Regulatory Changes for 2017

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Quality Payment Programs

By Alpha Lillstrom Cheng, JD, MA
July 7, 2017

As you know, the Centers for Medicare & Medicaid Services (CMS) is responsible for developing, proposing, and finalizing regulations in order to implement health care–related legislation that has been passed by Congress and signed into law. On behalf of the more than 4,200 members of the Private Practice Section, PPS regularly analyzes and provides stakeholder input in the form of “comments” to proposed rules that pertain to private practice physical therapy.

Regulatory Changes for 2017

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Bundled Payment Program

By Alpha Lillstrom Cheng, JD, MA
June 6, 2017

As you know, the Centers for Medicare & Medicaid Services (CMS) is responsible for developing, proposing, and finalizing regulations in order to implement health care–related legislation that has been passed by Congress and signed into law. The regulatory process consists of publishing proposed rules for public viewing and requesting stakeholder input in the form of “comments.” On behalf of our over 4,200 members, the Private Practice Section (PPS) regularly analyzes and responds to regulatory activity that pertains to private practice physical therapy.

In recent years, payment for services provided to Medicare beneficiaries has been moving away from the standard fee-for-service model and toward payment on the basis of quality; therefore, regulatory proposals relevant to the practice of and payment for physical therapy care have been increasing in number and complexity. This year three such rules will go into effect. In the March issue of Impact, this column covered the changes in the 2017 Medicare Physician Fee Schedule (MPFS), which resulted in payment adjustments for care provided by physical therapists and other providers who are paid under the fee schedule. In this column, I will discuss the planned expansion of the Comprehensive Care for Joint Replacement (CJR) bundling program and the impact this policy could have on physical therapists in private practice.

Reconciliation Explained

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The best option for making changes to the ACA?

By Alpha Lillstrom Cheng, JD, MA
May 5, 2017

The word of the year for health care policy is reconciliation. This special legislative procedure has been used for decades to pass controversial legislation with a simple majority vote in each chamber of the US Congress. Using standard legislative procedure, a divisive issue such as health care reform or repeal legislation would likely be bogged down and effectively sidelined. This is because, under regular order, the Senate allows for unlimited debate, known as the filibuster, which can be used to block legislative action. While Republicans currently have the majority in both houses of Congress, their 52-48 majority in the Senate is insufficient to assemble the 60 votes commonly needed to cut off debate and pass legislation. Therefore, the Republican party and the White House are now seeking to use reconciliation—a complicated yet useful tool—to pursue the passage of health care legislation that would otherwise not succeed in the Senate.

Regulatory Changes for 2017

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Medicare Physician Fee Schedule Update for Calendar Year 2017

By Alpha Lillstrom Cheng, JD, MA
March 3, 2017

The Centers for Medicare & Medicaid Services (CMS) is responsible for developing, proposing, and finalizing regulations in order to implement health legislation that has been passed by Congress and signed into law. The regulatory process consists of publishing proposed rules and requests for information in order to allow for public review and to receive stakeholder input in the form of “comments.” On behalf of the over 4,200 members, the Private Practice Section (PPS) regularly analyzes and responds to regulatory initiatives that pertain to private practice physical therapy.

Legislative and Regulatory Advocacy Priorities for the 115th Congress

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By Alpha Lillstrom Cheng, JD, MA, and Jerry Connolly, PT, CAE
February 2, 2017

Every two years, each seat in the House of Representatives and one-third of the one hundred U.S. Senate seats are up for election. The 115th Congress began on January 3, 2017, when all of the members of the House of Representatives and 34 U.S. senators were sworn in for their terms in office. This new Congress is the most diverse in history, with more minority lawmakers than ever before and a record 21 women in the U.S. Senate. There are 52 new members of the House of Representatives, and the House’s Republican majority was reduced by a dozen to 47. Republicans also hold the majority in the Senate with 52 members to the 46 Democrats and 2 independents who caucus with the Democrats. There are seven new senators, three of whom (Chris Van Hollen [D-MD], Tammy Duckworth [D-IL], and Todd Young [R-IN]) moved from serving their district in the House to representing their whole state in the Senate. While the GOP majority is smaller than in previous Congresses, the party still controls the floor and committee agendas in both chambers.

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