Posts Tagged medicare

TAKE ACTION! Medicare Opt Out Legislation

TAKE ACTION! Just a quick note as a follow up to this post: Thanks to Jason Bellamy, Director, Web & New Media, APTA for letting me know about a new action item regarding the ability of physical therapists to opt out of Medicare. On March 21, 2013, Representative Tom Price (R-GA) introduced the Medicare Patient Empowerment Act of 2013 (HR 1310), which would provide physical therapists with the ability to privately contract with Medicare beneficiaries. Everyone can take action on this issue – APTA members, non members, patients and other healthcare professionals! How to Take Action APTA has posted information on Medicare private contracting (“opt out”) in its federal issues area, which includes links for members and nonmembers to be able to take action: http://www.apta.org/FederalIssues/PrivateContracting/ The template action letter can be personalized – it’s a quick and effective way to let your voice be heard. Unfortunately, the Opt Out legislation isn’t one of APTA’s “priority” legislative issues for 2013, which makes it even more necessary to keep the grass roots energy going! Please take a minute to speak out for our profession.      

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Repeal of the Medicare Cap on Outpatient Therapy and amendment for Physical Therapists to Opt Out of Medicare

Repeal of the Medicare Cap on Outpatient Therapy and amendment for Physical Therapists to Opt Out of Medicare

On my mind today: Following is a list of the Members of the Ways and Means Subcommittee on Health. We need to contact these folks to ask them to support H.R. 1546 (112th): Medicare Access to Rehabilitation Services Act of 2011. This will amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. By repealing the outpatient rehabilitation caps we will allow patients with chronic illnesses and complicated recoveries to continue to access the care they need to live a full and functional life. If your representative is not on this list, please contact them anyway. Every representative matters. Ways and Means Subcommittee on Health Rep. Kevin Brady, TX, Chairman Rep. Sam Johnson, TX Rep. Paul Ryan, WI Rep. Devin Nunes, CA Rep. Peter Roskam, IL Rep. Jim Gerlach, PA Rep. Tom Price, GA Rep. Vern Buchanan, FL our credit card findercurrent financial climate the Rep. Adrian Smith, NE Rep. Jim McDermott, WA, Ranking Member Rep. Mike Thompson, CA Rep. Earl Blumenauer, OR Rep. Ron Kind, WI Rep. Bill Pascrell, NJ Contact Info: Ways and Means Committee Office 1102 Longworth House Office Building Washington D.C. 20515 P: 202-225-3625 F: 202-225-2610 We also need to ask our representatives to amend Section 1802(b)(5)(B) of the Social Security Act, which currently prohibits physical therapists from entering into private contracts with Medicare patients to provide services. Because the current law does not allow physical therapists to “opt out” of Medicare, small physical therapist owned private practices that do not participate with Medicare are prohibited from treating Medicare patients. This prohibits a significant portion of the population from seeking physical therapy care from the provider of their choice. Nearly all other healthcare providers and physicians are able to “opt out” and many service providers (massage therapists and personal trainers) are not […]

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Patient’s Rights (or lack thereof)……….AKA You guys need to get mad and do something!

So there has been a good deal of underground rumbling going on in the PT world this week. Because I like to be well informed (i.e. I’m a nerd), I participate in all sorts of social media to stay on top of things. Using Facebook, Twitter and LinkedIn allow me to “talk” with people all over the world and hear about trends. The trend I am paying attention to this week is that PT’s in private practice are mad! And you, the consumer/patient, should be mad too! Why should you be mad? Because no one fully explains your rights to you as a patient, and things are going on that affect you, and you have no idea about it! The issues that affect you and your ability to access the health insurance you pay for every month include the following: 1) You have a choice of where you want to receive physical therapy. Your doctor can make a recommendation, but cannot require you to go to a specific PT clinic (especially one that he/she owns). This is actually illegal; but, it happens all the time. If I had a dollar for every time a patient told me, “I had no idea I could go somewhere else” I would be a rich woman. When your doctor recommends physical therapy (or when you ask your doctor for a physical therapy referral, which is also your right as a patient), they can give you a list of options for your care. They can also mention that they have a physician owned physical therapy clinic (POPTS) next door or across town, but they cannot require you to receive your therapy there. emergency same day loansforeign country would 2) If you want to see a therapist who does not participate with insurance companies, call your […]

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Gotta Love Autocorrect!

Alright, up front I have to say that this was not originally going to be today’s topic……..however, it was so funny and ironic that I had to share.  I was texting a message today and must have started spelling the word “insurance” incorrectly, because all of a sudden the word uninsured popped up and my mind read it as “uninsurance”……..and I laughed out loud at the thought of uninsurance because that’s what most of us have!  We all pay a ridiculous amount of money for “insurance” that often fails when we need it most.  How often have you been forced to either discharge a patient or make them sign a self-pay waiver (Aetna…..25 visits, anyone) because of their insurance? How many patients get upset that their insurance prevents them from seeing the provider they want to see? (Medicare patients, anyone)?  Ever have a patient whose insurance won’t cover an MRI until they have had a trial of physical therapy and failed all conservative treatment? How absurd that our insurance companies are often the ones preventing us from accessing the care we need. As P.T.’s and also as healthcare consumers/patients, we have to take a stand against this.  This shift is happening slowly, as more patients and therapists get to the end of their rope and abandon traditional insurance based healthcare; but, we are still the minority. My current beef is with Medicare.  As a P.T., I can never, ever opt-out of Medicare.  Believe me, I checked into it for days to get to the bottom of this.  I was actually told by Highmark, our local Medicare carrier, that as a P.T. I could opt-out, they even directed me to the form I could use. But, after running this by many other therapists, and the APTA, I found out that the […]

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