2011 Proposed Physician Fee Schedule Rule Contains Proposed Pay Cuts for Outpatient Therapy Services
As reported by APTA.org, the Centers for Medicare & Medicaid Services (CMS) issued the proposed physician fee schedule rule that would implement key provisions of the Patient Protection and Affordable Care Act of 2010 and update payment rates under the physician fee schedule for services furnished on or after January 1, 2011 (CY 2011).
If this rule becomes effective, physicians, physical therapists and other health care professionals would receive a 6.1% cut to their Medicare payments starting January 1, 2011 in addition to the 21.3% reduction that has been delayed several times already this year due to the flawed Sustainable Growth Rate (SGR) formula. This reduction was replaced with a 2.2% update until November 30, 2010, when the President signed the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010″ on Friday, June 25.
In addition to the projected reductions due to the SGR, CMS also proposes a multiple procedure payment reduction policy (MPPR) that would result in significant reductions in payment for outpatient therapy services. Specifically, CMS proposes to make full payment for the therapy service or unit with the highest practice expense value and payment of 50 percent of the practice expense component for the second and subsequent procedures or units of the service furnished during the same day for the same patient. The work and malpractice components of the therapy service payment would not be reduced. The proposed multiple procedure payment reduction policy would apply to both the services paid under the physician fee schedule (PFS) that are furnished in the office setting and those services paid at the PFS rates that are furnished by outpatient hospitals, home health agencies (Part B), skilled nursing facilities (Part B), comprehensive rehabilitation facilities, and other entities that are paid by Medicare for outpatient therapy services. It is estimated that if the multiple procedure payment reduction policy were implemented, payment for outpatient therapy services would be reduced by approximately 13% in addition to the projected SGR payment cut for CY 2011.
The APTA believes that CMS’s proposal to apply the multiple procedure payment reduction to outpatient therapy services is based on flawed presumptions and has no justification. The APTA states that it will aggressively work to stop implementation of the proposed MPPR policy and the SGR payment reductions.
Flow sheets are one form of documentation used by physical therapists in the daily notes for patient care. They provide a format for documenting exercises, repetitions and weights.
In Chart Links’ Rehabilitation Software, flow sheets provide electronic management of clinical data entry and review of patient progress over time. Flow sheets can accommodate multi-disciplinary documentation requirements and may be linked to progress notes and charges.
Visit the Chart Links website for more information about electronic physical therapy documentation.
The American Occupational Therapy Association (AOTA), which represents the professional interests and concerns of more than 140,000 occupational therapists, assistants and students nationwide, released the following statement in response to First Lady Michelle Obama’s “Let’s Move” campaign, which aims to solve the epidemic of childhood obesity within a generation.
Dear Mrs. Obama,
The American Occupational Therapy Association (AOTA) supports primary, secondary, and tertiary prevention for the management of obesity. AOTA is firmly dedicated to promoting community health, increasing life expectancy, and improving the quality of life for all people. As such, we were thrilled to hear about your ambitious “Let’s Move” campaign.
As you already know, one-third of U.S. children and adolescents are overweight or obese. Obesity is the leading modifiable risk factor contributing to early mortality; type 2 diabetes; cardiovascular disease; metabolic syndrome; breast, prostate, and colon cancer; gallbladder disease; sleep apnea; musculoskeletal disorders; and associated limitations in physical activity.
Our current brand, “Living Life To Its Fullest™,” promotes the profession’s comprehensive approach to health, which covers psychosocial, physical, cognitive, and environmental barriers to full participation in life activities.
Within the United States, millions of people struggle and fail to achieve a healthy weight using current methods. However, occupational therapy’s holistic and unique focus on occupation and daily life activities offers structured intervention and support for the management of obesity across the life span regardless of ability. As practitioners, we enable people – of all ages – to live life to its fullest and will stand by you during this campaign to provide education and awareness about solutions to obesity.
Founded in 1917, the American Occupational Therapy Association (AOTA) represents the professional interests and concerns of more than 140,000 occupational therapists, assistants and students nationwide. The Association educates the public and advances the profession of occupational therapy by providing resources, setting standards including accreditations and serving as an advocate to improve health care. Based in Bethesda, Md., AOTA’s major programs and activities are directed toward promoting the professional development of its members and assuring consumer access to quality services so patients can maximize their individual potential.