In The News

APTA, Lawmakers Press for Payment Relief by March 11 Deadline

Remember that old saying, "strike while the iron is hot"? Things are hot on Capitol Hill (and there's still time to act).

With a March 11 deadline looming for passage of legislation to keep the federal government running, APTA and other organizations are pressing lawmakers to include two major initiatives that could have a significant impact on payment for physical therapy: continuation of the pause placed on so-called sequestration cuts, and inclusion of a bill that would address the PTA payment differential system.

The most recent advocacy efforts come by way to two letters sent to Congress that spell out the need for relief — one on the sequester cuts signed by 50 professional and patient organizations, another on the PTA and occupational therapy assistant differential from six bipartisan members of the U.S. House of Representatives. Though aimed at different topics, the letters share the common theme that now is not the time to squeeze providers and threaten patient access to care.

Both letters arrive on Capitol Hill just as lawmakers stare down a March 11 deadline to craft a spending package to keep the government running.

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Outpatient Therapy Medicare Physician Fee Schedule Calculator

APTA's outpatient therapy fee schedule spreadsheet helps you determine your payment for services under Medicare.

The APTA Medicare Physician Fee Schedule calculator incorporates the 50% multiple procedure payment reduction for values under the Medicare physician fee schedule and applies the overall 2% sequestration cut on Medicare payments as well as the Merit-based Incentive Payment System adjustment factor (beginning in 2021).

The calculator provides participating as well as nonparticipating provider fee calculations, and allows providers to compare the current year’s payment rate with the previous year’s payment rate.

Click here to read more. 

 

What is Long Covid? Current Understanding About Risks, Symptoms and Recovery

Washington Post | By Allyson Chiu

The condition known as long covid continues to frustrate its sufferers, baffle scientists and alarm people who are concerned about being infected by the coronavirus. The term, a widely used catchall phrase for persistent symptoms that can range from mild to debilitating and last for weeks, months or longer, is technically known as Post-Acute Sequelae of SARS-CoV-2 infection, or PASC. But scientists say much remains unknown about long covid, which is also referred to colloquially as “long-haul covid,” “long-term covid,” “post-covid conditions” and “post-covid syndrome,” among other names.

“This is a condition that we don’t even have an agreed upon name for yet, and we don’t have any understanding really of what’s going on down at a chemical level,” said Greg Vanichkachorn, medical director of Mayo Clinic’s COVID-19 Activity Rehabilitation Program. “So, until we have that kind of understanding, it’s really important that we not make quick decisions about what long covid can or can’t be.”

Read more @ Washington Post

 

CDC Peels Off Mask Recommendations for Most U.S. Counties

MedPage Today | By Molly Walker

After much speculation, CDC unveiled its new criteria on Friday [February 25, 2022] for masking throughout communities based on healthcare indicators, where only 30% of the country would currently be recommended to wear a mask.

These metrics are a combination of new hospital admissions, hospital bed utilization for COVID patients, as well as incidence of cases in a community, combined to indicate either a low risk (green), medium risk (yellow), or high risk (orange) of severe disease in a particular county.

By the most current CDC data, this means that only 28.2% of the population lives in a high-risk county, though 37.3% of U.S. counties would be classified as high-risk. About 40% of counties are classified as medium risk (containing 42% of the nation's population), while 23% are classified as low risk (29.5% of the population).

Read more @ MedPage Today

 

Medicare Advantage Benefits in 2022 Target Home as a Setting, Diabetes as a Condition

Home Health Care News

Medicare Advantage (MA) supplemental benefits adoption has been slow by some measures and rapid by others. 

A new report from the consulting firm Milliman offers a look into that dynamic and shows exactly where each of those benefits stands in 2022.

Among the primarily-health related benefits, in-home support services (IHSS) remains the most popular benefit by a large margin. Meanwhile, adult day service offerings have actually fallen off from 2021.

As for the Special Supplemental Benefits for the Chronically Ill (SSBCI), the services that home care agencies can provide also remain the most popular. Those include the food and produce, meals beyond a limited basis, non-medical transportation and general supports for living offerings.

IHSS can be offered through both the primarily-health related and SSBCI pathways. The benefit has seen significant uptick over the last couple years. Now, 544 plans are offering it, a 268% increase from the 148 plans that offered IHSS in 2020.

“That’s really significant growth from when this was first available as a benefit,” Tyler Cromer, a principal for ATI Advisory, told Home Health Care News when initial MA benefits data for 2022 was first released. “There’s a lot of good news here for home care providers.”

As for adult day services, it’s drop in popularity among plans could be due to a few reasons. In 2021, 88 plans offered the benefit, up from 63 in 2020. But in 2022, just 42 plans are on board with the benefit.

Adult day services were hit hard by COVID-19 over the past two years. For long periods of time, operators in a lot of states were not even allowed to open and struggled to stay afloat.

Additionally, because MA plans are still experimenting with supplemental benefits, the amount of hours they pay for – for any given service – is sometimes meager. With that in mind, the benefit may not be worth it right now for either side – provider or MA plan.

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