Cash Based Physical Therapy and the new Medicare Functional Reporting regulations are just two of the big topics the Florida Physical Therapists in Private Practice will tackle for you at the 3rd annual conference at the Lake Buena Vista Hilton on May 18th and 19th, 2013.
We'll have Nancy Beckley, President of Nancy Beckley & Associates LLC, discussing Medicare Compliance.
Pauline Franko of Encompass Consulting and Education will discuss new requirements for Functional Reporting using G-codes.
For private practice physical therapists interested in expanding their revenue base away from traditional Medicare and commercial insurance, Dr. Aaron LeBauer PT, DPT, LMBT will discuss how you can build a practice like his, which is 100% cash-based.
We will have an expo with many physical therapy vendors as well as a Saturday professional luncheon where you can continue your learning.
A clinical track will run concurrent with a business-oriented track. You should bring your Office Manager and staff to fully capture all the information at the 2013 FLPTPP conference. Get three of you signed up for only $575!
More programming is available at the Florida Physical Therapists in Private Practice (FLPTPP) web site.
We'll see you there!
Sign up here.
Showing posts with label florida. Show all posts
Showing posts with label florida. Show all posts
Thursday, April 4, 2013
Saturday, September 29, 2012
Price, not More Visits, Drives Cost Increases in Healthcare
Why should you care?
Commercial health care costs are going up - does it matter whether price or patient volume is to blame?
Yes. The Town Hall meeting at the recent Florida Physical Therapy Association (FPTA) meeting included discussion about Copayment reform legislation in Florida.
Some voices in the Town Hall argued that Copayment reform legislation in Florida is not necessary since rising physical therapy utilization indicates there are no barriers to patient access to physical therapists.
Increasing health care costs, to employers via premiums and to employees in the form of rising Copayments, reduce access to physical therapist services.
Do we want to live in an America where only the rich or the employed have access to physical therapist services?
The findings of the Health Care Cost Institute from September 2012 found that
According to a September 25th Washington Post article:
Other state physical therapy associations have not seen the same rapid success with Copayment reform. There is not even uniform agreement that Copayment reform is necessary for patients. Florida is one example where there is disagreement.
Some other opponents of Copayment reform at the recent Town Hall meeting in Daytona Beach spoke out and suggested that insurance companies would "get mad" at the FPTA if we, as an organization, supported Copayment reform.
These opponents, who are physical therapists, are supporting the insurance companies because the insurance companies support them.
When insurance companies set the political agenda for the FPTA we are allowing them to put profits before patients. We need Copayment reform to protect patients. From the Post article:
This problem wont go away and it can't be solved through "free market" methods.
States need legislative reform that lowers Copayments for patients.
Commercial health care costs are going up - does it matter whether price or patient volume is to blame?
Yes. The Town Hall meeting at the recent Florida Physical Therapy Association (FPTA) meeting included discussion about Copayment reform legislation in Florida.
Some voices in the Town Hall argued that Copayment reform legislation in Florida is not necessary since rising physical therapy utilization indicates there are no barriers to patient access to physical therapists.
Increasing health care costs, to employers via premiums and to employees in the form of rising Copayments, reduce access to physical therapist services.
Do we want to live in an America where only the rich or the employed have access to physical therapist services?
The findings of the Health Care Cost Institute from September 2012 found that
"... price growth for outpatient facilities and professional procedures remained higher than (patient volume) utilization growth.".The prices paid were the primary drivers of health care spending in 2011.
According to a September 25th Washington Post article:
"Employers typically have tried to control costs by reducing the volume of care delivered, whether that means higher co-pays for doctor visits or using prevention to catch costly diseases earlier."Copayment reform for physical therapy patients was a "slam dunk" in Kentucky, South Dakota and New Jersey in 2011 and 2012.
Other state physical therapy associations have not seen the same rapid success with Copayment reform. There is not even uniform agreement that Copayment reform is necessary for patients. Florida is one example where there is disagreement.
Some other opponents of Copayment reform at the recent Town Hall meeting in Daytona Beach spoke out and suggested that insurance companies would "get mad" at the FPTA if we, as an organization, supported Copayment reform.
These opponents, who are physical therapists, are supporting the insurance companies because the insurance companies support them.
When insurance companies set the political agenda for the FPTA we are allowing them to put profits before patients. We need Copayment reform to protect patients. From the Post article:
"Some economists have argued that government regulation is exactly what we need to slow price growth and ensure patient access.
Maryland is the only state in the USA where the government sets the rates that hospitals can charge insurance companies.
Maryland's hospitals from 1977 to 2009 experienced the lowest cumulative increase in cost per adjusted admission of any state in the nation. And private insurers pay the same rates as public insurers.
All states except Maryland gravitated away from those models, as states have looked for more competition and less regulation in health-care markets."Consumers will continue to need physical therapy services and employers will continue to buy lower priced health care with lower premiums for their employees. This means higher Copayments.
This problem wont go away and it can't be solved through "free market" methods.
States need legislative reform that lowers Copayments for patients.
Saturday, August 4, 2012
Free Giveaways at 2012 Florida Private Practice Conference
Monday, April 30, 2012
Volunteers Needed for Florida Physical Therapists' Committee
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| Florida Physical Therapists in Private Practice (FLPTPP) Call for Volunteers |
Thursday, April 12, 2012
Governor Scott signs Physical Therapist/PTA Temporary License Bill into Law
Physical Therapists and Physical Therapists Assistants graduating from Florida based PT and PTA programs will be able to obtain temporary licensure thanks to Governor Rick Scott signing HB 799 into law on Friday, April 6, 2012.
With Governor’s Scott’s signature HB 799 will become law effective June 1.
HB 799 was a major priority of the Florida Physical Therapy Association (FPTA) along with the state’s 11 Physical Therapy and 15 Physical Therapy Assistant schools.
Passage of the legislation can be attributed to the hard work of our PT and PTA students, faculty, and FPTA leadership and legislative counsel.
As a recap, HB 799 and its companion SB 1228 were heard in a total of six committees of reference and passed every single committee without objection. On final passage in the Florida House of Representatives HB 799 passed 114-0 and then passed 36-0 in the Florida Senate.
While process barriers were ever present during the 2012 session, the legislation steamed on toward final passage. However, it wasn’t until the final day, March 9 at 11:22 p.m. that HB 799 achieved final passage and was enrolled. On Friday, March 23, the Florida House of Representatives procedurally released HB 799 from its purview to be considered by Florida Governor Rick Scott.
As mentioned previously, Governor Scott signed the bill into law Friday, April 6. FPTA’s strategy was textbook advocacy for taking an idea and making it a law.
Thank you to the following legislative sponsors:
With Governor’s Scott’s signature HB 799 will become law effective June 1.
Passage of the legislation can be attributed to the hard work of our PT and PTA students, faculty, and FPTA leadership and legislative counsel.
As a recap, HB 799 and its companion SB 1228 were heard in a total of six committees of reference and passed every single committee without objection. On final passage in the Florida House of Representatives HB 799 passed 114-0 and then passed 36-0 in the Florida Senate.
While process barriers were ever present during the 2012 session, the legislation steamed on toward final passage. However, it wasn’t until the final day, March 9 at 11:22 p.m. that HB 799 achieved final passage and was enrolled. On Friday, March 23, the Florida House of Representatives procedurally released HB 799 from its purview to be considered by Florida Governor Rick Scott.
As mentioned previously, Governor Scott signed the bill into law Friday, April 6. FPTA’s strategy was textbook advocacy for taking an idea and making it a law.
Thank you to the following legislative sponsors:
- Rep. Tom Goodson, R-Titusville
- Senator Bill Montford, D-Tallahassee
Tuesday, March 27, 2012
12 weeks of Physical Therapy Required By New Medicare Guidelines Prior to Joint Replacement in Florida
Medicare has begun to deny hospital charges for total joint replacement surgery IF the surgeon has failed to implement up to 12 weeks of pre-operative PT and/or bracing, according to Vincent Hudson, CEO of the medical consulting practice PMC, Inc.
Vincent made his comments on March 20th on LinkedIn in the Physical Therapists in Private Practice group.
This agressive new program in Medicare Audits is threatening physician and hospital reimbursement for total joint replacements and lumbar spine fusion in many states across the country.
The expanded use of Medicare Administrator Contractor (MAC) pre-payment audits has placed a premium on documentation in the hospital record and may threaten reimbursement for physicians with poor documentation skills.
On November 15, 2011, CMS announced three new 3-year demonstration projects (reported here by PTD). The Recovery Audit Prepayment Review Demonstration is designed to help curb improper Medicare and Medicaid payments.
As proposed, the demonstration would allow Medicare recovery auditors to review claims after services are provided but before the claims are paid to ensure that the provider complied with all Medicare payment rules. This would prevent improper payments before they are made.
Seven states with high populations of fraud- and error-prone providers are targeted
The contractor for MAC jurisdiction 9 is First Coast Service Options (FCSO), which includes Florida, Puerto Rico, and the Virgin Islands. FCSO developed a local coverage determination (LCD) on total joint replacements.
The original draft LCD included a requirement that multiple 12-week nonsurgical interventions, such as physical therapy, be documented prior to surgical total joint replacement.
Revisions to the LCD now require only one non-surgical intervention, such as 12 weeks of physical therapy.
Weeks later, the MAC announced a new prepayment audit of 15 specific DRGs, 4 of which are orthopaedic codes, including those that cover total joint replacements.
Get out there and educate your physicians, especially your family practice docs and your unaffiliated orthopedic surgeons who will want to avoid denials.
They'll appreciate the heads-up.
"Medicare A has denied payment to hospitals, and I am sure will trickle over to physicians.
This new standard should be increasing the numbers of referrals we see from Medicare.
As in most cases, I expect to see other commercial insurances to follow shortly.
Make your referring physicians aware of this, as hospitals have already begun to do so..."
This agressive new program in Medicare Audits is threatening physician and hospital reimbursement for total joint replacements and lumbar spine fusion in many states across the country.
The expanded use of Medicare Administrator Contractor (MAC) pre-payment audits has placed a premium on documentation in the hospital record and may threaten reimbursement for physicians with poor documentation skills.
On November 15, 2011, CMS announced three new 3-year demonstration projects (reported here by PTD). The Recovery Audit Prepayment Review Demonstration is designed to help curb improper Medicare and Medicaid payments.
As proposed, the demonstration would allow Medicare recovery auditors to review claims after services are provided but before the claims are paid to ensure that the provider complied with all Medicare payment rules. This would prevent improper payments before they are made.
Seven states with high populations of fraud- and error-prone providers are targeted
- Florida
- California
- Michigan
- Texas
- New York
- Louisiana
- Illinois
- Pennsylvania
- Ohio
- North Carolina
- Missouri
The contractor for MAC jurisdiction 9 is First Coast Service Options (FCSO), which includes Florida, Puerto Rico, and the Virgin Islands. FCSO developed a local coverage determination (LCD) on total joint replacements.
The original draft LCD included a requirement that multiple 12-week nonsurgical interventions, such as physical therapy, be documented prior to surgical total joint replacement.
Revisions to the LCD now require only one non-surgical intervention, such as 12 weeks of physical therapy.
Weeks later, the MAC announced a new prepayment audit of 15 specific DRGs, 4 of which are orthopaedic codes, including those that cover total joint replacements.
"As with the Total Knee replacement, the medical record documentation must indicate continued symptoms following medication ....there also must be documentation of a trial of physical therapy and/or external joint support provided equal to or greater than 12 weeks..."I agree with Vincent.
Get out there and educate your physicians, especially your family practice docs and your unaffiliated orthopedic surgeons who will want to avoid denials.
They'll appreciate the heads-up.
Saturday, March 24, 2012
All Florida Physical Therapists Contact Governor Rick Scott Immediately!!
Please contact Governor Rick Scott and request that he sign into law HB 799 by Rep. Tom Goodson and Senator Bill Montford, regarding temporary license for the practice of physical therapy.
Current Situation: The House of Representatives and Florida Senate passed HB 799 unanimously on Friday, March 9, 2012.
The Legislation is now headed to Governor Rick Scott for final action to be signed into law. On behalf of the FPTA, please begin contacting Governor Rick Scott and request that he Sign HB 799 into law.
The Problem: Due to national testing procedure changes adopted in 2011, the physical therapy exam in Florida is only given a limited number of times (3-5) each year and the seats are limited. Due to the change in testing procedures at the national level, Florida Physical Therapy Program graduates may wait three to four months after graduation to sit for the exam. This has created a backlog of graduates waiting to take the exam.
Further, as twenty-four jurisdictions currently offer temporary licenses and permits, graduates of Florida schools are being enticed to leave the state to obtain immediate employment elsewhere in these high demand physical therapy provider positions.
The Solution: The unanimous passage of HB 799, by Rep. Goodson and Sen., Montford amends chapter 486, Florida Statutes, to allow Physical Therapy Program graduates of accredited programs, who are waiting to take the exam after graduation, to work under a temporary license permit. The legislation will also grant a similar license to physical therapist assistant graduates. Again, they would work under the direct supervision of a physical therapist. Similarly, if the exam is passed, they may continue working but cannot continue if the exam is failed.
Both temporary permit licenses are intended to help put graduates to work immediately in a profession that is in demand to serve our aging state population and to retain the graduates from our Florida institutions. The direct supervision relationship is already well established during final clinical education internships.
The Florida Department of Health, Division of Medical Quality Assurance, Florida Board of Physical Therapy, has reviewed this legislative proposal and supports authorization for the physical therapy and physical therapy assistant temporary permit licensees.
The Florida Medical Association has reviewed the bill and has no objection.
Accredited Physical Therapy Schools in Florida (Doctor of Physical Therapy)
Message:
E-Mail: http://www.flgov.com/contact-gov-scott/email-the-governor/
Mail: The Honorable Governor Rick Scott State of Florida PL 05, The Capitol 400 South Monroe Street, Tallahassee, Florida 32399-0001
Phone: (850) 488-4441
Dear Governor Scott:
Please accept this letter on behalf of myself and the nearly 5,000 practicing physical therapists, physical therapist assistants, and students in training who are members of the Florida Physical Therapy Association as a request that you sign into law HB 799 by Representative Tom Goodson, and Senate sponsor, Senator Bill Montford, regarding a temporary license for the practice of physical therapy.
The temporary license legislation would create a non-renewable temporary license valid for six months for recent graduates of accredited physical therapy schools. This will allow students from the schools of physical therapy in Florida to continue their on-the-job training, just as they trained as interns before graduation.
Much of the need for this legislation was generated by the fact that the Department no longer administers its own examination, but instead utilizes the national examination to demonstrate competency for physical therapy licensure. As such, graduates can wait up to three or four months before being allowed to sit for the examination, which is administered as few times as three per year, and will soon be offered up to five times per year.
The bill requires strict supervision on site by a licensed physical therapist and no physical therapist may supervise more than one temporary licensee at a time. The bill also provides physical therapy assistant graduates may receive a temporary license while, again, awaiting their opportunity to take the examination.
The Association believes that there are sufficient safeguards built into this law to protect the public while at the same time allowing the physical therapy grads to remain in Florida and be put to work serving clients who need physical therapy services. The legislation allows students the opportunity to begin their physical therapy practice in Florida without having to move to other states that currently allow temporary physical therapy practice.
In addition, the Department of Health Medical Quality Assurance Board of Physical Therapy supported establishment of temporary license. As the population of Florida ages, the need for physical therapy will continue to grow and the State must do everything it can to keep graduates of accredited institutions at home and working in Florida.
It is respectfully requested that you sign this legislation into law.
Signed,
Your name and address
Current Situation: The House of Representatives and Florida Senate passed HB 799 unanimously on Friday, March 9, 2012.
The Legislation is now headed to Governor Rick Scott for final action to be signed into law. On behalf of the FPTA, please begin contacting Governor Rick Scott and request that he Sign HB 799 into law.
The Problem: Due to national testing procedure changes adopted in 2011, the physical therapy exam in Florida is only given a limited number of times (3-5) each year and the seats are limited. Due to the change in testing procedures at the national level, Florida Physical Therapy Program graduates may wait three to four months after graduation to sit for the exam. This has created a backlog of graduates waiting to take the exam.
Further, as twenty-four jurisdictions currently offer temporary licenses and permits, graduates of Florida schools are being enticed to leave the state to obtain immediate employment elsewhere in these high demand physical therapy provider positions.
The Solution: The unanimous passage of HB 799, by Rep. Goodson and Sen., Montford amends chapter 486, Florida Statutes, to allow Physical Therapy Program graduates of accredited programs, who are waiting to take the exam after graduation, to work under a temporary license permit. The legislation will also grant a similar license to physical therapist assistant graduates. Again, they would work under the direct supervision of a physical therapist. Similarly, if the exam is passed, they may continue working but cannot continue if the exam is failed.
Both temporary permit licenses are intended to help put graduates to work immediately in a profession that is in demand to serve our aging state population and to retain the graduates from our Florida institutions. The direct supervision relationship is already well established during final clinical education internships.
The Florida Department of Health, Division of Medical Quality Assurance, Florida Board of Physical Therapy, has reviewed this legislative proposal and supports authorization for the physical therapy and physical therapy assistant temporary permit licensees.
The Florida Medical Association has reviewed the bill and has no objection.
Accredited Physical Therapy Schools in Florida (Doctor of Physical Therapy)
- Florida Agricultural and Mechanical University
- Tallahassee Florida Gulf Coast University
- Ft. Myers Florida International University
- Miami Nova Southeastern University
- Ft. Lauderdale - Davie & Tampa
- University of Central Florida - Orlando
- University of Florida - Gainesville
- University of Miami - Miami
- University of North Florida - Jacksonville
- University of South Florida - Tampa
- University of St Augustine for Health Sciences - St. Augustine
- Broward College - Coconut Creek
- Keiser University - Sarasota
- College of Central Florida - Ocala
- Miami Dade College - Miami
- Daytona State College - Daytona Beach
- Pensacola State College - Pensacola
- Florida Gateway College - Lake City
- Polk State College - Winter Haven
- Florida State College at Jacksonville - Jacksonville
- St. Petersburg College - St. Petersburg
- Gulf Coast State College - Panama City
- State College of Florida - Bradenton
- Herzing University - Winter Park
- South University - Tampa
- Indian River State College - Ft. Pierce
- South University - Royal Palm Beach
- Keiser University - Ft. Lauderdale
- Seminole State College of Florida - Altamonte Springs
Message:
E-Mail: http://www.flgov.com/contact-gov-scott/email-the-governor/
Mail: The Honorable Governor Rick Scott State of Florida PL 05, The Capitol 400 South Monroe Street, Tallahassee, Florida 32399-0001
Phone: (850) 488-4441
Dear Governor Scott:
Please accept this letter on behalf of myself and the nearly 5,000 practicing physical therapists, physical therapist assistants, and students in training who are members of the Florida Physical Therapy Association as a request that you sign into law HB 799 by Representative Tom Goodson, and Senate sponsor, Senator Bill Montford, regarding a temporary license for the practice of physical therapy.
The temporary license legislation would create a non-renewable temporary license valid for six months for recent graduates of accredited physical therapy schools. This will allow students from the schools of physical therapy in Florida to continue their on-the-job training, just as they trained as interns before graduation.
Much of the need for this legislation was generated by the fact that the Department no longer administers its own examination, but instead utilizes the national examination to demonstrate competency for physical therapy licensure. As such, graduates can wait up to three or four months before being allowed to sit for the examination, which is administered as few times as three per year, and will soon be offered up to five times per year.
The bill requires strict supervision on site by a licensed physical therapist and no physical therapist may supervise more than one temporary licensee at a time. The bill also provides physical therapy assistant graduates may receive a temporary license while, again, awaiting their opportunity to take the examination.
The Association believes that there are sufficient safeguards built into this law to protect the public while at the same time allowing the physical therapy grads to remain in Florida and be put to work serving clients who need physical therapy services. The legislation allows students the opportunity to begin their physical therapy practice in Florida without having to move to other states that currently allow temporary physical therapy practice.
In addition, the Department of Health Medical Quality Assurance Board of Physical Therapy supported establishment of temporary license. As the population of Florida ages, the need for physical therapy will continue to grow and the State must do everything it can to keep graduates of accredited institutions at home and working in Florida.
It is respectfully requested that you sign this legislation into law.
Signed,
Your name and address
Friday, March 2, 2012
The Fight for Fair CoPays in PT in Motion
We've addressed physical therapist co-payments on this blog before:
Now, the flagship trade magazine of the American Physical Therapy Association has picked up the torch in the March 2012 issue of PT in Motion, The Fight for Fair CoPays.
Its worth reading no matter what setting you work in.
For those of you in Florida, the Florida Physical Therapists in Private Practice have prepared a special White Paper on the CoPay issue which will be available to members.
Contact the FLPTPP website for more details.
Get informed.
If CoPay legislation hasn't come to your state yet it may be coming soon.
Physical therapists' patients need CoPay legislation.
Now, the flagship trade magazine of the American Physical Therapy Association has picked up the torch in the March 2012 issue of PT in Motion, The Fight for Fair CoPays.
Its worth reading no matter what setting you work in.
For those of you in Florida, the Florida Physical Therapists in Private Practice have prepared a special White Paper on the CoPay issue which will be available to members.
Contact the FLPTPP website for more details.
Get informed.
If CoPay legislation hasn't come to your state yet it may be coming soon.
Physical therapists' patients need CoPay legislation.
Monday, February 6, 2012
Six Foods to Help You Recover More Quickly after an Injury
All-natural, whole foods are the basis of any healthy diet. In addition to providing the nutrients needed for basic health and wellness, these foods also help to fight disease, prevent infection, and even help the body repair itself after an injury.
Whether your injury was sustained through an accident or from working out, there are many foods that you can incorporate into your diet to speed recovery. Here are a few of the best foods to help you recover more quickly after an injury:
About the Author: Bridget Sandorford is a grant researcher and writer for CulinarySchools.org. Along with her passion for whipping up recipes that incorporate “superfoods”, she recently finished research on California Culinary Schools and Culinary Arts Schools in Florida.
Whether your injury was sustained through an accident or from working out, there are many foods that you can incorporate into your diet to speed recovery. Here are a few of the best foods to help you recover more quickly after an injury:
- Pineapple - This tropical fruit contains an enzyme called bromelain that helps to fight pain and reduce inflammation in the body. Eat plenty of fresh pineapple to help heal injuries. Add pineapple to smoothies, eat it whole for breakfast or a snack, or use it as a salad topper. There are many more ways to enjoy this delicious fruit.
- Berries - Strawberries, blueberries, raspberries, blackberries and goji berries are all nutritional powerhouses that are loaded with antioxidants that help reduce inflammation and reverse cell damage. Berries also improve circulation and strengthen collagen. Choose fresh and whole versions of the fruit, rather than juices or frozen berries. You can add them to smoothies, muffins, breakfast cereals, granola, and more, or you can enjoy them plain as a snack.
- Ginger - Ginger has been shown to help all kinds of ailments in the body, including fighting the flu, relieving nausea, and improving digestion. It has also been shown to reduce muscle pain. Enjoy ginger tea or snack on crystallized, candied ginger for a sweet snack. You can also add it to stir fries or soups for a more savory treat.
- Mango - Here's another delicious tropical fruit that helps to reduce inflammation in the body. Enjoy it as you would other fruits, by adding it to smoothies, salads, or breakfast dishes. You can even get creative and turn it into a salsa or throw it into a stir fry.
- Protein - Protein is the building block of muscles. It helps to enhance glycogen stores and to rebuild muscle tissue, speeding recovery. Choose lean sources of protein, such as fish, poultry, and beans. When choosing meats, select sources that have been grass-fed or wild caught.
- Raw Foods - Raw foods contain living enzymes that encourage cellular regeneration and help to fight inflammation in the body. Eating foods in their raw form also ensures that nutrients are not destroyed in the cooking process, allowing your body to get the greatest benefit from them. Meats and dairy should not be consumed raw as bacteria can cause illness. However, raw fruits and vegetables should be consumed in large quantities each day for optimal health. Even some grains can be sprouted and eaten raw.
About the Author: Bridget Sandorford is a grant researcher and writer for CulinarySchools.org. Along with her passion for whipping up recipes that incorporate “superfoods”, she recently finished research on California Culinary Schools and Culinary Arts Schools in Florida.
Tuesday, January 31, 2012
California and Florida Physical Therapy Bills Move Forward
Physical therapists across the United States have gotten off to a fast start in 2012, as evidenced by two bills moving forward in California and in Florida.
California Senate bill SB 924 allows consumers to go directly to a physical therapist for treatment without first going through their doctor.
Senator Curren Price's bill was approved unanimously Monday, January 30th, 2012.
The Senate bill is a compromise bill that requires a therapist to refer a patient to doctors if the therapist learns that the patient needs medical attention.
It also requires the therapist to get a doctor's approval if the therapy goes beyond 12 visits or 30 business days.
Previous versions of the bill were opposed by the politically powerful California Medical Association (CMA). The CMA has not taken a position on the new compromise bill. The bill now goes to the California State Assembly.
Also, congratulations to the Florida Physical Therapy Association (FPTA) which scored an impresive victory Tuesday, January 17, 2012 as HB 799, the physical therapy temporary license bill by Rep. Tom Goodson passed out of its first committee of reference.
HB 799 by Rep. Goodson amends chapter 486, Florida Statutes, to allow Physical Therapy graduates of accredited programs, who are waiting to take the exam after graduation, to work under a temporary license permit.
The graduate would work under the direct supervision of a physical therapist while working (in the same room) and could only function in this temporary capacity until the results of the first exam are known. A licensed physical therapist may only supervise one temporary licensee permit at a time.
If the graduate with a temporary permit passes, they can continue working under the temporary permit until the permanent license is issued. If the graduate fails the exam, the temporary license is revoked and they may not work until passing the exam.
The legislation will also grant a similar license to physical therapist assistant graduates. Again, they would work under the direct supervision of a physical therapist. Similarly, if the exam is passed, they may continue working but cannot continue if the exam is failed.
California Senate bill SB 924 allows consumers to go directly to a physical therapist for treatment without first going through their doctor.
Senator Curren Price's bill was approved unanimously Monday, January 30th, 2012.
The Senate bill is a compromise bill that requires a therapist to refer a patient to doctors if the therapist learns that the patient needs medical attention.
It also requires the therapist to get a doctor's approval if the therapy goes beyond 12 visits or 30 business days.
Previous versions of the bill were opposed by the politically powerful California Medical Association (CMA). The CMA has not taken a position on the new compromise bill. The bill now goes to the California State Assembly.
Also, congratulations to the Florida Physical Therapy Association (FPTA) which scored an impresive victory Tuesday, January 17, 2012 as HB 799, the physical therapy temporary license bill by Rep. Tom Goodson passed out of its first committee of reference.
HB 799 by Rep. Goodson amends chapter 486, Florida Statutes, to allow Physical Therapy graduates of accredited programs, who are waiting to take the exam after graduation, to work under a temporary license permit.
The graduate would work under the direct supervision of a physical therapist while working (in the same room) and could only function in this temporary capacity until the results of the first exam are known. A licensed physical therapist may only supervise one temporary licensee permit at a time.
If the graduate with a temporary permit passes, they can continue working under the temporary permit until the permanent license is issued. If the graduate fails the exam, the temporary license is revoked and they may not work until passing the exam.
The legislation will also grant a similar license to physical therapist assistant graduates. Again, they would work under the direct supervision of a physical therapist. Similarly, if the exam is passed, they may continue working but cannot continue if the exam is failed.
Wednesday, January 25, 2012
Psst! Want a HOT tip? Form your own Physical Therapist Association...
All kidding aside, newly formed physical therapist associations seem to be a growth industry lately.
Full disclosure, I am on the Board of Directors of the Florida Physical Therapists in Private Practice (FLPTPP).
However, I do not belong to any of the following:
Some of these groups, like the NJSIPT, have their own Political Action Committee (PAC) for soliting contributions. Will that decrease contributions to traditional physical therapist associations?
No, I don't think it will. There are more PACs in existence in 2012 than EVER in history and this Presidential election will require EACH political party to raise $1 BILLION dollars to field a candidate.
Does the presence of seperate groups confuse legislators who may be used to just one PT group per state?
No, just look at the physicians' societies - in Florida we have the following:
Not as long as the money keeps flowing! :)
Full disclosure, I am on the Board of Directors of the Florida Physical Therapists in Private Practice (FLPTPP).
However, I do not belong to any of the following:
- Physical Therapy Business Alliance (PTBA)
- Physical Therapy Alliance of Upstate New York (PTAUNY)
- New Jersey Society of Independent Physical Therapists (NJSIPT)
"While our profession has successful organizations of "individuals" (American Physical Therapy Association, Sections of the Association, Components), a void exists in which the professional interests of physical therapy can be championed as businesses."These three groups are organized to support the business activities of private practice physical therapy clinics. According to the PTAUNY website:
"The purpose of this organization was and is to keep the private practice owners and therapists informed of local and national trends, promote our practice, provide continuing education opportunities and communicate with local third party payers on issues that affect the services we provide."The common thread of all three groups seems to be declining reimbursement and an inability of private practice physical therapists to act collectively. especially when negotiating third party insurance contracts. According to the FLPTPP website:
"... we will assist our members to control their financial well-being through improved reimbursement, sharing of expertise & best practices, and volume purchasing power."While some traditional physical therapist organizations may feel stifled by these newly-formed groups, I think there is still plenty of oxygen left in the room.
Some of these groups, like the NJSIPT, have their own Political Action Committee (PAC) for soliting contributions. Will that decrease contributions to traditional physical therapist associations?
No, I don't think it will. There are more PACs in existence in 2012 than EVER in history and this Presidential election will require EACH political party to raise $1 BILLION dollars to field a candidate.
Does the presence of seperate groups confuse legislators who may be used to just one PT group per state?
No, just look at the physicians' societies - in Florida we have the following:
- 1 Florida Medical Association
- 17 sub-specialty physician asosciations (eg: orthopedics, family practice, etc.) AND
- 67 county medical societies, one for each of the Florida counties.
Not as long as the money keeps flowing! :)
Monday, January 23, 2012
Florida Temporary Licensure - From a Ripple to a Wave
Fast forward to January 16th, 2012—myself, some close peers, and colleagues in Physical Therapy are attending the Advocacy Forum put on by the Florida Physical Therapy Association (FPTA) in Tallahassee, Florida.
The 2012 FPTA Advocacy Forum was a success.
The forum allowed students and clinicians to learn more about the political process, how to advocate for our profession culminating with attendees having the opportunity to observe our own bill navigate a key House committee.
The bill passed unanimously in the Health and Human Services Quality sub-committee. The advancement of our bill that day has created a ripple effect. The result forwards the ultimate goal of allowing new graduates to practice while waiting to sit for board exams, but also splashes into important directions relating to the association’s future.
Equally important is the impact on the dozen physical therapy students in attendance at the capital in concert with the excitement from those students still in class on the home front who were kept notified through social media. Representing the future of the profession, we have truly seen democracy at work . . . .SO EXCITING.
Temporary licensure was re-exposed by a student this September to the FPTA in Orlando at a district caucus during the association’s annual conference. At the general assembly gathering the next day, University of St. Augustine students were recognized for raising $1000 for PT-PAC. Soon thereafter we each witnessed the organization quickly vote in support to pursue the legislature. Furthermore, not only did students witness their dollars at work, the receptiveness by the practicing clinicians to the idea served as justification and encouragement to students who do not think their voice could be heard. It further served as validation to those individuals who moan and grumble on the fees for FPTA/APTA membership they pay.
Here we are today, spearheaded by young professionals who juggle the rigors of doctoral education and sacrifice valuable study time (more importantly free time) to advocate for their trade. I felt as proud as when I had received my acceptance letter to PT school as the number of students at the advocacy forum exceeded the amount of practicing clinicians.
Thank you for making a difference.
The undulation of the Temporary Licensure stone thrown into the pool of politics is further seen in the development of the organization’s relationship with Tallahassee. We have made headway not only with our sponsors in the House (Rep. Tom Goodson) and in the Senate (Senator Bill Montford), but also with Doctor of Osteopathic Medicine Ronald Renuart, the vice chair of the Health and Human Services Quality Subcommittee. Eric Chaconas, PT, DPT, FAAOMPT and I were introduced to “Doc” Renuart in Jacksonville last fall.
The receptiveness from Representative Renuart that day left me feeling that the FPTA would have a tough road ahead of them. However; Rep. Renuart was in full support of our bill on Tuesday arguing that Florida produces great physical therapists and we need to keep them here!
Anything is possible. We need to keep the swell that we have created this January 2012 session from turning into a tsunami headed in our own direction.
The day was a success. I am not looking at the glass optimistically as if it were half full. I am certainly not looking at the glass pessimistically as if it were half empty. I am however looking at the glass opportunistically; to drink it. Simply put, as a member of the FPTA, we need to evaluate and reflect our triumphs and mishaps. The organization, location, and presentations given during the advocacy training were terrific. Awesome hotel, food, excellent support information, and presentations that were interesting, helpful, and informative.
However, our sponsor in the House thought we were massage therapists. At one point, I had to explain to him that physical therapists were to bones and muscles as dentists were to gums and teeth so he would stop raving about the massages he has had before. He was good for a non-controversial issue, but what about direct access or dry needling? He clearly did not know the field.
There were many questions that could have been anticipated (dates, how it was before, why tests dates) but had to be answered by several different individuals because one could not fully articulate the nuances of our field. In fairness, legislators are bombarded with issues from hundreds of fields; the education of our elected officials is our job. The advancement of our bill that day has created a ripple effect that shouldn’t be left unrecognized.
I read a blog by Mike Reinold, a physical therapist that I hope to meet someday, and Head Athletic Trainer/Assistant Director of Medical Services for the Boston Red Sox. The article highlighted the common adage used in physical therapy called the “kinetic chain.” Dr. Reinold’s focal point was that far too often the body is more analogous to a ripple in the water with some parts not following the notion “a chain is only as strong as its weakest link”. He noted that the body follows a “kinetic ripple.”
My extreme love for Anatomy and Biomechanics was put on the back burner, for I found the ripple synonymous with our progress in the state capital on January 17th. I was intrigued in that the correlation heads in all directions. Perhaps we can all look further into Temporary licensure in that not only does the legislation create jobs for new graduates, but also lays the foundation for the future of young practitioners, their involvement, and the success for the organization at the Capital. FPTA staff, students and clinicians…stay diligent, because you never know what’s over the next wave.
Leighton Peavler, SPT, FPTA, GAC
Student Representative, University of St. Augustine for Health Sciences
For comments and questions, please do not hesitate to contact Leighton at LeightonPeavler@gmail.com
Saturday, January 21, 2012
Why Politics Is Important to Physical Therapists
Congratulations to Eric Chaconas, DPT of the Florida Government Affairs Committee and and Scott Harp, PhD Vice President of the Florida Physical Therapy Association for hitting their attendance goals for the 2012 Florida State Advocacy Training program in Tallahassee on January 16 and 17, 2012.
Thirty five physical therapists and physical therapist assistants attended and the 2012 Advocacy Day was a HUGE success!
I highly recommend Charles Krauthhamer's excellent article in the Washington Post on December 30th which asks Are We Alone in the Universe?
Don't worry, its not science fiction - rather, Krauthhamer posits that politics is the driver of history and the organizer of our affairs:
Thirty five physical therapists and physical therapist assistants attended and the 2012 Advocacy Day was a HUGE success!
"FPTA members were treated to visits during the Advocacy Workshop by both Senator Montford and Rep. Goodson who offered praise and strong support for physical therapist and students taking time to travel to Tallahassee to advocate for their profession.
“The perfect lobbyist for the physical therapy profession is physical therapists and your students in training,” said Senator Montford.Why is politics important for the physical therapist?
I highly recommend Charles Krauthhamer's excellent article in the Washington Post on December 30th which asks Are We Alone in the Universe?
Don't worry, its not science fiction - rather, Krauthhamer posits that politics is the driver of history and the organizer of our affairs:
"This is the work of politics — understood as the ordering of society and the regulation of power to permit human flourishing while simultaneously restraining the most Hobbesian human instincts.
There could be no greater irony: For all the sublimity of art, physics, music, mathematics and other manifestations of human genius, everything depends on the mundane, frustrating, often debased vocation known as politics (and its most exacting subspecialty — statecraft).
Because if we don’t get politics right, everything else risks extinction.
We grow justly weary of our politics. But we must remember this: Politics — in all its grubby, grasping, corrupt, contemptible manifestations — is sovereign in human affairs. Everything ultimately rests upon it.
Fairly or not, politics is the driver of history."
Tuesday, January 10, 2012
Florida Legislative Session Opens Today!
Florida physical therapists get ready to lobby!
The start of the 2012 Florida Legislative session is today, January 10th, 2012.
Physical therapists can learn to set up their Bill Tracker with the Florida Senate video and with the Florida House of Representatives video, below.
2:03 min.
If you've never so much as picked up a phone to call your legislator then this may be YOUR year.
The Florida Physical Therapy Association (FPTA) is committed to helping you organize at the grassroots level.
Go to their web site at FPTA.org and find out how you can get invloved.
Watch this video and sign up for Bill Tracker to get started.
The start of the 2012 Florida Legislative session is today, January 10th, 2012.
Physical therapists can learn to set up their Bill Tracker with the Florida Senate video and with the Florida House of Representatives video, below.
2:03 min.
If you've never so much as picked up a phone to call your legislator then this may be YOUR year.
The Florida Physical Therapy Association (FPTA) is committed to helping you organize at the grassroots level.
Go to their web site at FPTA.org and find out how you can get invloved.
Watch this video and sign up for Bill Tracker to get started.
Wednesday, November 16, 2011
Medicare Discusses New, Unpublished CERT Error Rates Affecting Physical Therapists in Florida
I just sat in on the quarterly Medicare First Coast Service Options (FCSO) Provider Outreach and Education Advisory Group, Part B (POE AG - B) conference call which revealed the newest, unpublished data on physical therapy practices in Florida.
The Medicare TOP PRIORITY for Florida is reducing their CERT error rate which at this time stands at an ALL TIME HIGH of 14.5%.
Most important, the number one cause of this high error rate is INSUFFICIENT DOCUMENTATION.
Specifically, 81% of the CERT error rate was due to one of the following:
Physical therapists can improve their documentation using some simple tools:
The Medicare TOP PRIORITY for Florida is reducing their CERT error rate which at this time stands at an ALL TIME HIGH of 14.5%.
Most important, the number one cause of this high error rate is INSUFFICIENT DOCUMENTATION.
Specifically, 81% of the CERT error rate was due to one of the following:
- The written Plan of Care was not included
- The Progress Notes did not include reasons for continuing therapy.
- No daily treatment notes
- No physician certification of the Plan of Care
Physical therapists can improve their documentation using some simple tools:
- Use graphic displays of patient functional progress
- Use the FCSO Interactive Worksheet to understand what documentation is required for Medically Necessary services.
- Consider additional justification statements when the physical therapy services exceed the initial treatment period, typically one month.
Wednesday, March 16, 2011
Key Contacts Important for Physical Therapist Advocates
"They'll take your money!" said the Senator.
He laughed as he stepped into the elevator. We joined in the laughter, aware of the power differential he created and agreeing with the truth of his words.
"Everybody's up here in Tallahassee playing defense. Even if you physical therapists have nothing on the table this session you need to stay involved."
He was tutoring us now. We remained silent and nodded respectfully.
I was standing next to my former employee and the current owner of three outpatient physical therapy clinics in Bradenton, Florida. I own one clinic. Together, our combined ages just matched the Senator's age.
The Senator knew us from visits to his office back in the district. He was always cordial but I had seen him show a healthy distrust of medical professionals - his construction business paid heavy workers' compensation premiums every year and Medicaid fraud-busting was his top priority.
Could we persuade him to see physical therapists differently?
"The papers keep saying you will run for one of Florida's two open Congressional seats in 2012?" I said
"My wife wants me to retire - but I'm having a great time!"
The Senator got off the elevator to go to his committee meeting. "See you boys later!" he said over his shoulder.
Being a Key Contact
Physicians have more money than physical therapists and chiropractors have been a political force in Florida for longer than I have been alive.
So, what can physical therapists bring to compete with dollars and political precedence?
Compelling stories and a genuine focus on the patient.
Physical therapists can tell stories about helping people walk after devastating accidents. Or, we can describe simple, safe interventions that enable people to live independently - all without drugs or surgery.
Witness the effect of stories and a genuine patient focus on this improbable political victory by Larry Benz, DPT and a determined grassroots effort in Kentucky:
The Legislature is divided into two houses. The House of Representatives and the Senate make laws that govern Florida. There are 120 members of the House of Representatives and 40 members of the Senate.
We need your help.
If you have considered helping your professional association and you feel that you could share your patients' successful stories or speak up for the profession please contact Eric Chaconas, DPT to be added to the list of Florida's Key Contacts.
He laughed as he stepped into the elevator. We joined in the laughter, aware of the power differential he created and agreeing with the truth of his words.
"Everybody's up here in Tallahassee playing defense. Even if you physical therapists have nothing on the table this session you need to stay involved."
He was tutoring us now. We remained silent and nodded respectfully.
I was standing next to my former employee and the current owner of three outpatient physical therapy clinics in Bradenton, Florida. I own one clinic. Together, our combined ages just matched the Senator's age.
The Senator knew us from visits to his office back in the district. He was always cordial but I had seen him show a healthy distrust of medical professionals - his construction business paid heavy workers' compensation premiums every year and Medicaid fraud-busting was his top priority.
Could we persuade him to see physical therapists differently?
"The papers keep saying you will run for one of Florida's two open Congressional seats in 2012?" I said
"My wife wants me to retire - but I'm having a great time!"
The Senator got off the elevator to go to his committee meeting. "See you boys later!" he said over his shoulder.
Being a Key Contact
Physicians have more money than physical therapists and chiropractors have been a political force in Florida for longer than I have been alive.
So, what can physical therapists bring to compete with dollars and political precedence?
Compelling stories and a genuine focus on the patient.
Physical therapists can tell stories about helping people walk after devastating accidents. Or, we can describe simple, safe interventions that enable people to live independently - all without drugs or surgery.
Witness the effect of stories and a genuine patient focus on this improbable political victory by Larry Benz, DPT and a determined grassroots effort in Kentucky:
"Get organized, be bold, and go for it.Physical therapists are not natural political operators - that's what makes us stand out in a positive way in places like Tallahassee.
PT's don't go in front of legislators very often and when we do we have great patient testimonies, empirical evidence, and a host of intangibles that at the end of the day are easy to understand and resonate with many.
While you can never underestimate the power of the political process, you can prevail."
The Legislature is divided into two houses. The House of Representatives and the Senate make laws that govern Florida. There are 120 members of the House of Representatives and 40 members of the Senate.
We need your help.
If you have considered helping your professional association and you feel that you could share your patients' successful stories or speak up for the profession please contact Eric Chaconas, DPT to be added to the list of Florida's Key Contacts.
Tuesday, December 29, 2009
Merry Christmas from First Coast Service Options
Physical therapists have been given the 'gift' of maintenance therapy on some patients.
This 'gift' comes wrapped in bureaucratic gobbledeegook but is still an improvement over the dogmatic, no-way, no-how ban on maintenance therapy paid by Medicare that existed prior to February 2, 2009. (note: the FCSO primary geographic jurisdiction is only in the state of Florida)
Skilled Maintenance Therapy for Safety
The specific reference is located on pages 21-22 of the FCSO Local Coverage Determination.
I'll give you an example of the garbled way in which Medicare makes known it's intent:
However, the LCD goes on to say:
If strengthening/confidence building exercises to prevent falls could be construed as maintenance, then these services seem to fit the new definition of 'Skilled Maintenance Therapy for Safety'.
It even seems appropriate to set goals for these 'feeble and unstable' patients such as 'No reported falls in 30 days' to measure the impact of our intervention.
Come to think of it, if I've assessed falls risk, constructed goals, designed an exercise plan of care and attempted to measure the impact then maybe I should just treat these people.
Does anybody else read this LCD the way I do?
Maybe next year I'll ask Santa for the gift of gobbledeegook.
This 'gift' comes wrapped in bureaucratic gobbledeegook but is still an improvement over the dogmatic, no-way, no-how ban on maintenance therapy paid by Medicare that existed prior to February 2, 2009. (note: the FCSO primary geographic jurisdiction is only in the state of Florida)
Skilled Maintenance Therapy for Safety
The specific reference is located on pages 21-22 of the FCSO Local Coverage Determination.
I'll give you an example of the garbled way in which Medicare makes known it's intent:
"If the services required to maintain function involve the use of complex and sophisticated therapy procedures, the judgment and skill of a therapist may be necessary for the safe and effective delivery of such services.The most obvious example in outpatient PT would have us treating patients at risk for, say, falling down in the home - even if the interventions might be construed as low level, 'unskilled' treatments.
When the patient’s safety is at risk, those reasonable and necessary services shall be covered even if the skills of a therapist are not ordinarily needed to carry out the activities preformed as part of the maintenance program."
However, the LCD goes on to say:
"It is not medically necessary for a therapist to perform or supervise maintenance programs that do not require the professional skills of a therapist.The LCD seems to contradict itself: If assessment of falls risk is "complex and sophisticated" then they are skilled.
These situations include: (among others)...repetitive exercises to maintain gait or maintain strength and endurance, and assisted walking, such as that provided in support for feeble and unstable patients."
If strengthening/confidence building exercises to prevent falls could be construed as maintenance, then these services seem to fit the new definition of 'Skilled Maintenance Therapy for Safety'.
It even seems appropriate to set goals for these 'feeble and unstable' patients such as 'No reported falls in 30 days' to measure the impact of our intervention.
Come to think of it, if I've assessed falls risk, constructed goals, designed an exercise plan of care and attempted to measure the impact then maybe I should just treat these people.
Does anybody else read this LCD the way I do?
Maybe next year I'll ask Santa for the gift of gobbledeegook.
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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.