Prime Mover - October 2008

New Mexico Physical Therapy Association

Thank you to everyone who attended our Fall Conference. We've received some great feedback on the John Childs course and hope those of you who attended are successfully using the techniques in your practice. For those who attended the APTA presentation on Medicare guidelines and/or NMAPTA's presentation on Legislative issues, we hope that you gained valuable information to navigate these sometime confusing areas. Thanks again to Claudia Segura and Linda Obendorfer for planning the meeting and to Sahreem Luergan for presenting the Legislative issues update. We will not be having a Spring 2009 conference, but we are very excited about plans for our Fall 2009 conference that will also include the election of new officers. If you are interested in volunteering to serve or want more information, please contact Pat Bartels. More details will be available on dates and locations for Fall Conference in early 2009.

I am currently working with our board members to update the contract with APTA for Executive Director Services for 2009. The contract that we have had since 2006 has worked well for NMAPTA by allowing us to use APTA's resources in addition to the great executive director support. Our Executive Director is Suzie Callan, whose hard work and organizational skills have been a huge asset to all of us who are volunteers in our professional organization.

We want to hear from you! Please share your suggestions and feedback by contacting me at kim_parker-guerrero@chs.net or Suzie Callan at suziecallan@apta.org. We are planning on sending out a member survey in early 2009 to get your feedback on topics such as membership expectations, continuing education needs, and practice support but in the meantime contact Suzie or myself.

I just want to let you know how much I've appreciated the opportunity to serve as your President. The time has flown by - I've learned so much and have met so many wonderful people that are now friends. I hope that you will consider running for office so you too can have this great experience. It truly is an honor.

Kim

Genia Devenport FROM THE VICE PRESIDENT

The Professional Practice Committee has been hard at work revising the policies and procedures related to the functions of our committee. Following a review of the NMAPTA bylaws, the functions of the Professional Practice Committee include but are not limited to:

Membership Recruitment, Retention, and Development
Public Relations Publication (electronic and or printed media) of the Chapter Newsletter - "The Prime Mover"
Service Awards
The Chapter Directory
Liaisons with Special Interest Groups and with the State Licensing Board
Standards of Practice

It is the function of this committee to also provide oversight of the NMAPTA website which is not addressed in our bylaws or policies and procedures. We have decided to revise our policies to address each function as stated in the bylaws. We have successfully completed drafting the following policies: Liaison Policy, NM Chapter APTA Awards Policy, and a Prime Mover Policy. We have initial drafts submitted by our committee members on membership, public relations, and standards of practice which we will be addressing next. In addition, a policy on the website will also be drafted for review.

Included in this edition of the Prime Mover is the final draft of the Prime Mover policy for your review. Please return comments on any changes or additions. Your thoughts and suggestions are appreciated. A special thanks to members of our committee: Karen Martin Summers, Traci Reindle, Lance Hipple, Meghan Haid, Cindy Lawton, John Guarino, and Kim Parker-Guerrero.

Genia Devenport, Vice President

PROPOSED PRIME MOVER POLICY

POLICY: The NM Chapter APTA will develop and maintain an official publication named "The Prime Mover" to serve as a vehicle of communication between the Board of Directors and the Chapter membership.

PURPOSE: The Prime Mover will improve communication and awareness between physical therapists within the state to assist in meeting the goals of the Chapter and the Association. All material published will conform to the ethical standards of the American Physical Therapy Association.

PROCEDURE(S):

5.1 Content: The information in the Prime Mover may include, but not be limited to, the following:

5.1.1   Reports from the Board of Directors representing the committees such as finance, education, legislative, and professional practice.
5.1.2   Reports from the executive committee including the President, Vice President, Secretary, and Treasurer.
5.1.3 Columns that would serve to inform the readership of various area activities such as "Specialty Areas," featured facilities, letters to the editor.
5.1.4 Each issue will contain contact information for the NMAPTA Board of Directors and the Executive Director.
5.1.5 All members are encouraged to participate by contributing articles to the newsletter. All accepted articles will have a by-line giving credit to the author.

5.2 Timeliness: The Prime Mover will be timely and dependable.
5.2.1 The Prime Mover will be published at a minimum of twice a year and sent to the members of the NMAPTA and to all advertisers in the issue. In addition, the Professional Practice Committee may also choose, in addition to its' membership, to send the Prime Mover to New Mexico licensed physical therapists who are non-members of the NMAPTA.

5.3 Professional Development: The Prime Mover will encourage professional development by including the following types of information:
5.3.1 Information on upcoming continuing education classes approved by the CE reviewer or offered by the NMAPTA
5.3.2 Reviews of professional articles or books
5.3.3 Information on professional meetings, such as an orthopedic study group meeting
5.3.4 Suggestions from the field
5.3.5 Case studies

5.4 Student Involvement: The Prime Mover will encourage involvement of physical therapy and physical therapy assistant students in the Chapter by publishing information that directly impacts the students such as:
5.4.1 UNM School of Physical Therapy column
5.4.2 Column from PTA programs in state
5.4.3 Scholarship information
5.4.4 Articles written by students with special emphasis on summaries of current research performed by the student population

5.5 Finances: The Prime Mover will be financially self-sufficient by charging a fee for advertisements. Advertisers may include but are not limited to:
5.5.1 Durable medical equipment vendors
5.5.2 Employment opportunities
5.5.3 Sponsors of continuing education coursework approved by the NMAPTA CE reviewer

5.6 Publication: The Prime Mover may be published through electronic media to Chapter membership.
5.6.1 Cost-effective methods of publication through electronic means will be utilized when possible utilizing email lists of membership.
5.6.2 Hard copy publication to Chapter members and non-members may be considered when possible to promote membership opportunities and enhance communication to all New Mexico licensed physical therapy practitioners.

5.7 Responsibility and procedures: The Professional Practice Committee is responsible for the oversight of the Prime Mover and will provide advice to the Executive Director in the call for articles and approval of the final draft.
5.7.1 A call for articles to the Board of Directors and/or membership will be made through the Executive Director who will forward all articles for review and editing to the Professional Practice Committee Chair or designee. The Chair will submit articles to the Professional Practice Committee members for review and editing, as appropriate, for publication.
5.7.2 Articles may be solicited from various members, as needed, to address current Chapter business.
5.7.3 The Executive Director will prepare a draft of the publication and receive final approval from the Committee Chair prior to publication.
5.7.4 A copy will be forwarded to the Webmaster for publication on the Chapter website.
5.7.5 Archives will be maintained, as appropriate, electronically for future reference when needed.

REIMBURSEMENT NEWS - OCTOBER 2008

See below for the latest E-notes from the APTA Private Payment Policy &

Advocacy Unit:

Reimbursement Chair Meeting: The Reimbursement Chair meeting combined into the State Policy and Payment Forum was a huge success! This was the first time ever that Payment Policy and State Government Affairs joined forces to have a combined meeting. This event was designed to increase participants' involvement in and knowledge of policy and payment issues that have an impact on the practice of physical therapy, and improve their advocacy efforts at the state level.

Recovery Audit Contractors: On Monday, October 6, 2008 the Centers for Medicare and Medicaid Services (CMS) announced the names of the four companies awarded contracts as Recovery Audit Contractors (RACs) and the first states to be affected. These companies will be requesting medical records for review to identify and recoup Medicare overpayments from providers. The new RACS are:

Region A (initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island and New York): Diversified Collection Services, Inc.
Region B (initially working in Michigan, Indiana and Minnesota): CGI Technologies and Solutions, Inc
Region C (initially working in South Carolina, Florida, Colorado and New Mexico): Connolly Consulting Associates, Inc.
Region D (initially working in Montana, Wyoming, North Dakota, South Dakota, Utah and Arizona): HealthDataInsights, Inc.

While the RACs have been implemented in these states as of October 1, 2008, CMS does not anticipate that the RACs will make immediate requests for records. More information about the RACs can be found on the APTA website at www.apta.org/medicare under the "Denials, Audits, and Appeals" subsection. If you have additional questions, please contact Payment and Policy Advocacy at 800-999-2782 X8511.

Link to chart:
http://www.apta.org/AM/Template.cfm?Section=Home&Template=/MembersOnly.cfm&ContentID=52226

Update to a Medicare Learning Network Educational Product: CMS Form 1500 Web-Based Training Course: The CMS Form 1500 Web-based Training (WBT) course has been updated (July 2008) and is now available from the Centers for Medicare & Medicaid Services Medicare Learning Network. This WBT course provides information that will allow you to file Medicare Part B claims accurately and reduce your chances of receiving unprocessable rejections.

To access this WBT, visit http://www.cms.hhs.gov/mlngeninfo/, scroll down to "Related Links Inside CMS" and select "Web-based training Modules", scroll down to "Office Management Information" to select this training.

Transmittal on ABNs: CMS issued a Transmittal on ABNs on September 5 on the Revised Form CMS-R-131 Advance Beneficiary Notice of Noncoveragehttp://www.cms.hhs.gov/transmittals/downloads/R1587CP.pdf

Guidance for Health Care Providers and Consumers on the HIPAA Privacy Rule and Communications with a Patient's Family, Friends, or Others Involved in the Patient's Care: The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has published two new HIPAA Privacy Rule guidance documents. The documents discuss when a health care provider may share a patient's health information with the patient's family, friends, or others involved in the patient's care. These new guides answer common questions about these permitted and important communications and target an area of the HIPAA Privacy Rule that is frequently misunderstood by health care providers and patients alike.

The provider guide is available at http://www.hhs.gov/ocr/hipaa/provider_ffg.pdf.

The consumer guide is available at http://www.hhs.gov/ocr/hipaa/consumer_ffg.pdf.

ICD-10-CM/PCS: The Centers for Medicare & Medicaid Services (CMS) will host a series of national provider calls that will provide an overview of ICD-10 and how it differs from ICD-9-CM. The presentations will include the major impacts providers should consider when planning to update any systems with ICD-10 codes. Issues such as differences in code length, alpha-numeric characters, and increased details captured by the codes will be explained. This overview will help the provider and payer community think about future reporting, system updates, and training, considering that ICD-10 may be implemented in the future.

A PowerPoint slide presentation has been posted on the ICD-10 Web Page at http://www.cms.hhs.gov/ICD10.

Part A and Part B Providers (except Hospitals)
November 12, 2008
12:30 p.m. - 2:30 p.m. EST
Registration information for this conference call will be forthcoming. http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp#TopOfPage.

Healthy Consumer Report: An article highlighted in the Wall Street Journal focuses on the difficulties consumers face when appealing insurers' denials of coverage, in addition to providing strategies in appealing these denials.

Pushing Back When Insurers Deny Coverage for Treatment http://online.wsj.com/article/SB122230334120773621.html

Unit Updates
Erik Van Doorne is the new Senior Director of Payment Policy & Advocacy: Erik will be responsible for directing and managing the Payment Policy and Advocacy Department, which includes federal payment and policies and private insurer payment and policies. Erik has been a practicing physical therapist for the last 14 years and is currently Owner/President of Manual Orthopaedic Physiotherapy, a private practice based in Wilmington, Delaware. Erik also has been an active member of APTA, including involvement with the House of Delegates and the Advisory Panel on Reimbursement Policy and Planning. He is a member of the Private Practice, Orthopedic, Geriatrics, and Health Policy and Administration sections and has been involved at the chapter level, serving as President of the Delaware Chapter from 2000-2003. Erik also has been Delegate and Alternate Delegate to the AMA RUC/HCPAC. Erik will be transitioning to APTA in the coming months as he prepares to sell his practice and move to the Alexandria area. Erik can be reached at erikvandoorne@apta.org.

Upcoming Audio Conferences: On October 28, APTA Payment Policy and Advocacy staff will present "Management of Your Revenue Cycle and Appeals: Tools for Office Managers and Clinicians," offering guidance on reducing administrative time and expense by improving the handling of appeals of denied claims, scheduling of patients, and managing cash flow.

On November 19, APTA Payment Policy and Advocacy staff, along with a guest speaker will present, "Remaining Compliant: What PTs Need to Know." This audioconference will focuses on rules on discounting services, giving gifts to referral sources, and handling relationships with physicians that refer patients will be some of the topics.

Registration for both audioconferences is now open.

An audioconference on the final rule for the 2009 Medicare Physician Fee Schedule is planned for early December.

APTA Insurance Forum: The annual APTA Insurance Forum will be held at the Four Points by Sheraton in downtown Washington DC on December 4th and 5th. This year's program will include sessions on the Guide to Physical Therapist Practice and CPT Coding for Services provided by Physical Therapists. The program will also include Key Practice in Industrial Physical Therapy, highlighting work in the Kentucky coal mines; another speaker will address Physical Therapists Management of Overweight/Obese Patient/Clients, and another will be discussing EMG and Nerve Conduction Testing.

2008 NEW MEXICO LEGISLATIVE CANDIDATE SURVEY RESULTS

Submitted by Sahreem Luergan, PT

Below is the 2008 New Mexico State Legislative Candidate Survey sent out by the NMAPTA Legislative Committee to educate candidates about issues impacting physical therapists in New Mexico. The survey was sent to 154 candidates for State House and Senate seats and included a paid postage return envelope. We received 37 surveys back, which equates to a ~24% response rate. We have tallied the responses to our questions and included comments from the candidates. Their responses were generally quite supportive of our profession.

We are in the process of following up with any candidates who had specific questions. We feel this survey is a useful tool to maintain open dialogue between PTs and legislators. If you have any questions or comments about the survey, please email Gretchen Johnson, PT, NMAPTA State Leglislative Chair at: santafejohnsons@cnsp.com

The New Mexico Chapter of the American Physical Therapy Association (NMAPTA) is the professional association for licensed physical therapists (PTs), licensed physical therapist assistants (PTAs), and students of physical therapy in the state of New Mexico. We represent over 400 therapists and assistants that work in hospitals, out-patient clinics, rehab facilities, home health agencies, nursing homes, schools and other settings.

Professional Practice
1. With regards to professional practice in the State of New Mexico, State statute currently gives the legislature the power to create practice boards and acts and to hold public hearings and call expert witnesses when changes to practice acts are proposed. In recent legislative sessions, there has been interest in creating a Super Board to deal with changes to scope of professional practice. Our view of this matter is that Scope of Practice bills would create another bureaucratic layer for changes in professional practice acts with a super board heavily weighted with physicians. Although physicians are astute professionals, we do not feel that they are necessarily aware of what is appropriate for our scope of practice in terms of our education and training. In some instances, there could be issues that would provide conflicts of interests, making unbiased decisions impossible.   On a national level, there is a coalition of six professional licensing boards that have created a document to assist legislators and regulatory agencies with making decisions about changes to health care professions' scopes of practice, as opposed to re-creating the wheel locally with a Super Board.

Given this information, do you support legislation to create a Super Board to address changes in scope of practice for health care professionals?

□ Yes (1)     □ No (27)     □ Undecided (9)

COMMENTS

I will generally vote for less bureaucracy. But, I will always look at both sides of an issue to be fair- Jeff Carr, Candidate, House Dist #22, PO Box 313, Eagle Nest, NM 87718, 575-377-7012 (h), 575-770-0335 (w) hastings@wildblue.net
I would be very interested in reviewing the document you mention. We as legislators, are lay people and most of the special bills are to increase the scope of practice - much more than training and education. When it comes to prescriptive authority, it becomes very serious, in counteracting with other Rx's, etc- Sue Wilson Beffort, Incumbent, Senate District #19, 67 Raindance Rd., Sandia Park, NM, , 505-292-7116 (h) suebeffort@hotmail.com
I would need more info, but I don't think we need more boards-George Peterson, Candidate, House District #58, 204 E. Mt. View Rd., Roswell, NM 88203, georgelocal51@yahoo.com, 575-317-2353 (w)
I'm not sure medical doctors can adequately oversee their own profession, let alone any others. They are doctors, not wizards- Gerald Ortiz y Pino, Incumbent, Senate District #12, 400 12th NW, Albuquerque, NM 87102, 505-243-1509 (h), 505-250-1280 (w), jortizyp@msn.com
I favor less regulation, super boards seem like more regulation. I oppose extra regulation. I prefer less licensing rather than more!- Lee Cotter, Candidate, Senate District #36, 6670 Butterfield Ridge, Las Cruces, NM 88007, 575-525-3200
Overregulation merely makes it harder for NM residents to receive the services they need from licensed providers. Regulatory relief is needed to benefit both provider and consumer - Dennis Roch, Candidate, House District #67, PO Box 1391, Tucumcari, NM 88401, 575-799-7796 (h), 575-461-3910 (w), denroch@hotmail.com
Need to study the issue - Gloria C. Vaughn, Incumbent, House District # 51, 503 East 16th St., Alamagordo, NM 88310, 575-434-2819
Agree with your analysis-Leonard Lee Rawson, Incumbent Senate District #37, PO Box 996, Las Cruces, NM 88004, 575-522-8289 (h), 575-528-1801 (w), lrawson@rawson-inc.com
The proposed board would be taken from recommendations from Governor, legislature, and those involved. That might not be a bad idea if it will help answer some of the health problems citizens encounter.Mario Trujillo, Candidate, House District # 64, 600 Wrangler Way, Clovis, NM 88101, 575-760-1332 (h), 575-763-5591, mvmtrujillo@plateautel.net
I have worked with PAs and dental hygienists. Don't think putting the MDs in charge is the right answer. Thanks for the question.- Nathan Cote, Incumbent, House District #53, 15475 Space Murals Lane, Las Cruces, NM 88011, 575-373-0902 (h), 575-202-1872 (c), ncote@zianet.com
I am thinking in the long run this will not be good for your practice. I 'd like more info - Joni Gutierrez, House District #33, PO Box 842, Mesilla, NM 88046, 575-647-5577, jonig@zianet.com
I agree that the composition of this proposed board could be problematic- Ellen Wedum, incumbent, House District # 59, PO Box 1086, Cloudcroft, NM 88317, 575-682-2464 (h), wedum59@gmail.com
In NM, we spend so little time in session that it is very difficult to figure out, for example, if we should accept the positions of dueling professionals, optometrists, ophthalmologists, psychologists, or psychiatrists, etc.- Gail Chasey, House District #18, 1206 Las Lomas NE, Albuquerque, NM 87106, 505-266-5191 (h), gailchasey@msn.com
I understand your fear of lack of representation. I would like the board to make recommendations, but the final decision to be the legislature. It is very hard for lawyers, teachers, realtors to understand many of these detailed issues. We need you professionals to sort it out before it comes to us, but legislators make the final decision - Steve Komadina, Incumbent, Senate District #9, PO Box 2085, Corrales, NM 87048, 505-3284696 (c), 505-893-2840 (w), komadina@stevekomadina.com
I will not support legislation to create any super board- Andy Nunez, incumbent, Andy Nunez, House District # 36, PO Box 746, Hatch, NM 87937, 575-267-3451 (h), 575-644-3014 (w), annunez@zianet.com
I would need to see the legislation, but I do not believe more bureaucracy is the ready answer- Ronald G. Toya, Candidate House District # 17, 124 Camino de Amador NW, Albuquerque, NM 87107, 505-344-9092 (h), votetoya@comcast.net

Practice Autonomy
2. The US military has long allowed physical therapists autonomy in providing physical rehabilitation. In military settings, the physical therapist is often the first provider for patients with musculoskeletal injuries. With their unique and extensive education, physical therapists evaluate the patient and then determine if the patient needs further assessment and care by a specialist, such as an orthopedist. PTs can order diagnostic tests and imaging studies. This has saved the military time and money and is a model that has been in practice for several years. More recent studies have demonstrated that self-referred patients in the private sector are seen for fewer visits than if referred by a physician.

Examples of ways to promote autonomy, or "direct access", to physical therapy include encouraging insurance companies to pay for self-referrals to physical therapy, and
supporting legislation that allows patient choice for physical therapy services, without requiring an initial referral by a physician.

Considering this information, do you support legislation that would promote autonomy for physical therapists?

□ Yes (32) □ No □ Undecided (5)

COMMENTS

The "gatekeeper" has been removed from most HMO referrals. In terms of cost containment, certainly serious injuries need much help and I would support self-referrals in many instances. Like all medical care, unlimited use fore minor things can increase premiums even more than they are now-Sue Wilson Beffort
Our entire medical care system needs to be revamped so that address to needed care is not unnecessarily impeded by routing everything through the most expensive link in the chain-Gerald Ortiz y Pino
Probably yes, I may have some questions. Is there any kind of established relationship between physical therapists and the patient's doctor or other health care provider, even if only on information flow? Does the PT serve as a kind of primary care provider? These are just information questions so I have a better understanding of the system- Danice Picraux, Incumbent, House District #25, 4308 Avenida La Resolana NE, Albuquerque, NM 87110, 505-232-2977
I favor less regulation. Easy ways for patients to get to professionals without difficulty-Lee S. Cotter
This approach represents an "open market place" approach to health care, which is where our best reform hopes lie-Dennis Roch
I am just like you in that I cannot see some insurance patients without PCP referral. That is why I support health savings accounts where patients are totally free to buy the service they want and shop for care-Steve Komadina
I support the self-referral component, but do believe giving insurance companies more mandates (above the 57 we now have) will not do anything but raise health care costs-Ronald Toya

Physical Therapist Shortage
3. There is a shortage of physical therapists with the hardest hit areas being small cities and towns. New Mexico is a rural state, and, as such, the shortage of physical therapists is especially problematic. This affects the delivery of much need physical rehabilitation services in school settings, home health, hospitals, and private practices.

There are many effective methods to bring physical therapists to New Mexico. Here are some examples:

Increase funding to the physical therapy department at the University of New Mexico in order to increase the number of available slots in the physical therapy program.
Loan forgiveness or assistance for working in rural areas.
Promote direct access to physical therapy, as discussed in Question #2.

In general, do you support legislation that would attract physical therapists to live and work in New Mexico?

□ Yes (35) □ No □ Undecided (2)

COMMENTS

Really like option 2 and other 2 options are also attractive- Janice Saxton, House Dist. #22, 123 Juniper Rd., PO Box 1139, Placitas, NM 87043, jnsaxton@msn.com, 505-867-1139 (h), 505 301-3126 (w)
My husband had a series of sessions with a physical therapist for his terrible spine pain and you all did a great job with him. Thank you for the service you provide. I know about the shortage and am working on it-Sue Wilson Beffort
I'd like to generalize this point to all health care professionals and ancillary care providers-Gerald Ortiz y Pino
I like personal choice and incentives, things like #2 I like-Lee Cotter As a school district administrator in rural NM, I know first-hand the difficulty of finding adequate ancillary service providers! Increased ability to recruit and retain would benefit rural communities especially- Dennis Roch
Very important to rural communities! As a trustee for Dan Trigg Hospital, I understand the need for physical therapists- Craig Cosner, Candidate, House District #67, PO Box 563, Tucumcari, NM 88401, lkc3004@plateautel.net, 575-461-3004 (h)
We need incentives for all mid-level and other medical providers-Nathan Cote I would like to know how well these incentives have worked in other states. Ellen Wedum
I would be happy to introduce or co-sponsor such legislation-Steve Komadina
Depends on the legislation but increasing health care professionals to NM can only benefit the state-Ronald Toya

Physical Therapy Education Programs

The Physical Therapy program at UNM needs to convert to a Clinical Doctorate (DPT) level within the next year. This conversion is mandated at a national level, with 85% of PT programs nationally now offering this degree level. UNM is the only PT program in the state and the only one of ten programs offered regionally that does not offer the DPT. In 2007, 41% of qualified applicants to the UNM program accepted positions in out-of-state programs. NM residents compose 99% of students in the average accepted class. Nearly 50% of these students are from smaller NM communities. By converting to the DPT, we hope to stop the flow of students to out-of-state programs since once they leave they are far less likely to return to NM to practice. The process of funding this conversion is underway through the UNM School of Medicine.

COMMENTS

I support this!-Janice Sexton
Good news!-Danice Picraux
I personally and members of my family have benefited from the help of physical therapists-H. Diane Snyder, Incumbent, Senate District #15, 7006 Elna Ct. NE, Albuquerque, NM 817110, hdsnyder@spinn.net, 505-830-1669 (h)

SUMMARY OF PT LICENSING BOARD MEETING