• articleJan 10, 2011 | 2 min. read

    46 states give direct access to a therapy evaluation without a referral

    With the addition of Hawaii, 46 states now give patients the ability to get an evaluation from physical therapists without having to get a referral from their doctor. Patients in Hawaii now can be evaluated and treated by physical therapists without first having to obtain a physician referral. With the passage of new State Board of Physical Therapy regulations last month, Hawaii becomes the 46th state to achieve direct access. On November 9, 2010, the Hawaii Board …

  • articleJan 2, 2011 | 2 min. read

    Washington State Governor Restored Medicaid Funding for Therapy

    Workign together a number of assocaitions provided the governor with "concrete suggestions" including alternative cuts that gave Washington's governor the information she needed to restore therapy to the Medicaid budget. On December 17, Washington Gov Christine Gregoire restored funding for adult physical therapy services as part of her supplemental budget recommendations to the FY2011 state budget. Gregoire withdrew threatened cuts that would have eliminated physical, occupational, and speech therapies. The restored funding prevents elimination of physical therapy, …

  • articleJan 2, 2011 | 2 min. read

    Multiple Procedure Payment Reduction (MPPR) of 5% for Therapy Services

    CMS will make full payment for the therapy service or unit with the highest practice expense value and reduce payment of the practice expense component by 20% in the office setting and 25% in institutional settings for the second and subsequent procedures or units of service furnished during the same day for the same patient. Based on policy changes required by the Physician Payment and Therapy Relief Act of 2010, the Centers for Medicare and Medicaid Services …

  • 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 …

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