Filed under: Industry Updates — Editor @ 12:00 pm

On the afternoon of November 1, 2012, the Medicare Payment Advisory Commission (“MedPAC”) unanimously adopted a series of recommendations, which, if ultimately enacted by Congress, would have a profound adverse impact on providers of outpatient therapy services and the patients they serve. The recommendations that MedPAC approved will be included in the Commission’s report to Congress that was mandated by the Middle Class Tax Relief and Job Creations Act of 2012. MedPAC’s actions do not carry the force of law and must be passed by Congress if they are to become effective. It should be stressed that MedPAC adopted the recommendations despite the vigorous and vocal opposition to many of them by a broad array of rehabilitation providers, patient and disease groups, and other health care stakeholders. (more…)

Middle-Aged Brains Are Already Past Their Prime [01-09-12]

Filed under: Industry Updates — Editor @ 11:47 am

You may want to read this twice if you’re older than 45. In fact, you may have to.  That’s because your mental abilities are already in decline, according to a study of 7,390 British civil servants just published in BMJ, the British Medical Journal.  For men and women who were between 45 and 49 when first tested, the ability to reason declined 3.6 percent over the next decade, the study found. And the decline was even faster for people in their 50s and 60s, especially men. (more…)

Current Extension of Exceptions Process for Medicare Therapy Caps [01-09-12]

Filed under: Industry Updates — Editor @ 11:32 am

Section 304 of the TPTCCA extends the exceptions process for outpatient therapy caps. Outpatient therapy service providers may continue to submit claims with HCPCS modifier KX, when an exception is appropriate, for services furnished on or after January 1, 2012, through February 29, 2012.

The therapy caps are determined on a calendar year basis, so all patients begin a new cap year on January 1, 2012.

For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,880.

For occupational therapy services, the limit is $1,880.

Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached, and also apply for services above the cap where HCPCS modifier KX is used.

Understanding U.S. Health Care Spending [08-24-11]

Filed under: Industry Updates — Editor @ 1:48 pm

In July, the National Institute for Health Care Management released its report on Understanding U.S. Health Care Spending. The Key Points of the report included: (more…)

11th Circuit Court of Appeals Finds Part of the Affordable Care Act Unconstitutional [08-13-11]

Filed under: Industry Updates — Editor @ 11:05 am

On August 12, 2011, a three judge panel of the 11th Circuit Court of Appeals ruled in the Florida multi-state challenge to health care reform and found the mandatory requirement to purchase health insurance unconstitutional. Unlike the lower court, however, the Appeals Court did not invalidate the entire law and held that the Act’s other provisions remain legally operative after the mandate’s excision. The decision was 2-1 with one judge dissenting. (more…)

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