In the News

Technical Expert Panel Nominations

Posted: January 6, 2020

The Centers for Medicare and Medicaid Services (CMS) is seeking nominees to serve on 2 different technical expert panels that are of relevance to the physical therapy profession:

1. Technical expert panel to develop days at home quality measure
2. Technical expert panel to develop functional outcome quality measures for the home health setting

APTA would like to nominate members to serve on these TEPs. Members can find information about both opportunities, including the time commitment, by clicking on each TEP above and logging in to view details. Please contact the Director of Regulatory Affairs, Kara Gainer ([email protected]), as soon as possible if you or someone you know would to be considered for nomination for either TEP. 



The CMS is Seeking Feedback

Posted: January 6, 2020

The Centers for Medicare and Medicaid Services (CMS) announced that it is seeking additional feedback regarding elimination of Medicare regulations that require stricter supervision compared to state scope of practice laws, or that limit health professionals from practicing at the top of their license.

CMS is seeking this feedback in response to the President’s Executive Order (EO) on Protecting and Improving Medicare for our Nation’s Seniors. The EO directs the Secretary of Health and Human Services (HHS) to propose reforms to the Medicare program, including changes that eliminate supervision and licensure requirements of the program that are “more stringent than other applicable federal or state laws.” CMS emphasized that these requirements limit healthcare professionals.  

CMS also continues to welcome input on ways in which CMS can reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience. I have attached the press release for more information.

We are encouraging all physical therapists, physical therapist assistants, and physical therapy students to send their thoughts and comments to APTA’s Director of Regulatory Affairs, Kara Gainer, at [email protected] by Friday, January 10, 2020 so that we may incorporate such feedback into APTA’s comment letter to CMS.

In addition, in the coming days, APTA will be making available a unique template letter on APTA’s Regulatory Take Action webpage for physical therapists, physical therapist assistants, and physical therapy students to use to submit their own comments. The agency has requested responses by January 17, 2020.

Should you have any questions, please contact the Director of Regulatory Affairs, Kara Gainer at [email protected].



APTA, AOTA, ASHA: New Home Health Payment System No Reason to Compromise Care

As a new Medicare Part A payment model for home health agencies (HHAs) gets set to launch January 1, APTA and two other provider organizations are urging HHAs to keep patient access to needed care front-and-center, and not react to the new system with "unnecessary staffing changes."

In a joint statement by APTA, the American Occupational Therapy Association (AOTA), and the American Speech-Language-Hearing Association (ASHA), the organizations state:

"APTA, AOTA, and ASHA are aware of the potential for clinicians and assistants to be negatively impacted by the reactions of some home health agencies when implementing Medicare’s Patient-Driven Groupings Model (PDGM) on January 1, 2020. Unnecessary staffing changes could affect the clinicians’ practice patterns and their ability to exercise clinical judgment, as well as patients’ access to care — ultimately damaging the quality of therapy provided by home health agencies. Our organizations continue ongoing dialogue with CMS and home health agencies to ensure that Medicare beneficiaries continue receiving the skilled therapy they need. APTA, AOTA, and ASHA are committed to advocating on behalf of our professions and the people they treat."

The statement summarizes one of the central points APTA, AOTA, and ASHA have been driving home since PDGM was finalized for implementation on January 1, 2020: that PDGM changes nothing in terms of CMS' requirements that HHAs provide high-quality reasonable and necessary rehabilitation services and that clinicians use clinical judgment in determining appropriate frequency, duration, and modality of services.

As the new system is implemented, the association will be gathering on-the-ground information from physical therapists and physical therapist assistants on how HHAs are responding, and will share those reports with CMS. CMS will also be tracking utilization and patient outcomes under PDGM to ensure appropriate provision of therapy. If you have experiences to share related to implementation of PDGM (or the SNF PDPM), reach out to [email protected].

Learn the basics of how you can manage the PDGM in this "Compliance Matters" column published in PT in Motion magazine. Need more information? APTA has created an entire PDGM webpage with multiple resources to help you understand and make the case for your value in the system.


APTA's Latest 'Quarterly Report' Available Electronically Now

Posted: Dec. 17, 2019

The latest print issue -- Vol. 54 No. 4 -- of the APTA Home Health Quarterly Report is on its way to section members, but members can read it now on the section's new Quarterly Report Library page and selecting either the E-Reader or Download option (you must be signed in as a member). Not a member? Join us!

If you use the E-Reader, try using the handy new electronic table of contents. Just click the third button from the left on the control panel, and the table of contents appears. 




Posted: December 18, 2019

As part of overall efforts to move Medicare payment away from fee for service and toward a structure that holds providers accountable for patient outcomes and costs, the Centers for Medicare and Medicaid Services (CMS) has made significant changes to the skilled nursing facility (SNF) and home health payment systems. The SNF Patient-Driven Payment Model (PDPM) began October 1, and the Home Health Patient-Driven Groupings Model (PDGM) begins January 1, 2020.

Both PDPM and PDGM align payment with patient characteristics, conditions, and needs, and eliminate the connection between reimbursement and the volume of therapy services provided—time spent and number of visits. This change makes it ever more important to show the value and cost-effectiveness of physical therapist services within SNFs and home health care. At the same time, what doesn't change is the coverage criteria or documentation requirements associated with the skilled therapy service coverage under PDPM and PDGM. More important, there is no change to the care needs of patients, which should be the primary driver of care decisions, including the type, duration, and intensity of skilled therapies.

APTA has been working to keep the profession up-to-date with the evolution of the PDPM and PDGM through our news and social media outlets, webinars, phone-in sessions, and other free, open access resources on the APTA SNF and Home Health Payment Models website.

Three of the APTA Sections - Home Health Section, Academy of Geriatric Physical Therapy, and HPA the Catalyst, have a number of other resources on their respective websites to help clinicians prepare and thrive in these new payment models.

APTA also has been actively communicating with the press to highlight concerns surrounding the industry’s implementation of PDPM and potential inappropriate behaviors. Recent articles include:

The new payment models do not change the value of physical therapy services or patient needs. PDPM and PDGM expect rehabilitation professionals will continue to furnish high-quality therapy services that are reasonable and necessary. APTA maintains an ongoing dialogue with CMS and we are sharing with them the feedback we’re receiving from physical therapists and physical therapist assistants regarding their experiences with PDPM and PDGM. APTA will continue to carefully monitor implementation of the models and advocate for appropriate changes as CMS evaluates the systems during the first year of implementation.

Questions? Comments? Concerns? All physical therapists and physical therapist assistants (members and non-members) are encouraged to share their PDPM and PDGM experiences at [email protected]. Also, if you’d like to join the Post-Acute Care online community (Hub), please contact Kara Gainer at [email protected].

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