for youth with chronic conditions or disabilities. Children with disabilities and chronic conditions are living longer, and there is increased interest in designing interventions that will help youth transition to adulthood. Key transitions include not only the move from pediatric to adult health care services but also gradual changes in social roles and activities, such as completing high school, leaving the family home, and working.

    Topics of most interest for the series, which will run over the next 2 years, include:

    • Empirical evaluation of transitions models, programs, and services
    • Youth and family experiences of transitions
    • Critical engagement with transition theory
    • Analyses of transition policies
    • Global perspectives on transitions

    Qualitative or quantitative empirical studies are preferred, but high-quality commentaries or reviews will be considered.

    Find author and submission guidelines on the "For Authors and Reviewers" page at www.utpjournals.com/ptc. Direct any questions you have to guest editor Shauna Kingsnorth, PhD, at skingsnorth@hollandbloorview.ca or 416/425-6220, ext. 3547.

    CA Couple Challenges Donors to Match $50,000 for Foundation Center of Excellence Campaign

    Longtime supporters of the Foundation for Physical Therapy Nancy Byl, PT, PhD, FAPTA, and her husband Fred Byl, MD, of Oakland, California, have challenged other individual donors to match their $50,000 gift in support of the Center of Excellence (COE) for Health Services/Health Policy Research.

    Donors who contribute at least $10,000 within 2013 (including first payments on multiyear pledges to the campaign) will be recognized as part of the Byl Matching Gift Challenge in Foundation publications and donor recognition events. Donors should reference "Byl Matching Gift Challenge" on their donation correspondence, or contact Foundation Executive Director Barbara Malm for more information.

    The Foundation recently surpassed the $2 million benchmark, raising more than two-thirds of the $3 million in funds needed to launch the nation's first center dedicated to expanding the number of physical therapy scientists in the field of health services and health policy.

    Read the Foundation's press release for comments from Nancy Byl and Foundation President William G. Boissonnault, PT, DPT, DHSc, FAPTA, FAAOMPT, about the challenge and the COE initiative.

    Sample Privacy Notices Now Available for Health Care Providers

    If you need help creating a Notice of Privacy Practice to comply with the HIPAA privacy rules, the federal government has developed model notices that you can customize, reproduce, and distribute either in print or electronically to patients.

    The Health Portability and Accountability Act (HIPAA) give patients a right to be informed of the privacy practices of their health care providers and health plans and of their privacy rights regarding their personal health information. HIPAA requires providers and plans to notify patients of these rights. By using a model notice, you will know you are providing the information in compliance with the regulations and that the notice reflects recent regulatory changes to the HIPAA privacy and security rules.

    You can download the model notice as a booklet, as a multipage document, as a single page presentation, or as text only.

    APTA includes this and many other resources on its HIPAA webpage.

    Centers for Medicare and Medicaid Services Delays Enforcement of DME Face-To-Face Requirement

    [Editor's Note: This article, updated October 11, 2013, replaces a previous version, "Deadline on Hold for Requirement to Meet Face-to-Face With Patients Before Ordering DME," published September 19, 2013.]

    The Centers for Medicare and Medicaid Services (CMS) announced further delay in enforcement of the new Medicare durable medical equipment "face-to-face" encounter requirement for certain items of DME. The Affordable Care Act requires that a physician must document that a physician, nurse practitioner, physician assistant or clinical nurse specialist has had a face-to-face encounter with the patient within 6 months before the order is written for the DME. CMS said it will announce the new enforcement date in calendar year 2014, and suppliers and physicians who are currently implementing the face-to-face requirement should continue to do so.

    Health Care Spending Would Fuel Long-Term Budget Deficit, Says CBO

    While the federal deficit is expected to continue shrinking over the next few years, it gradually will grow again, mostly from expenses related to the government's health care programs and Social Security, reported the Congressional Budget Office (CBO) this week.

    The deficit shrank this year to its smallest size since 2008: roughly 4% of gross domestic product, compared with a peak of almost 10%, said CBO in its 2013 Long-Term Budget Outlook (.pdf). CBO cited the reasons as the economy's gradual recovery from the 2007–2009 recession, the waning budgetary effects of policies enacted in response to the weak economy, and other changes to tax and spending policies. If current laws governing taxes and spending were generally unchanged—an assumption that underlies CBO's 10-year baseline budget projections—the deficit would fall to 2% by 2015.

    However, CBO projects that budget deficits would gradually rise again under current law, mainly because of increasing interest costs and growing spending for Social Security and health care programs (Medicare, Medicaid, the Children's Health Insurance Program, and subsidies to be provided through health insurance exchanges). CBO expects interest rates to rebound in coming years from their current unusually low levels, sharply raising the government's cost of borrowing.

    Education Leadership Institute Fellowship Accepting Applications for 2014

    APTA's Education Leadership Institute (ELI) Fellowship, a collaborative with the American Council of Academic Physical Therapy (ACAPT), Education Section, Physical Therapist Assistant Educators Special Interest Group, and APTA, now is accepting applications for 2014. Submission deadline is December 20, 2013. This yearlong invitational blended learning (online and onsite components) fellowship program includes mentorship and is designed to develop emerging and novice (0-7 years) physical therapist and physical therapist assistant education program directors with leadership skills to facilitate change, think strategically, and engage in public discourse to advance the physical therapy profession.

    Applicants are selected based on the strength of their application and meeting all eligibility criteria. To learn more about the Education Leadership Institute Fellowship, go to the ELI webpage.

    Residency/Fellowship Education Introduces 1-Stop Application System

    Applicants to physical therapist residency and fellowship programs now can complete 1 comprehensive application and submit it to the participating program(s) of their choosing.

    APTA has launched the new centralized application system for residency and fellowship programs. The news RF-PTCAS is being administered through the same vendor that oversees Physical Therapist Centralized Application Service (PTCAS) for professional physical therapist education.

    To learn more about residency and fellowship education for physical therapists, as well as RF-PTCAS and the participating programs, please visit the ABPTRFE website at www.abptrfe.org/RFPTCAS or e-mail APTA at resfel@apta.org.

    APTA News App Now Available

    Want to access APTA news as it posts, in the palm of your hand?

    The free APTA News app, available for download in Apple and Google Play app stores, allows quick access to APTA'sPT in Motion: News Now, as well as national events and advocacy opportunities, among other features.

    It's a terrific option for those who want to stay connected but don't follow APTA on Facebook or Twitter.

    Study: System Review Confirms Physical Therapy Benefits for Parkinson Disease

    Physical therapy improved short-term functional ability or minimized secondary complications for patients with Parkinson disease (PD), based on a systematic review of randomized controlled trials (RCTs) of intervention versus no intervention in patients with PD.

    Researchers for the study, published ahead of print this week by Cochrane Database System Review, reported that the benefit was significant for speed, 2- or 6-minute walk test, Freezing of Gait questionnaire, Timed Up & Go test, Functional Reach test, Berg Balance Scale, and clinician-rated UPDRS.

    Most of any observed differences between treatments were small, the researchers said, noting that these conclusions were based on indirect comparisons of the studies chosen for the review. A consensus menu of "best practice" physical therapy is needed, they concluded, as are large RCTs to demonstrate longer-term efficacy and cost-effectiveness of physical therapy interventions for PD.

    The review identified 39 trials with 1827 participants, published up to the end of January 2012. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance, and martial arts. The researchers used tests for heterogeneity to assess for differences in treatment effect across the different interventions.

    Look for the full text of this study in APTA's Open Door and PTNow in about 6-8 weeks.

    Joint Commission Wants Your Comments on Optional Memory Care Certification

    The Joint Commission's proposed standards for an optional memory care certification within the nursing and rehabilitation center accreditation program are out for field review, and your comments can help shape final standards. Comments are due October 16, 2013.

    The Joint Commission emphasizes that these optional certification requirements would be in addition to the accreditation requirements that will apply to all Joint Commission-accredited long-term care organizations. While accreditation requirements address the prevalence of dementia in nursing homes, says the Joint Commission, the optional certification will recognize organizations for their dementia care specialization, particularly for organizations providing specialized dementia care in a distinct unit or area. Key areas that distinguish the memory care optional certification requirements from the accreditation requirements include the role of the coordinator, staff education and training, feature of the physical environment, and activity programming.

    To comment, follow the instructions on the standard field reviews page—download and review the proposal, then submit comments by October 16 via an online survey, an online form, or e-mail to the Joint Commission. Direct any questions you have to Jennifer Tarpey, Department of Standards and Survey Methods, 630/792-5919 or jtarpey@jointcommission.org.

    New APTA Resources Focus on Physician Self-Referral

    Activity on physician self-referral, in particular efforts regarding the exceptions to the
    in-office ancillary services (IOAS) exception to the Stark self-referral laws, has ramped up this year, and APTA has new online resources to help members understand federal self-referral efforts and get involved.

    New on APTA's Self-Referral webpage:

    • "Take AIM" video alert features APTA President Paul Rockar Jr, PT, DPT, MS.
    • Prezi presentation visually walks you through the issue.
    • "Self-Referral 101" takes a more textual approach to explaining the issue.

    You’ll also find APTA's position paper on self-referral, news items, and links to the Government Accountability Office reports that implicate financial incentive in physical self-referrals to prostate cancer radiation therapy, advanced imaging, and anatomic pathology services. (A fourth report, on self-referral in physical therapy, is due this fall and will be posted here as well.)

    Upcoming Events: World Parkinson Congress, Musculoskeletal Summit

    APTA partners with or cosponsors these upcoming events that physical therapists and physical therapist assistants should consider attending. Visit the websites for registration information.

    World Parkinson Congress, October 1-4 in Montreal, Quebec, Canada
    Terry Ellis, PT, PhD, NCS, a member of the programming committee, will participate in a preconference session, host a roundtable, and lead workshops.

    US Bone and Joint Initiative Musculoskeletal Summit, November 18-19 in Washington, DC

    Add your input from a physical therapy perspective to this interdisciplinary meeting. Maura Daly Iverson, PT, DPT, MPH, ScD, will help facilitate the session "How can the patient obtain best practices?"

    Last Call for Proposals: CPG/CPA Development

    Member teams that want to apply for financial support from APTA to develop clinical practice guidelines and clinical practice appraisals are reminded that the deadline for applications is next week, September 15.

    Proposals for CPG/CPA development must focus on clinical practice areas that are important and relevant to the practice of physical therapy. The proposal must be supported and submitted by an APTA section. Each proposal will be considered individually and will be awarded in part or in full depending on the priorities of the association and the strength of the proposal.

    For more information or for a copy of the proposal submission document, contact Anita Bemis-Dougherty, director, Practice Department, at anitabemis-dougherty@apta.org or 800/999-2782, ext. 3176.

    WebMD Description of Physical Therapy Updated for Accuracy

    If you visit WebMD's page describing physical therapy, thank some of your member colleagues who over the last month notified APTA that the content describing the role of the physical therapist included inaccuracies and omissions. APTA contacted WebMD requesting they revise their content, and staff provided them with suggested revisions. The page now provides a more accurate description of physical therapists.

    APTA Recommends Changes to Proposed 2014 Medicare Payment Schedules

    The therapy cap and its application to critical access hospitals, PQRS, incident-to billing, MPPR, functional claims-based data collection, and OPPS adjunct bundling services are among the issues APTA addressed in comments last week to the Centers for Medicare & Medicaid Services (CMS). The comments were in response to Medicare's 2014 payment proposals for the physician fee schedule (View APTA comments.), clinical laboratory fee schedule, other revisions to Medicare Part B payment, and the hospital outpatient prospective and ambulatory surgical center payment systems (OPPS) (View APTA comments.).

    The full comments are posted on www.apta.org and highlights are summarized below.

    For the physician fee schedule, clinical laboratory fee schedule, and other revisions to Part B for 2014, which were announced July 19, APTA made these recommendations:

    Critical Access Hospitals (CAHs)

    CMS should not permanently apply the therapy cap to critical access hospitals. CMS can and should continue to interpret congressional intent to treat hospitals and CAHs in the same manner in the application or nonapplication of the therapy caps.

    Multiple Procedure Payment Reduction (MPPR)

    CMS should mitigate the impact of the MPPR cuts, including no longer applying the MPPR across multiple therapy disciplines and working with Congress on long-term reform of the payment system.

    Incident-to Billing Provisions

    CMS should ensure that its proposal requiring individuals who perform incident-to services to meet state requirements is included in the final rule.

    Physician Quality Reporting System (PQRS)

    • CMS should not increase the number of required individual measures for successful reporting in 2014 from 3 to 9.
    • Medicare should continue to allow measures groups, such as the back pain measure group, to be reported via claims-based reporting.
    • CMS should not eliminate claims-based reporting in 2017.
    • Medicare should allow measures 126 and 127 (diabetic foot and ankle care measures) to continue to be reported via claims-based reporting.

    Qualified Clinical Data Registry Requirements

    • CMS should extend the deadline for registries to qualify for 2015 data collection from January 1, 2014, to April 1, 2014.
    • A registry should not have to publically report detailed descriptions on measures under development, as the details might not yet be final.
    • For new registries, the number of measures required for reporting should be 3 instead of 9.
    • Public data reporting should not be required at the outset and should be vetted through a validation process prior to public release.

    Functional Limitation Data Reporting Recommendations

    • APTA expressed concerns about the absence of 1 standardized tool to measure patient function.
    • Providers should be able to demonstrate patient complexity via use of a modifier such as “low,” moderate,” or “high.”
    • In the future CMS should consider permitting providers to report functional limitation data through other mechanisms, such as registries or electronic health records, in addition to claims.
    • In the acute care hospital setting, CMS should consider exempting from reporting observation status patients and Part A patients rebilled under Part B, as these patients do not exemplify the typical outpatient therapy episode of care.
    • For patients who did not have a formal discharge, CMS should change the episode definition from 60 days from the last date of service to 30 days.
    • ICF categories should be expanded in future years.
    • CMS, APTA, and other key stakeholders should collaborate to develop a standardized core data set for functional limitation reporting.
    • Ultimately, CMS should reform the payment system for outpatient therapy to a per-session system based on severity and intensity.

    For OPPS, APTA recommended that CMS remove physical therapy services provided by qualified physical therapists and physical therapist assistants from the list of potential adjunctive services included in the new 29 comprehensive APCs. APTA also recommended the removal of the direct supervision requirement for outpatient therapeutic services in CAHs under OPPS because it is burdensome, unnecessary, and not based on clinical need.

    Final Call for Poster Abstracts for NEXT Conference 2014

    There are only 2 weeks left to submit abstracts for poster presentations for APTA's NEXT Conference, to be held in Charlotte, North Carolina, June 11-14. The following types of presentations are being sought:

    • Research reports: presentations of original scientific data collected by the author(s)
    • Special interest reports: presentations of innovative concepts, ideas, devices, or products developed to meet the special needs of patients and clients
    • Theory reports: presentations of a theory, idea, concept, or model that describes a foundation for the practice of physical therapy
    • Multimedia technology programs: presentations that include demonstrations of computer software and/or web-based programs for instruction, research, and management

    Individuals may submit up to 2 abstracts as the presenting author; unlimited submissions are allowed as a secondary author. The deadline is September 23, 2013.

    For further information and to access the online submission site, visit www.apta.org/Conference/Submissions.

    Healing After the Boston Marathon Bombing; What Are the Lessons for PTs?

    Physical therapists (PTs) worked with many survivors of the Boston Marathon bombing in the days and weeks following the April attack. Read about their experiences and the myriad ways they helped the injured in September's PT in Motion. Many of the runners and spectators still need physical therapy; some will for years to come. This remarkable feature story recounts not only the immediate experiences of those PTs but also presents valuable information for other PTs on topics ranging from acute care to wound care.

    Two Ways to Contribute to MoveForwardPT.com

    In case you missed the announcement a few weeks ago, APTA’s MoveForwardPT.com consumer website wants your help in 2 areas:

    • If any current or former patients are willing to share their physical therapy success stories, Move Forward Radio may want to interview them in upcoming episodes.
    • Two vacant Editorial Board positions are waiting to be filled by members with strong clinical backgrounds, proven writing skills, and interest in developing evidence-based, consumer-friendly content.

    Follow the links above for details.

    Celebrate Extraordinary PTs and PTAs: Nominate for Honors and Awards

    Help your colleagues or students receive recognition for their achievements by nominating them for an APTA national honor or award.

    Each year APTA celebrates members' outstanding achievements in the areas of overall accomplishment, education, practice and service, publications, research, and academic excellence. Award recipients are recognized in June with a ceremony and reception at NEXT, APTA's annual conference and exposition.

    The 2014 call for nominations is now open and will close December 1, 2013. The electronic submission process is quick and easy; go to APTA's Honors and Awards page, and click on the specific honor, award, or scholarship to obtain guidelines, requirements, and a link to the online submission site.