medicarepatients · 2018. 4. 14. · cert.mdt 1854andylane maryville,tn 37803 w: 865-577-2137 h:...

23
4205 Hillsboro Road, Suite 317 Nashville, Tennessee 37215 PRESORTED FIRST-CLASS MAIL US POSTAGE PAID NASHVILLE, TN PERMIT NO. 480 TENNESSEE PHYSICAL THERAPY ASSOCIATION SUMMER 2013 VOLUME 42 TPTA has a new website: TPTATN.ORG Medicare Patients 2013 Legislative Wrap-up Making Your Voice Heard District Meeting News Research Grant Funds Available TPTA FALL MEETING Memphis, Tennessee at the Peabody September 27-28

Upload: others

Post on 05-Oct-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

4205 Hillsboro Road, Suite 317Nashville, Tennessee 37215

PRESORTEDFIRST-CLASS MAIL

US POSTAGE PAIDNASHVILLE, TNPERMIT NO. 480

T E N N E S S E E P H Y S I C A L T H E R A P Y A S S O C I AT I O N

SUMMER 2013VOLUME 42

TPTA has a new website:

TPTATN.ORG

Medicare Patients

2013 Legislative Wrap-up

Making Your Voice Heard

District Meeting News

Research Grant Funds Available

TPTA FALL MEETINGMemphis, Tennesseeat the PeabodySeptember 27-28

Page 2: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

B O A R D O F D I R E C T O R S

The VOLUNTEER VOICE is apublication of the TennesseePhysical Therapy Association. Themagazine is published up to fourtimes a year and is sent to allmembers of the APTA in Tennessee.

ADVERTISING &SUBSCRIPTIONS

All advertisements in theVOLUNTEER VOICE are acceptedon the basis of conformance withthe ethical standards of theAmerican Physical TherapyAssociation but no effort is made toverify the accuracy of claims madein such advertisements. Acceptanceof advertisements does not implyendorsement by the VOLUNTEERVOICE or by theAmerican PhysicalTherapy Association.

RATES1/8 Page . . . . . . . . . . . . . $ 60.001/4 Page . . . . . . . . . . . . . $ 95.001/2 Page . . . . . . . . . . . . . $ 115.00Full Page . . . . . . . . . . . . $ 200.00Back Page . . . . . . . . . . . . $ 250.00

Job Opening andContinuing Education Columns

$35.00 for under 100 words.$65.00 over 100 words,not to exceed 200 words.

Companies listing their name,address, phone number, andrepresentative are called PATRONS.These companies are listed in eachissue of the VOLUNTEER VOICE.Cost is $50.00 per issue.

SUBSCRIPTIONS$50.00 per year (3 issues)

for non-members.

Please submit all articles and newsitems relation to physical therapy to:

TPTA OfficeDebbie Lowenthalor Amy Breedlove4205 Hillsboro Road, Suite 317Nashville, TN 37215W: 615/269-5312F: 615/297-5852E-Mail: [email protected]

Executive CommitteePresidentTerm Exp 2013Scott Newton,PT, DPT, OCS, CWS

408 South Third StPulaski, TN 38478-3806W: 931-424-5588F: 931-424-5590H: [email protected]

Vice-PresidentTerm Exp 2013Alan Meade, PT,ScDPT, MPH

1305White StKingsport, TN 37664W: 423-578-1560H: 423-246-4125F: [email protected]

SecretaryTerm Expires 2014Jane David – PT, DPT914 Pipkin Rd.Jackson, TN 38305-9674W: 731-424-3520x214F: 731-425-9551H: [email protected]

TreasurerTerm Exp 2014Baron Johnson PT1032 Foxdale DrMaryville, TN 37803W: 865-238-6060H: 865-233-0588F: [email protected]

Chief DelegateTerm Expires 2014Pamela D. Ritzline,EdD, PT

Dept of Physical Therapy930 Madison AvenueSte 640Memphis, TN 38163W: 901-448-5888H: 317-696-1080F: [email protected]

District ChairsChattanoogaConnie Petty, PT,ATC, CHT

Center for SportsMedicine andOrthopaedics7480 Ziegler RdChattanooga, TN 37421Office:423-697-2056ext7321Cell: [email protected]

JacksonFelicia Ingram, DPT940 Custer AveDyersburg, TN 38024-5802W: 731-855-7983H: 731-217-1750F: [email protected]

KnoxvilleJeanne Hartsell, PT, OCS9505 Trails EndKnoxville, TN 37931-4220W: 865-482-7730H: 865-951-5606F: [email protected]

NashvilleDenise Bellardo, PT2316 Warfield LaneNashville, TN 37215H: [email protected]

Tri-CitiesJames Kidd, PT1903 Loire Valley RdJohnson City, TN 37064W: 423-282-5435H: 423-926-1632F: [email protected]

MemphisBertie Gatlin PT, PCS1873 Pisgah RdCordova, TN 38016W: 901-448-5888F: [email protected]

South CentralAmy Crouse, PT, OCS1494 Bern DriveSpring Hill, TN 37174W: [email protected]

Upper CumberlandLarry Burks, PT306 N. Hickory AveCookeville, TN 38501W: 931-526-2345H: 931-525-3944F: [email protected]

Committees -VOTINGPractice ChairJody Swearingen, PT1005 Achiever Cr.Spring Hill, TN 37174W: 615-771-0134C: [email protected]

Legislative ChairJoe Black, DPT, SCSP O Box 6167Maryville, TN 37802W: 865-977-8282H: 865-996-9438F: [email protected]

Membership ChairJustin Meade, PT1021 Forrest Ridge DrKingsport, TN 37660-6629W: 423-392-5188H: [email protected]

PTAAllison Bolt PTA630 Rumble Wood LnSeymour, TN 37865C: [email protected]

Other Committees –Non-votingImmediate PastPresidentJoe Black, DPT, SCSP O Box 6167Maryville, TN 37802W: 865-977-8282H: 865-996-9438F: [email protected]

State LicenseBoard LiaisonCathy Hinton, PT, PhD108 Stoneway CloseNashville, TN 37209W: 615-460-6718H: 615-356-8419F: [email protected]

EthicsPat Flemming,PT,DSc, GCS

1028 Beech GroveNashville, TN 37027Brentwood, TN 37027W: 615-936-5280H: 615-516-7185F: [email protected]

NominatingGail Bursch,PT, MSEd, CWS

1214 Graybar LnNashville, TN 37215-1620W: 615-460-6725F: [email protected]

Awards ChairDanny Smith,PT, DHSC, OCS, SCS

539 Division StElizabethton, TN 37643W: 423-543-0073F: [email protected]

Communication ChairMike Ray PT, MS, OCS,Cert. MDT

1854 Andy LaneMaryville, TN 37803W: 865-577-2137H: 865-380-5711F: [email protected]

ReimbursementNick Cantrell, PT1622 Russell St.Nashville, TN 37206W: 615-885-7848F: [email protected]

ProgramAlan Meade, PT, MPH1305White StKingsport, TN 37664W: 423-578-1560H: 423-246-4125F: [email protected]

ResearchKristin R. Archer,PhD, DPT

941Yearling WayNashville, TN 37221W: 615-322-2732F: [email protected]

LobbyistEstie HarrisMegan FrazierSmith, Harris & Carr511 Union St #710Nashville, TN 37219615/[email protected]

TPTA OfficeDebbie LowenthalAmy Breedlove4205 Hillsboro Rd.Suite 317Nashville, TN 37215W: 615/269-5312F: 615/[email protected]

T P T A L O B B Y I S TEstie Harris

Smith, Harris, & Carr615/255-2643

Weekly updates are provided on thewebsite. The information to view the

website is listed below:Website - www.sjc.ccUser Name - PTAPassword - 1023

“Opinions expressed by the authors are their own and do not necessarilyreflect the views of the Tennessee Physical Therapy Association.”

L I C E N S U R EOffice of Health Licensure & Regulation

Board of Physical TherapyAttn: Mike Salyers, Administrator

Board of PTTennessee Health Related Boards227 French Landing, Suite 300Heritage Place Metro Center

Nashville, TN 37228615.532.5132

State Web Site:http://health.state.tn.us/Boards/PT/index.htm

Peer Assistance Program 1-615-726-4001

Page 3: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

2V O L U N T E E R V O I C E S U M M E R 2 0 1 3

OnApril 14th, I had the opportunity to contribute my voice to the 2013 Federal Advocacy ForuminWashington DC. As anAPTAmember and the 2013 student legislative affairs liaison for the TPTA,it was an honor to help raise awareness for some of the most pressing issues that are impacting thephysical therapy profession. Each year, the FederalAdvocacy Forum provides physical therapists andphysical therapy students from across the country with the opportunity to meet with theirCongressman and Senators to discuss current issues that are impacting the physical therapyprofession. This year, over 250 physical therapists and physical therapy students gathered inWashington DC to discuss the Medicare Access to Rehabilitation Services Act, the Physical TherapyWorkforce and Patient Access Act and encourage members of Congress and the Senate to repeal theMedicare therapy cap.

As a second year DPT student and a newcomer to the Forum, I was excited to become involvedand share my perspective with my elected officials, but also concerned that my lack of experiencewithin the profession would dampen the significance of my contribution. I quickly realized, however,that despite my background, lack of experience as a physical therapist and knowledge of the details

within a piece of legislation, what mattered most was myability to clearly articulate how the changes would impactme as a future physical therapist. The legislative processwe have developed in the United States is most valuablebecause of the importance we place on every voice andevery citizen, regardless of position or status. As astudent, I found my voice heard, my contributionmeasurable and my experience rich. It’s far too easy to

become complacent with the status quo and expect that otherswill fight for the changes that you long to see. Each of us,students and therapists alike, have the privilege to impact the

direction our profession will take. Much of this momentum comesfrom direct involvement and advocating for the changes we want tosee. The Federal Advocacy Forum is an excellent way to do justthat. I look forward to participating next year and hope you willconsider joining your fellow APTA members in Washington DCnext spring. �

Making your Voice Heard

Page 4: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 33

As most of you know, the Medicare TherapyCap for 2013 is $1900 combined for Speech andPhysical Therapies. There is still an exceptionsprocess if your patient requires therapy beyond the$1900 threshold. The Manual Medical Reviewbegan in October 2012 for patients that haveexceeded $3700. Initially everyone was subject topre-payment review. However, some things haverecently changed. As of April 1, 2013, Tennesseeis now under post payment review, meaning thatyou should continue to treat your patients andRecovery Audit Contractors will be asking fordocumentation after you are paid.

Keep in mind the following regarding theManual Medical Review Process:

• Recovery Audit Contractors (RACs) are paida contingency fee for denials (they get paidwhen they deny payments)

• RACs will not be looking at claims below the$3,700 threshold.

• RACs will use Medicare AdministrativeContractors (MACs) to send letters toproviders.

• Post payment review states will get paid firstand then will receive a request fordocumentation. Review will take 30-45 days.

• RACs will have tracking portals. Providerscan go to the portal and see if the informationthey submitted was received and view thestatus of the decision.

• RACs will be accepting information by fax,mail, CD, DVD, and ESMD (electronicsubmission).

• ABNs – In order to collect cash when thetherapy cap is exceeded, providers must haveissued an ABN. However, providers shouldonly issue ABN if they think the services arenot reasonable and necessary. Providersshould not be giving blanket ABN notices atthe $1,900 or $3,700 level.

• APTA will continue to have monthlymeetings with CMS regarding the RAC auditsand providing feedback on problems providersare seeing. You should contact the APTA ifyou are having difficulty with this process sothey can let CMS know.

APTA has good information available on theirwebsite to help you understand the changes toMedicare. Also, we are working to get theTherapy Cap permanently repealed. Let yourlegislators know how it impacts you through theAPTA's Legislative Action Center.

Sarah Suddarth Byrd, PT, DPTFederal Affairs LiasonPhysical TherapistPulaski Physical Therapy �

Medicare Patients, the TherapyCap and the Manual MedicalReview Process

Page 5: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

4V O L U N T E E R V O I C E S U M M E R 2 0 1 3

TPTA FALL MEETINGMemphis, TennesseeSeptember 27th & 28th

SITE: Peabody Hotel

COURSE SCHEDULE

Neuro Tract:Graded Motor Imaging

Multiple Sclerosis

Parkinson's Disease

Orthopedic Tract:Eclectic Approach to Manual Therapy

Dry Needling

Bleeding Disorders and Functional Outcomes

McKenzie or Mulligan Based

Movement Impairment Syndromes

Determining Spine Exercise Prescription: PTA Decision Criteria:(A course strictly for PTAs only)

Pediatric Tract:Torticollis Diagnosis, Intervention, and Evidence Based Practice

Health Administration/Business Tract:Healthcare Reform, Healthcare Policy, Payment Policy, ACOs,

Shared Savings, Where does the PT profession fit in?

Acute Care, Avoidance of Hospital Admission, Readmission,Chronic Disease States: How can PT assist in this process?

Pharmacology with the Acute Care Patient

G-Codes and Functional Outcomes Implementation: How are we doing?

Anatomy for LE

Ethics and Jurisprudence

Page 6: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 35

CHATTANOOGA

The Chattanooga District has had wonderful meetings this spring. Alliance Physical Therapy hostedone meeting with Dr Mark Sumida providing a question and answer session on orthopedic surgicalprocedures and post-op rehab. The May meeting was hosted by The Center for Sports Medicine andOrthopaedics. Dr Todd Grebner spoke on the topic of Disorders of the Bicep Tendon. Participantswere awarded Class 1. We welcome Rhonda Haley as our new Legislative Chair. The District isplanning to host an Ethics and Jurisprudence course in the early fall. A community outreach event isalso being considered for the fall.

Connie Petty, PT, ATC, CHTDirector of RehabilitationCenter for Sports Medicine and Orthopaedics423-697-2056423-499-5640 fax

NASHVILLE

Greetings from the Nashville District! We have just concluded our season of meetings coupled withdinner and CEU’s. Our final meeting was held May seventh at Belmont University. The CEU course,“Falls Risk Outcome Measures: Which Ones are Best for my Patient or Patient Population?” wastaught by Pat Flemming PT, DSc, GSC and was well attended. The excellent presentation generatedinsightful clinical discussion among the attendees, and all the concepts and resources provided wereimmediately clinically applicable. We are grateful to SunMedical for providing our dinner thatevening.

District Meeting News

Page 7: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt
Page 8: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 37

The first session of the 108th GeneralAssembly adjourned on April 19, 2013. Thiswas the earliest adjournment of the GeneralAssembly in over two decades. Leadership inboth houses made a concerted effort to finishby the end of April. The House ofRepresentatives implemented a 15-bill limit formembers this session, and after some initialpushback by members, the bill limit waswidely regarded as welcome change to thelawmaking process.

Despite the General Assembly’s newfoundcommitment to efficiency, the age-old tensionbetween the House and the Senate remained.Most notably, two important bills failed to passat the eleventh hour. HB 702, known morecommonly as the “charter authorizer” bill,failed to pass the Senate. HB 702 would haveallowed the state to overrule local schooldistricts if they decided to reject applicationsfor new charter schools in the school district.The bill was high priority for Speaker BethHarwell.

In the House, SB 780, which was a piece ofpriority legislation for Lt. Governor RonRamsey, met a similar fate as HB 702 andfailed to pass. SB 780 would have redrawnTennessee’s Judicial Districts for the first timesince the early 1980’s. The bill would havereduced the number of Tennessee’s JudicialDistricts from 31 to 29.

Even with the end of session legislativebattles between the House and the Senate, mostlegislators in both chambers agreed that firstsession of the 108th General Assembly was asuccessful one. From a lobbyist’s perspective,the condensed session created new challenges,

but overall, the session was an enjoyable one.Some items of interest from this session

include:

The BudgetWhen Gov Haslam introduced his $32

billion budget in January he prioritized fullyfunding the BEP and TennCare programgrowth; funding higher education based onoutcomes; providing a salary increase for stateemployees; investing in long-deferred capitalprojects; and making significant deposits to thestate’s rainy day fund. He did this by usingnew state revenues, revenue growth, andmaking small strategic cuts in various statedepartments and agencies.

TaxesGovernor Haslam’s FY 2013/14 budget

further reduced the sales tax on food from5.25% to 5%.

Further, he accounted for the legislativelyscheduled increase in the inheritance taxexemption from $1.25 million to $ 2 million.Lastly, the FY 2013/14 budget further increasedthe exemption on the Hall Income tax for those65 and older. The new exemption is $33,000 forsingle filers and $59,000 for joint filers.

ADMINISTRATION LEGISLATION

Workers CompensationPublic Chapter 289 made four key changes

to Workers’ Compensation Law in Tennessee:First, the new system requires employees to file

continued on page 8

2013 Legislative Wrap-upBy: Estie Harris & Meagan Frazier

Page 9: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

8V O L U N T E E R V O I C E S U M M E R 2 0 1 3

their claims in a newly created Court ofWorkers’ Compensation Claims within theDivision of Workers’ Compensation in theDepartment of Labor and WorkforceDevelopment. This key reform will effectivelytake Workers’ Compensation proceedings outof Tennessee’s Circuit Courts and into thenewly formed Administrative Court. Second,there will be an Ombudsman program withinthe Workers’ Compensation Division to aidemployees and employers, who are notrepresented by counsel, navigate the newlycreated system. Third, the newly enactedreforms allow for a neutral construction ofWorkers’ Compensation law, so that neither theemployee nor the employer has an advantage.Finally, the newly enacted reforms toTennessee’s Workers’ Compensation lawprovide for a much clearer standard forcausation that requires that the employee’sinjury arise primarily out of employment asopposed to non-work related activities.

Medicaid ExpansionIn an unusual joint session, the Governor

announced that he would not be seekingbudgetary authorization from the GeneralAssembly to expand the Medicaid program inTennessee as allowed by the Affordable CareAct. Instead, he announced that he was goingto seek permission to implement a “TennesseePlan.” The Tennessee Plan is modeled after theArkansas proposal which will place theexpansion population onto the state’s chosenexchange, with the additional federal dollarsbeing used to buy the individual a healthinsurance policy from the exchangemarketplace. There will be differencesbetween the current TennCare benefit structureand the exchange benefit structure includingbenefits differences and allowing for co-

payments. Additionally, the Tennessee Planwill have a circuit breaker allowing for the stateto cease providing the health insurance policywhen the federal dollars are removed orreduced. The Haslam administration iscurrently in negotiations with the federalauthorities to seek permission to proceed withthis proposal.

During his remarks, the Governorcommitted to not pursuing any expansionwithout the General Assembly’s specificauthorization and with that assurance, thelegislature shelved SB804 /HB937 whichwould have specifically disallowed theexpenditure of any funds in expandingMedicaid in TN.

TPTA LEGISLATION

In conjunction with the TennesseeChiropractic Association and the TennesseeOccupational TherapyAssociation, SB 726/HB859 was introduced by Sen. Bo Watson andRep. Jeremy Durham. The legislation’s intentwas to prohibit any health insurance companyfrom imposing a co-payment or co-insuranceamount for services rendered during an officevisit to a physical therapist, occupationaltherapist or chiropractor which was higher thanthe services rendered during an office visit to aprimary care physician. It was modeled afterlegislation passed in Kentucky and SouthDakota.

The legislation was opposed by theinsurance industry and ultimately deferred to“summer study” by the House Insurance andBanking Subcommittee by Chair JimmyMatlock. It remains in play for the 2014session.

continued on page 9

Page 10: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 39

OTHER ITEMS OF INTEREST

Early termination of the Board of PhysicalTherapy

Because of the financial shortfallsexperienced by the Board of Physical Therapythe last few years, SB 371/HB800 wasintroduced by the Chairs of the GovernmentOperations Committee. After the Chair of thePT Board appeared before the Gov OpsCommittee in January, the legislation was notpursued. PT Board Chair Wilkerson explainedthat the Board had raised fees and the staff fromthe TN Department of Health confirmed thatthey expected the board to regain self-sufficiency status.

Assault of a Health Care WorkerPublic Chapter 325 increases the maximum

fine for assault or aggravated assault of ahealthcare worker from $5,000 to $15,000.Healthcare workers is defined a person who islicensed, certified, or otherwise authorized orpermitted to administer health care in theordinary course of business in the practicing ofa profession and should cover all our licensees.

Hospital Assessment FeeThe Tennessee Hospital Association’s

annual assessment fee passed and becamePublic Chapter 250. Like in previous years,this assessment when matched with federaldollars bought back all the proposed rate cutsfor hospitals and doctors as well as all of theproposed enrollee benefit cuts, includingphysical therapy.

ConcussionsA large group of interested parties

including the Tennessee Medical Association,TSSAA, NFL, TN Athletic Trainers, and the

TN Department of Health collaborated on anew concussion bill since the one in 2012stalled. Public Chapter 148 passed and willbecome effective on January 1, 2012.

The new law requires school –related andcommunity-based athletic activities to adoptguidelines to inform and educate coaches,school administrator, youth athletes and theirparents of the risks and symptoms ofconcussion and head injuries. Annually allcoaches, whether employed or volunteer, andschool athletic directors will be required tocomplete a concussion recognition safetyeducation course. The department of healthwill make such course available on its websitefor no charge. Also on an annual basis aconcussion information sheet must be signedand returned by all coaches prior to initiatingpractice or competition for the year. Schoolathletic directors and licensed health careprofessionals, if appointed, are also required tosign and return an information sheet prior to thestart of practice or competition for the year. Aconcussion information sheet must also bereviewed by youth athletes and parent and shallbe signed by the athlete’s parent.

The school-related or community-basedathletic governing board must establish aspolicy the immediate removal of any youthathlete who shows signs, symptoms orbehaviors consistent with a concussion fromactivity for evaluation by a licensed health careprofessional if available, which include PTs. Ifno licensed health care professional is availablea coach or other designated person shallevaluate. In determining whether a youthathlete suffered from a possible concussion, theCDC concussion signs and symptoms checklistmust be utilized. A policy must be establishedthat a youth athlete who has been removedfrom play shall not return to the activity during

continued on page 11

Page 11: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

Not all manual therapy is the same. Studies show that clinicians with advanced training and appliedresearch techniques have better patient outcomes.At BenchMark, we support our clinicians with advanced certi�cation opportunities, including OrthopedicResidency and Fellowship through Evidence in Motion, evidence-based application, collaboration and an atmosphere of excellence. This support is one reason why BenchMark has more therapists with advanced certi�cations in manual therapy and orthopedics, including board certi�ed Orthopedic Specialists, than any other physical therapy practice in the region. And our patient outcomes prove it!

Advanced Training, Collaboration and Excellence

What type of practice partner are you looking for?Call or email Pam MountzDirect line: 423.238.8901Toll free: 866.577.7342 x2243Email: [email protected]

Page 12: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 311

which the athlete suffered or was thought tohave suffered a concussion. Further suchathlete shall not participate in any team activitiesinvolving physical exertion until the athlete isevaluated by a health care provider and receiveswritten clearance from the provider for a full orgraduated return to play. In this case, a healthcare provider means a M.D., D.O., or clinicalneuropsychologist with concussion training andnot a PT. A school or community organizer mayallow a licensed health care professional,including PT, with specific knowledge of theyouth athlete’s condition to manage the youthathlete’s graduated return to play based on thedoctor’s recommendations. Such health careprofessional or other person acting in good faith,within the authority prescribed in the bill, shallbe liable on account of any act or omission whileengaged in these activities. “Good faith” doesnot include willful misconduct, gross negligenceor reckless disregard.

All licensed health care professionals,except M.D.s and D.O.s , performing any of thefunctions required by this law shall receivetraining in the evaluation and management ofconcussions. Each such professional shall, at aminimum, complete the National Federation ofState High School Association’s trainingcourse. Additional training may be required bythe TN Department of Health.

State Regulatory FeesSB390/HB802 2as introduced by the Chairs of

the Government Operations Committees and asintroduced would have required each healthrelated board to assess a state regulatory fee onlicensees. The legislation was never considered.The concept was that the Board would be able todetermine what amount would be charged perlicensee and the costs of theBoard could be passedon in that manner. It was never really fleshed out,

and several Boards expressed concern. It mayreturn at some point after further discussion.

Military spousesPublic Chapter 122 requires regulatory

boards to expedite the issuance of aprofessional or occupation license to spouses ofmilitary service members.

TelemedicineLegislation mandating that insurance

companies cover telemedicine services wasintroduced but did not pass. It is expected thatthe subject of telemedicine will come up duringthe next legislative session.

Utilization Review standardizationSen. Mark Green & Rep. Glen Casada

introduced SB 1142/HB926 on the subject ofutilization review. The legislation would haverevised requirements involving utilizationreview of pre-authorization for health careservices and provide that a UR agent cannotdeny coverage based solely on the grounds thatit does not meet evidence based standards.Further the legislation would have required thatmedical directors for insurance/UR companiesbe a Tennessee licensed physician.

The insurance industry fought thislegislation hard, but Sen. Green has made this apriority and you can expect further legislationdealing with utilization review.

Practitioners under IndictmentPublic Chapter 232 requires that a health

care practitioner who is under indictment for anoffense involving the sale or dispensing ofcontrolled substances to report that indictmentto the practitioners licensing board withinseven calendar days. Further, the legislation

continued on page 12

Page 13: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

12V O L U N T E E R V O I C E S U M M E R 2 0 1 3

requires that the licensing board staff conductan expedited review of the practitionersconduct and make a report to the Board.Lastly, it encourages the district attorney to alsonotify any appropriate licensing board.

GunsPublic Chapter 16 is more commonly

known as the “guns in trunks” bill. Under thislegislation, Handgun Carry Permit Holders inTennessee may now lawfully store "firearms"in their personal vehicles parked on public orprivate property. Firearms must be kept out ofsight and locked within the trunk, glove box, orinterior of a person's vehicle or a containersecurely affixed to the vehicle if the person isnot in the vehicle i.e. a truck box. A provisionin the law states that businesses will not beliable for damages or injuries caused byfirearms stored on their premises by employeesin accordance with the law. Note, nothing in thelaw states that employers "may not" disciplineor terminate employees that bring firearms ontoemployer property. However, nothing in thelaw states that employers "may" terminateemployees that bring firearms onto employerowned property.

Professional Privilege TaxPublic Chapter 419 requests the Dept of

Revenue to study the advisability of using theprofitability ratio for the type of vocation orprofession in determining the amount of theprofessional privilege tax. The Commissioneris required to make a report by January 15,2014.

WHAT’S NEXT

The second session of the 108th GeneralAssembly is set to begin on January 14, 2014.The Speaker and Lt. Gov have again committedto a rapid pace and have encouraged legislatorsto plan their legislative package well inadvance of session beginning. The 15 bill limitfor House members is expected to continue,and we expect that session will adjourn byearly to mid-April.

Public Chapters

The public chapters are accessible viahttp://www.tn.gov/sos/acts/index by number orsubject matter. �

Page 14: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 313

Page 15: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

14V O L U N T E E R V O I C E S U M M E R 2 0 1 3

Page 16: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt
Page 17: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

16V O L U N T E E R V O I C E S U M M E R 2 0 1 3

The Research Committee of the Tennessee Physical Therapy Association (TPTA) is solicitingapplications for research grant funds. Grant funds are available to assist TPTAmembers in conductingresearch. The application materials are located on the TPTA website and are attached. Membersshould submit one copy with the title of the project, investigator’s name(s), and contact informationas well as a copy without the investigator’s name(s).

Completed applications should be submitted electronically to the Research Committee Chair, Dr.Kristin R. Archer at [email protected]. The application deadline is August 1, 2013.

Awardees will be announced at the Fall business meeting September 28, 2013 in Memphis, TN.

Research Goals and GuidelinesGoals:

1. Encourage and support novel and innovative research relevant to physical therapy conducted byTPTA members.

2. Provide monetary stipends to assist researchers in either of two ways:a. Seed Money Grants – to encourage participation in researchb. Dissemination Grants – to promote dissemination of research findings in a peer reviewedformat (State, National, or International presentations or journal article).

3. Serve as a resource to current and prospective researchers.a. Research committee serves as a resource for recommendations associated with research projects.b. Research committee encourages collaboration or multi-site projects.

Guidelines for Distribution of TPTA Research Committee funds:

1. Grant Categoriesa. Seed Money Grants

i. Description1. Small clinical research grants not to exceed $1,000 each2. Maximum of 2 grants awarded each year

ii. Eligibility requirements1. TPTA member2. Preferential consideration for new investigators

Attention TPTA Members:

Research Grant Funds Available

Page 18: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

iii. Purpose1. Assist with research investigating clinical questions relevant to physical therapy

iv. Requirements1. Submission of required application components (see TPTA Research Grant ApplicationForm) to TPTA Research Committee Chair2. Evidence of appropriate Institutional Review Board approval for proposed project3. Completion of project within 12 months of receiving funding4. Submission of an executive summary of the findings to the Chair of the TPTA ResearchCommittee at the conclusion of the study

b. Dissemination Grantsi. Description

1. Small dissemination grants not to exceed $1,000 each2. Maximum of 2 grants awarded each year

ii. Eligibility requirements1. TPTA member

iii. Purpose1. Facilitate dissemination of the results of completed research projects

iv. Requirements1. Submission of required application components (see TPTA Research Grant ApplicationForm) to TPTA Research Committee Chair2. Evidence of project acceptance to a peer reviewed venue (one of the following)

a. Presentation at a professional meeting (State, National, International)b. Publication in a peer reviewed journal

2. Investigator/Researcher Categories – eligibility criteriaa. Student Investigator/Researcher:

i. TPTA memberii. Actively enrolled in an accredited physical therapist or physical therapist assistant educationprogram in Tennesseeiii. Categories of funding available

1. Seed Money Grants2. Dissemination Grants

b. New Investigator/Researcheri. TPTA memberii. Physical therapist or physical therapist assistantiii. Has not participated in more than three (3) peer reviewed venues (any combination ofpresentations or publications)iv. Categories of funding available

1. Seed Money Grants2. Dissemination Grants

c. Experienced Investigator/Researcheri. TPTA memberii. Physical therapist or physical therapist assistantiii. Categories of funding available

1. Seed Money Grants2. Dissemination Grants

Page 19: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

18V O L U N T E E R V O I C E S U M M E R 2 0 1 3

3. Application Requirementsa. Seed Money Grants

i. Letter of Application (include brief rationale for requested funds)ii. Completed Research Grant Application Formiii. Abstract of proposed research (< 500 words)iv. Evidence of appropriate Institutional Review Board approvalv. Proposed budgetvi. Dissemination plans

b. Dissemination Grantsi. Letter of Application (include brief rationale for requested funds)ii. Completed Research Grant Application Formiii. Abstract of research (< 500 words)iv. Current budgetv. Evidence of project acceptance to a peer reviewed venue (one of the following)

1. Presentation at a professional meeting (State, National, International)2. Publication in a peer reviewed journal

vi. Request for funding must occur within 12 months following acceptance of project to a peerreviewed venue

c. Abstract Specifics [exclude author(s)]i. < 500 words (excludes title and keywords)ii. Titleiii. Purposeiv. Subjectsv. Methodsvi. Resultsvii. Conclusions

4. Review of Applicationsa. Application Deadlines

i. February 1 – award(s) announced at Spring meetingii. August 1 – award(s) announced at Fall meeting

b. Applications will be reviewed by all TPTA Research Committee membersi. Exceptions

1. Conflict of Interest – committee members will not be allowed to review applicationssubmitted by current students or faculty affiliated with their institution

c. Decisionsi. Award decisions are based on need and merit of projectii. Applicants will receive notification in writing (letter or e-mail) of the funding decisioniii. All funding decisions are final

d. Unsuccessful applicants are encouraged to resubmit an application at the next applicationdeadline

Page 20: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

Call for Research Proposals:The Tennessee Physical Therapy Association (TPTA) is soliciting applications for research grants to assistTPTA members with the cost of conducting research. Two research grants are available.

1. Seed Money Grants – designed to assist with initiating new research2. Dissemination Grants – designed to assist with dissemination of information gathered froma completed project

All TPTA members are eligible and encouraged to apply for either grant; however, preferential considerationwill be given to students and new investigators/researchers. TPTA supports and encourages new researchinitiatives related to physical therapy.

Applicants please review the Guidelines for Distribution of TPTA Research Committee Funds andcomplete the TPTA Research Grant Application Form. Application deadlines are March 1 for the Springmeeting andAugust 1 for the Fall meeting. Completed applications should be submitted electronically to theTPTAResearch Committee Chair, Kristin R.Archer, PhD, DPT at [email protected]. Applicantswill receive electronic confirmation of receipt of materials. Incomplete applications will be returned withoutreview. All applicants will receive written notification of funding decisions. Funding decisions are at thediscretion of the TPTA Research Committee and all decisions are final. Awards will be announced at thesubsequent TPTA State meeting.

Research Grant Application FormApplicant Name: _________________________________________________________________________

TPTA Member: ____ Yes ____ No TPTA number: ________________________________________Address: _______________________________________________________________________________Telephone number: ____________________ E-mail address: ______________________________________Principal Investigator: _____________________________________________________________________Other Investigator(s): _____________________________________________________________________

Researcher/Investigator Category (Select One): Grant Category (Select One):___Student Investigator/Researcher ___Seed Money Grant___New Investigator/Researcher ___Dissemination Grant___Experienced Investigatory/Researcher

Additional Information:___Amount of funds requested (< $1,000): __________________________________All other funds received: ___________________________________________

TPTA Research Grant Applicant Checklist:___Letter of Application (include brief rationale for requested funds)___TPTA Research Grant Application Form___Dissemination GrantAbstract [< 500 words, excluding author(s)]___Dissemination GrantEvidence of Institutional Review Board Approval___Dissemination GrantItemized Budget___Dissemination GrantDissemination plans (for Seed Money Grants)___Dissemination GrantEvidence of Project Acceptance for Dissemination (for Dissemination Grants)___Dissemination GrantSubmitted prior to application deadline (February 1 for Spring meeting;

August 1 for Fall meeting)

Page 21: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

20V O L U N T E E R V O I C E S U M M E R 2 0 1 3

Page 22: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt

V O L U N T E E R V O I C ES U M M E R 2 0 1 321

~ Save the Date ~TPTA Fall Meeting 2013

September 27th & 28thMemphis, TN

Page 23: MedicarePatients · 2018. 4. 14. · Cert.MDT 1854AndyLane Maryville,TN 37803 W: 865-577-2137 H: 865-380-5711 F: 865-577-8796 mray@covhlth.com Reimbursement NickCantrel,PT 1622RussellSt