• articleJan 2, 2011 | 2 min. read

    Medicare and Medicaid Extenders Act of 2010 Update

    The legislation recently stopped the 24.9% payment cut from occurring on January 1, 2011. However, CMS announced that the conversion factor used to update payment for next year will be $33.9764 instead of the $36.8729 conversion factor that was in effect in 2010. The Centers for Medicare and Medicaid Services (CMS) this week released corrected payment amounts for 2011 that incorporate the changes included in the Medicare and Medicaid Extenders Act of 2010 that was signed into …

  • articleDec 21, 2010 | 2 min. read

    APTA defines "essential" in the context of essential benefits

    What is your interpretation of the word “essential” in the context of an essential benefit package? The official response from APTA: “Essential,” in the context of essential benefits provided under insurance plans, should mean benefits that are available and accessible to all individuals with coverage without increased premiums and co-payments. Essential benefits include, but are not limited, to preventing the spread of disease, improving and/or eradicating certain medical conditions or disease states, improving and minimizing the effects …

  • articleDec 21, 2010 | 2 min. read

    Physical Therapists should be included in the ACO model to be fully effective

    An Accountable Care Organization (ACO), is an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. APTA argues that PTs should be included in the ACO model in order to continue quality of care throughout different treatment settings. For an accountable care organization (ACO) model to be successful, it will be essential that …

  • articleDec 21, 2010 | 1 min. read

    President Obama stops SGR cuts

    By signing HR 4994 into law Presiden Obama prevents the scheduled 24.9% Sustainable Growth Rate (SGR) Medicare payment cut and extending current Medicare payment rates through December 31, 2011. On Wednesday, President Obama signed Senate Amendment to HR 4994, the Medicare and Medicaid Extenders Act of 2010, into law -- preventing the scheduled 24.9% Sustainable Growth Rate (SGR) Medicare payment cut and extending current Medicare payment rates through December 31, 2011. The law also extends the therapy …

  • articleDec 9, 2010 | 2 min. read

    The Medicare and Medicaid Extenders Act of 2010

    This legislation would prevent the scheduled 25.5% Medicare payment cut to physical therapists and other health care providers paid under the physician fee schedule. Today, the US House of Representatives passed Senate Amendment to H.R. 4994 , the Medicare and Medicaid Extenders Act of 2010 (by a vote of 409-2). This legislation would prevent the scheduled 25.5% Medicare payment cut to physical therapists and other health care providers paid under the physician fee schedule. The provision in …

  • articleDec 6, 2010 | 1 min. read

    Ad sponsored by APTA had impact on Medicare

    Scott Ward, APTA President, writes a letter talking about the importance of "strength in numbers" in urging Congress to pass legislation to extend the therapy cap exceptions process beyond December 31. A full-page ad on the detrimental effects of the therapy cap on Medicare beneficiaries ran yesterday in Roll Call and Politico – the two newspapers most widely read by members of Congress and their staff. The ad, sponsored by APTA and other members of the Therapy …

  • articleDec 6, 2010 | 1 min. read

    Phyical Therapists will continue to get paid by Medicare until Dec. 31

    A new ruling provdes an update and avoids Medicare cuts for now. Law Extends Current Payment Until December 31 Physical therapists and other health care providers who receive payment under the Medicare physician fee schedule will continue to be paid at the existing 2.2% Medicare payment update through December 31. The Physician Payment and Therapy Relief Act (PPTRA) of 2010, signed into law Tuesday, codifies a modification of the multiple procedure payment reduction (MPPR) finalized by the …

  • articleNov 20, 2010 | 2 min. read

    Temporary Reprieve to some Final Rule Changes Passed by Senate but the Fight is NOT Over!

    Last night the Senate passed a bill  by unanimous vote called The Physician Payment and Therapy Relief Act of 2010 (PPTRA) that allows a 30 day reprieve from the Medicare Final Rule and continue the existing 2.2% Medicare payment update that expires November 30. The PPTRA also changes  the multiple payment procedure reduction (MPPR) finalized by the Centers for Medicare & Medicaid Services (CMS) this month, by applying a 20% reduction, rather than the 25% reduction in the …

  • articleNov 18, 2010 | 4 min. read

    What PTs Should Know About 2011 Final Rule Medicare Changes

    Some major changes are headed our way in terms of the 2011 Medicare Final Rule on the Physician Fee schedule and Other Policies to be effective January 1, 2011.  The Rule included a number of provisions that have impact on outpatient therapy services. The net effect of the policies could lead to payment reductions of approximately 30%. If you see Medicare patients and they impact your revenue, there are several things to pay attention to and deal …

  • articleNov 16, 2010 | 2 min. read

    Medicare guidelines for skilled nursing home care and home health care are ruled too strinct

    Medicare budget cuts are forcing new guildines for skilled nursing home care and home health care but two courts have recently ruled these guidlines to be too strict. New guidlines would have meant it was the patient's responsability to prove their condition would improve over time with this assistance. The courts ruled that chronic patients in need of long-term care should not be denied services. WASHINGTON — Two federal courts have ruled that the Obama administration is …

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