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CMS Releases Medicare Physician Fee Schedule Proposed Rule for CY 2015

Posted on: July 6, 2014

Late on July 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, the Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare & Medicaid Innovation Models, & Other Revisions to Part B for CY 2015 (PFS) Proposed Rule effective for services on and after January 1, 2015. The proposed rule will be published in the Federal Register on July 11, 2014. CMS will accept comments on the proposed rule until September 2, 2014. To view the proposed rule, please visit the Federal Register Public Inspection Desk at https://www.federalregister.gov/public-inspection. CMS' Fact Sheet can be viewed  here

The Proposed Rule includes changes to the misvalued CPT code review process as well as several of the reporting initiatives that are associated with PFS payments the Physician Quality Reporting System (PQRS), Medicare Shared Savings Program and Medicare Electronic Health Record (EHR) Incentive Program, as well as changes to the Physician Compare tool on Medicare.gov. The proposed rule also continues the phased-in implementation of the physician value-based payment modifier. The modifier provides differential payments to physicians based on comparison of the quality of care furnished to beneficiaries and the cost of care. 

The following is an overview of the proposed policy and payment changes to the Medicare Physician Fee Schedule for Calendar Year 2015 of interest to NASL members.

Sustainable Growth Rate (SGR)
Although Medicare physician and Part B provider pay rates are due to be cut by at least 20 percent under the SGR, the proposed rule does not include proposals or announcements on the PFS update or SGR as these calculations are determined under a prescribed statutory formula that cannot be changed by CMS. The final figures are announced in the final rule in November. The Protecting Access to Medicare Act (PAMA) of 2014 provides for a zero percent PFS update for services furnished through March 31, 2015.

Potentially Misvalued Services Under the PFS
CMS has been engaged in a multi-year effort to identify and review potentially misvalued codes and to make adjustments where appropriate. In this year’s proposed rule, CMS is proposing to add about 80 codes to its list of potentially misvalued codes, 65 of which account for the majority of spending under the Physician Fee Schedule. CMS identified codes by reviewing high-expenditure services by specialty that have not been recently reviewed. Codes under review include those used in therapy such as 97032 Electrical stimulation, 97035 Ultrasound therapy, 97110 Therapeutic exercises, 97112 Neuromuscular reeducation, 97113 Aquatic therapy/exercises, 97116 Gait training therapy, 97140 Manual therapy 1/> regions, 97530 Therapeutic activities and G0283 Elec stim other than wound. 

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Tags: Contract Rehab Services, Senior Care Rehab, Nursing and Therapy, Therapy Management Services

The IMPACT Act Introduced in Congress

Posted on: June 29, 2014

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, a bi-partisan bill drafted by the Chairmen and Ranking Members of the House Ways and Means and Senate Finance Committees, was formally introduced yesterday. The bill had been circulated in draft form in March, and the bill that was introduced yesterday responds to much of the post-acute care (PAC) community’s feedback, including several specific recommendations made by NASL. The bill would require the use of standardized patient assessment instruments by post-acute providers to provide CMS with patient data that can be compared across the post-acute care settings.    

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Tags: Contract Rehab Services, Senior Care Rehab, Speech Language Pathology, Post-Acute Care Transformation, Therapy Management Services

NASL: MedPAC Releases June 2014 Report to Congress

Posted on: June 17, 2014

MedPAC Releases June 2014 Report to Congress
Site-Neutral Payments for Select Conditions Treated in IRFs and SNFs
MedPAC Testifies at Ways & Means Committee on the Report

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Tags: Contract Rehab Services, Senior Care Rehab, Nursing and Therapy, Therapy Management Services

7 months after merger, Heritage Healthcare and HealthPRO® Rehabilitation stronger than ever

Posted on: June 16, 2014

Representatives from Heritage Healthcare and HealthPRO® Rehabilitation report continued growth and success during the 7 months since their merger.

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Tags: Contract Rehab Services, Senior Care Rehab, Nursing and Therapy, Therapy Management Services

National Nursing Assistants Week, June 12-19

Posted on: June 11, 2014

This week, Heritage Healthcare celebrates National Nursing Assistants Week.

Now in its 37th year, this annual event, sponsored by the National Network of Career Nursing Assistants, is a special time to show our local and regional communities how residents, families and nursing assistants can work together to provide care for those who need it. 

There will be a number of fun, educational events held throughout the week, all aimed at showing us the amazing work nursing assistants do in hopes of encouraging others to get involved. 

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Tags: Contract Rehab Services, Senior Care Rehab, Nursing and Therapy, Therapy Management Services

Cognitive decline slowed by learning second language

Posted on: June 1, 2014

Is it time to add foreign language classes to your activities schedule? Individuals who speak two or more languages—even those who acquired the second language in adulthood—may experience slower cognitive decline from aging, according to new research published in Annals of Neurology.

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Tags: Contract Rehab Services, Senior Care Rehab, Speech Language Pathology, Cognition, Therapy Management Services

National Senior Health & Fitness Day

Posted on: May 27, 2014

100,000 older adults will participate in activities at more than 1,000 locations throughout the U.S. on Wednesday, May 28, 2014 as the 21st annual National Senior Health & Fitness Day is celebrated. The common goal for this day: to help keep older Americans healthy and fit. Always set for the last Wednesday in May, National Senior Health & Fitness Day is the nation's largest annual health promotion event for older adults.

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Tags: Contract Rehab Services, Senior Care Rehab, Therapy Management Services, Senior Health & Fitness

Heritage Healthcare Celebrates 15th Anniversary

Posted on: March 31, 2014

Heritage Healthcare continues to grow as it begins its 15th year of providing physical, occupational and speech therapy to the post acute market. Their ability to adapt to constant industry changes without compromising business principles led them to merge with HealthPRO® Rehabilitation in the fall of 2013. Their management expertise has a unique ability to effectively manage the clinical, regulatory, operational, and financial aspects of therapy. The combined companies provide targeted, real-time management support that enables each practice to achieve optimum success. They now provide contract therapy services at more than 470 skilled nursing facilities, continuing care retirement communities, assisted and independent living communities with recent diversification into hospitals, schools, home health, and outpatient clinics across 26 states while employing more than 5,600 associates – making them one of the largest independent therapy providers in the profession. “Because of the unique talents and professionalism of our associates and the trust our customers have afforded us, we’ve been able to maintain the principles of our company since our beginnings in 1999,” said Paul Shaw, President. The extensive industry experience of the leadership at Heritage Healthcare has been a firm foundation for growth. As healthcare and the contract therapy industry evolves with increased scrutiny and Medicare Reimbursement reductions, Heritage Healthcare has adhered to their core values. Honesty, Integrity and Compassionately Caring for others, as well as the practice of establishing long-term partner relationships with their customers, is their philosophy for longevity.

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Tags: Contract Rehab Services, Senior Care Rehab, Therapy Management Services, Physical Therapy

HealthPRO Rehabilitation Acquires Rehab Solutions

Posted on: January 14, 2014

HealthPRO® Rehabilitation, recently merged with Heritage Healthcare Inc., announced this week that it has acquired Matthews, North Carolina based Rehab Solutions, Inc. (“RSI”).  Rehab Solutions is a leading provider of contract therapy and reimbursement solutions to senior living providers in ten states with a reputation for strong clinical programming, reimbursement expertise, and innovative technology solutions. 

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Tags: Contract Rehab Services, Senior Care Rehab, Therapy Management Services, Physical Therapy

Health care workers will lead U.S. job gains to 2022

Posted on: December 22, 2013

Labor Department forecast: Aging Baby Boomers will reshape the employment market over the next decade.

The retirement of aging Baby Boomers will reshape the job market over the next decade, leading to the smallest portion of Americans employed or looking for work since the mid-1970s, barely six in 10, a new Labor Department forecast predicts.

The result: slower economic growth but new employment opportunities in health care, where millions of new jobs are likely to be created.

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Tags: Heritage Healthcare, Senior Care Rehab, Physical Therapy Jobs, Occupational Therapy Jobs