Happy Holidays! 2019 is almost over and we are that much closer to celebrating the 100-year anniversary of the American Physical Therapy Association in 2021. Keep your eyes open for upcoming events that the APTA is planning especially around Combined Section Meeting in Orlando in 2021! The Nebraska Chapter of the APTA will be celebrating 70 years and we will have some events surrounding our anniversary also! Please let me know if you are interested in helping to plan an anniversary event for our chapter! Sue Schuerman, retired physical therapist and past board member, is currently compiling historical information and recording oral histories from some of our long time members.
What has been going on in your state chapter:
- A new feature of our newsletter will be an article on Population Health from our Population Health Nebraska Champion, Jon Hausmann. Check out his article!
- The Nebraska Chapter along with the OT and SLP Nebraska associations will be jointly introducing a bill in the Unicameral next year to require insurance companies to inform providers of new requirements for participation at least 180 days in advance of implementation. It will also require the information to be sent to each provider in an orange envelope to alert a provider to this change! We will need your advocacy for this bill so watch out for future information.
- Our annual Legislative Breakfast at the Unicameral will be on February 4th! We will need lots of members to attend the breakfast to advocate for our profession!
- Dan McCutchen, our current secretary, is Nebraska’s liaison to the APTA for all centennial events.
- Spring meeting will be in Omaha, April 17-18th, with a great slate of courses planned. We will again this year have our Awards Celebration and Reception on Friday night. This year, the Awards reception, will be held at College of St. Mary’s. See you all there to celebrate excellence in our profession. Don’t forget to nominate a member for these awards!
- 2020 – we will be phasing in our new “brand” for the Nebraska Chapter. You will start to see our new logo on the website in early 2020. This is a joint effort between the APTA and all chapters/sections. It will be more apparent that we are part of the APTA and not a separate organization. The red in the logo has been retained for all you Cornhuskers!
- Have you entered your volunteer profile in the ENGAGE platform on the APTA website? Please do so to be notified of upcoming volunteer opportunities not only nationally but at the state level. Your NPTA will begin soon to post volunteer opportunities on the Engage Platform.
- Morgan Busboom SPT has been busy working on the Early Professional Special Interest Group we hope to roll out at our Spring conference! If any students or early career PT and PTAs are interested to be part of the first leaders of this group, please let me know!
I love our profession and I see great things in the future. It will take all of us to continue to work at the top of our license and continue to show our value! Please don’t hesitate to call me or email me with any suggestions on how we can make your association work better for you!
Thank you for membership and remember power is in numbers!
Grace Knott PT
Happy Holidays, everyone!
I would like to take this time to introduce myself and a new initiative that will become a staple for the Nebraska Physical Therapy Association. My name is Jon Hausmann, and I am the Population Health Champion for Nebraska.
What is Population Health? In a nutshell, it is the mindset that we can positively influence a large group of people to make healthy lifestyle changes and thus begin the process of fixing our broken healthcare system. As physical therapists, we are uniquely qualified and positioned to affect great change in our state, our region and our nation. Chronic disease is taking its toll on the health and wellbeing of our nation. While we continue to apply the old medical model of “fix what is broken”, we are diving deeper into the quagmire of paying more for health insurance coverage and health care, while receiving less. As you may be aware, the United States spends more per capita than any other country (Lancet 2017), yet we fall woefully short in preventable mortality (Kaiser Family Foundation). We CAN change this. If we can strategically place like-minded medical professionals with individual and corporate groups, we can partner with people in making real, lasting changes.
I am a physical therapist in Norfolk. I began my career as an Athletic Trainer and went back to school in 2005 to earn my DPT at the University of South Dakota in 2008. I have worked in outpatient PT since then, but have also picked up some work in other settings as well. I now own clinics in Pierce and Norfolk. I became interested in Population Health through some continuing education two years ago. I went through a 12-week Applied Prevention and Health Promotion Certification through the Institute of Clinical Excellence with Mike Eisenhart. We employ population health strategies in our outpatient clinics, and I have developed relationships with local employers to promote strategies to improve the health of their workforce.
There are resources that are available to you, and we will continue to update that information as soon as we can. Look for a “Population Health” section of the NPTA Website in the near future. In the meantime, please make sure you have signed up for the Council on Prevention, Health Promotion and Wellness at http://www.apta.org/CPHPW/SignUp/ and subscribe to the Population Health Forum at http://communities.apta.org/p/co/ly/gid=182.
Please feel free to reach out to me at any time. My email is [email protected] and my phone number is (402) 860-8105.
I want to bring to your attention a planned CEU activity happening locally, at CHI Immanuel, on March 13-15, 2020. It’s the on-site certification course towards earning a certificate in aquatic PT from the Academy of Aquatic Physical Therapy. To our knowledge, Omaha has never been a host site for this program. We at Creighton Pediatric Therapy and CHI Immanuel are co-sponsoring the event.
You can find more information here about the program: https://aquaticpt.org/captcc.cfm.
Thank you and have a great day!
Posted by: Kelly Nelson, PT, DPT
Certified Specialist in Pediatric Physical Therapy and Wound Management
Mentor, Pediatric Physical Therapy Residency Program
Creighton University Department of Physical Therapy
Campus address: Boyne 114D, Omaha, NE 68178; 402-280-4681 (p)
Clinic address: Creighton Pediatric Therapy, 17055 Frances Street Suite 103, Omaha, NE 68130; 402-280-2200 (p) or 402-660-0083 (cell)
Happy Fall/Winter, NPTA members!
We just have some quick updates in the world of reimbursement for Physical Therapy, both nationally and at the state level.
- Nebraska Total Care – we are working in conjunction with NTC and the Nebraska Occupational Association to create a webinar on defensible and medically necessary documentation guidelines. We have NPTA, NOTA, and NSLHA members on NTC’s Advisory Board to improve not only on documentation, but also improve the pre-authorization process for therapy services.
- NPTA, NOTA, and NSLHA have also been working closely with UnitedHealthcare on their new authorization process related to UHC’s Medicaid Plan (UnitedHealthcare Community Plan). For those of you who did not know this, UHCCP is a national plan for Medicaid, whereas NTC is a local plan. This process has NOT been implemented in all states. According to UHC, a concerning statistic is that 20 – 25% of all therapy claims are considered aberrant billing patterns! Furthermore, there is talk of this process being applied to their commercial lines….
A special thanks to Vicky McHugh, DPT, and NPTA President, Grace Knott, PT, who have been championing our cause in attempting to make changes to this overly burdensome process. We have met with the brass of United Healthcare of Nebraska locally, as well as Payer Chairs, and specialists at the APTA. Specifically, at the national level, additional thanks go to Elise Latawiec, Kara Gainer, Wanda Evans, and Kate Gilliard with the APTA.
An updated document from the APTA regarding IEP requests may be found on the NPTA website. https://npta.starchapter.com/restrictedDoc/Practice_Management/iep_toolkit_2019_for_members_only.pdf
Please use this in dealing with your UHCCP pediatric patients.
If you or your patients have complaints about the new UHCCP authorization process, please email https://nebraskalegislature.gov/divisions/ombud-filing.php.
- A hearing on a proposed bill (LR244) occurred in Lincoln on September 13, 2019. Grace Knott and Vicky McHugh testified on behalf of the NPTA. The proposed bill would eliminate the Multiple Procedure Payment Reduction (MPPR) process that UnitedHealthcare Community Plan applies to therapy services provided to Medicaid patients. Once the MPPR formula is applied, it reduces payment to providers by 10 – 14% and thus the reimbursement falls below the State Medicaid Fee Schedule. This proposed bill was sponsored by State Senator, Ben Hansen, a chiropractor from Omaha/Blair!!!
- Blue Cross Blue Shield has been requiring that you document your minutes spent completing each CPT code and this has been in effect since August 1, 2019.
- A hearing took place in Lincoln regarding proposed changes to the rules and regulations that govern Physical Therapy. Dry needling has been tied to the regulations regarding fine wire electromyography and Grace Knott, Nick Weber, Mike Stodden, and Mark Bertsch. The hearing lasted just 18 minutes!! No other members of the public, or professionals, or groups testified in person against the changes. However, commentary may be submitted via letter(s).
- Anthem will buy Medicaid operations owned by WellCare Health Plans in Missouri and Nebraska as part of a divestiture needed by Centene to win approval of its WellCare acquisition.
Brian Brunken, PT, MSPT, OCS
Recently, the Office of the Inspector General (OIG) published enforcement actions against 3 physical therapy practices. The case against Carolina Physical Therapy and Sports Medicine, LLC highlights the need for more compliance and billing education. According to the OIG report, “The United States contended that Carolina PT knowingly submitted claims to Medicare and TRICARE for services provided to multiple patients simultaneously as though the services were being provided by a physical therapist or physical therapist assistant to one patient at a time. As a result, Carolina PT received higher reimbursements than it would have if it had accurately represented the services. Additionally, the United States contended that Carolina PT knowingly submitted claims to Medicare and TRICARE for services provided by physical therapy assistants who were not supervised by a physical therapist, as required. Finally, the United States contended that Carolina PT knowingly submitted claims for attended electrical stimulation services when those services were in reality not attended by a licensed therapist or assistant and should have been billed as a lower cost unattended electrical stimulation service”.
Cases like these not only hurt the companies that violate the billing guidelines but also poorly represent physical therapy as a profession. As the need for physical therapy continues to grow, so does the need for more formalized compliance and billing education in physical therapy programs, for individual practitioners, and on the state-wide level. Let’s make a concerted effort to be leaders in healthcare in outcomes, expertise, and ethics.
Dan McCutchen, PT, DPT, OCS, is the Nebraska Physical Therapy Association secretary and Chief Compliance Officer and Director of Professional Development of Makovicka Physical Therapy. He can be reached at [email protected]
If you have ever wondered why membership is so important, look no further than the 8,700 comments submitted to CMS over the proposed 8% reduction in Medicare payments and the proposed PTA modifiers. These type of challenges will continue and we must be enthusiastic and voice our concerns. Please join, participate, and lead, the NPTA is always looking for great leaders in any capacity. Visit www.npta.org for more information.
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