A Resource for Functional Reporting in 2013 for Physical Therapists

Are you concerned about the new Medicare mandates for Functional Reporting for therapy services in 2013? Are you and your staff fully equipped to manage the change?  Do you know which are the best reporting templates?

I've written a new book for physical therapist managers to implement Functional Reporting based on 8 years of experience with self-report measures in my private practice.

This book is for therapists new to functional reporting as well as for therapists who need to gain that extra edge to remain competitive.

I've written this book, pictured in the upper left, for physical therapy managers to implement self-report questionnaires into their clinical workflow. The book was published January 7th, 2012 and it has so far sold well.

I started implementing functional testing systematically in 2005.  I had the help of my fellow PTs, physical therapist assistants, administrators, and various support staff.  We also started the Physician Quality Reporting Initiative (PQRI) in July 2007, the first year physical therapists were eligible to report.

Chapter One discusses the implementation process, Chapter Two discusses therapist-scored performance measures like the Berg score. The bulk of the book (pp. 73 - 131) describes in detail the self-report tests physical therapists use. I describe 20 self-report tests.

Smart managers will choose the top two or three tests for their high-volume caseloads. Click the link in the upper left to buy the book from the publisher's website at a substantial discount from Amazon. Please e-mail me with any questions you might have.

Live Functional Outcomes Webinar Now at PhysicalTherapy.com

How to Effectively Use Outcomes Questionnaires for Federal Quality Reporting, Better Productivity and Better Outcomes is a recorded webinar that will be also be aired live at PhysicalTherapy.com.

The webinar will start at 8am EST on Thursday, December 13th, 2012.

Membership is required and you can view the recorded webinar at any time, at your convenience.

Get ready for 2013 Functional Reporting or PQRS using standardized outcome measures with How to Effectively Use Outcomes Questionnaires for Federal Quality Reporting, Better Productivity and Better Outcomes.

Answers about Physical Therapy Functional Status Measures

I'm listening to the National Provider Call that covers the new functional reporting requirements for outpatient therapy services, including physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP) services, effective January 1, 2013.

Here is the presentation.

I notice that many of the participants questions that follwoed the presentation are answered in the links provided at the bottom of the National Provider Call-in page. You can go there now and download the material if you haven't already done so.

The new, non-payable G-codes will be a big hurdle for physical therapists, especially the small, outpatient physical therapist who spends his or her whole day treating patients.

I encourage you to review the CMS material. Also, reach out ot your friends and peers to see how they are handling this burden in their practice. E-mail me if I can help at my e-mail address.

Also, an e-mail mailbox has been created to answer questions related to Functional Status Reporting for Therapy Services at TherapyServicesNPC@cms.hhs.gov.

Patients Win! Maintenance Therapy Settlement Gets Preliminarily Approval!

Physical therapists' patients can take cheer this holiday season, nestled all snug their beds, with the knowledge that Maintenance Therapy will still be here through Christmas.

The class action lawsuit filed and won by the Center for Medicare Advocacy has tremendous potential to simplify therapy decision making by managers, therapists and patients.

Just in time, too, considering the Byzantine complexity brought by Medicare Manual Reporting and, now, Functional Reporting for 2013.

According to the Center for Medicare Advocacy, on Sunday, December 9th, 2012:

"A proposed settlement agreement was filed in federal District Court on October 16, 2012. On November 20, Chief Judge Christina Reiss of the District of Vermont signed an order preliminarily approving the settlement agreement. 

By December 10, 2012, notice of the settlement will be posted on the websites of numerous organizations, including the seven national organizations that served as plaintiffs in the case, which will alert advocates and beneficiaries to the terms of the settlement."

Many observers believe that Medicare will somehow acquit themselves of 35-plus years of illegal behavior and continue to deny care based on the just-overturned "Improvement Standard".  The CMA announcement, however, implies that the class participants, not Medicare, are the ones in position to accept or deny the Settlement.

"Class members will be able to file written objections to the settlement. 

The court will hold a Fairness Hearing on January 24, 2013 'to determine whether the settlement agreement is fair, reasonable and adequate,' after which it is hoped that the judge will issue an order permanently approving the settlement agreement."

The Settlement only applies to the illegal Improvement Standard, or the idea that people must make significant and measurable gains in function in order to continue receiving therapy services. Two further conditions still apply: the services must be of sufficient complexity that a lesser trained provider could not safely perform the care and the patient must still demonstrate that the services are medically necessary.

I've had conversations with therapists who support the Improvement Standard on the grounds that "we can't afford to expand Medicare right now".

The Settlement is not an expansion of Medicare. The Settlement is a clarification of the Congressional intent to provide Medicare beneficiaries with a level of care that would not leave them disabled and institutionalized.

For my entire 20-year career, I've been told by well-meaning PT managers and staff that we must "show progress" in order to treat our patients. In turn, my managers had been told by the Medicare Carriers and Fiscal Intermediaries (mainly Blue Cross/Blue Shield and other commercial insurers) that claims would be denied if the patients didn't "show progress".

It turns out that the insurance companies, acting under the aegis of Medicare, were breaking the law.

Here is testimony the the CMA website:

"These changes [from the Settlement] are extremely meaningful, as my mother has repeatedly been denied the ability to continue the physical therapy she needs in order to prevent further deterioration of her condition. 

It has been extraordinarily frustrating, and after the last cessation of Physical Therapy and subsequent deterioration actually endangered her life, her quality of life was greatly affected, resulting in extremely expensive 24/7 care. 

If she could have kept her PT services, this would not have happened!" 

-Veronica, New Hampshire

If the Settlement sticks (as I think it will) it will be the best Christmas present of my entire career.