2024 APTA PA Fall Reimbursement and Regulation Update 

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Course Registration

The webinar course will be held Tuesday and Wednesday, Oct. 8 and Oct. 9 from 1:00 p.m.-4:30 p.m.

About the Course

The primary focus of this seminar is to:

  1. Provide a brief update on Federal Rules updates and Commercial Insurer updates.
  2. Provide a comprehensive overview of Issues in Payment including coding, billing, denials, audits and the additional considerations for billing as it relates to practice as a physical therapist in Pennsylvania.

This includes outpatient physical therapy services provided in various settings: hospitals, home health, private practice, CORFs, rehab agencies and skilled nursing facilities. This seminar will dive into reimbursement proposed and finalized changes impacting physical therapy reimbursement and regulatory risk trends. This course also includes Physical therapists, physical therapist assistants, PT facility managers, PT compliance officers, and PT payment/reimbursement personnel employed by/consulting with PT facilities interested in remaining up to date with changes in payment and compliance with payer and regulatory requirements in the delivery of physical therapy services in Pennsylvania, are invited to register.

Registration Fee:

  • Member/Office Staff of Member* - $130
  • Non-APTA PA Member - $275
  • Student - $10

*APTA PA staff members must include their employer's APTA number in qualifying for discounted pricing. The APTA PA Office will cross-reference all attendees to ensure the correct registration type has been selected. If a non-member selects the member price, he or she will receive an invoice for the balance.

Register Here

Once your registration fee is processed, you will receive your Zoom registration link. It’s important that you complete your Zoom registration as soon as you receive the link. Don’t wait until the webinar date. 


 Course Agenda

(Important: Timeframes are subject to change to allow inclusion of issues that develop closer to the Updates.)

Tuesday, October 8, 2024  1:00 p.m. – 4:30 p.m.

1:00pm - 1:10pm

Introductions

1:10pm - 2:15pm

Commercial payer updates

  • Includes Highmark – Update on Trialliance meetings
  • Commercial trends
  • Auto, Worker’s Comp (if needed)

Federal Payer, CMS and National Payment Issues

  • Physician Fee Schedule Update
    • Payment cuts/conversion factor
    • KX and $3,000 thresholds
    • 2024 CPT Code RUC determinations – Update
  • HH, SNF, IRF – CMS proposed and final rules updates

1:00pm - 1:45pm

PA Medicaid Updates

2:15pm - 2:30pm

Break

2:30pm - 3:30pm

Medicaid Update (continued)

  • Improved Access
  • PA Legislative Initiatives

Prior Auth Initiatives

3:30pm – 4:00pm

State Telehealth Law Overview

4:00pm – 4:30pm

Q&A

 

Wednesday, October 9, 2024  1:00 p.m. – 4:30 p.m.

1:00pm – 2:00pm

MIPS – Update, 2025 proposals

2:00pm – 2:15pm

Break

2:15pm - 3:00pm

Direct-to-Employer (D2E) Model of Care

Getting Started – Compact Licensure Update

3:00pm-3:05pm

Break

3:05pm – 4:00pm

 

Hybrid Treatment and Payment Model Considerations

  • Remote Therapeutic monitoring (RTM)/Telehealth
  • Licensure/Compact Licensure
  • Maintenance Therapy
  • Consumer Influences
  • Practice Expansion Opportunities
  • Regulations Impacting Hybrid Case Management Models
  • Federal Advocacy

4:00pm – 4:30pm

Q&A


 Payment Specialists

Thomas Howell, PT, MPT
Tom is a Payment Specialist and Chair of the APTA-PA Payment Committee. Tom is from Philadelphia and graduated from Hahnemann (Drexel) but then spent 25 years out West returning to PA in 2017. He has been an APTA member since 1988 and held the position of Payment Specialist with the Idaho Physical Therapy Association. Tom is past President of the IPTA and served as the IPTA Federal Affairs Liaison. He is a member of the APTA HPA the Catalyst section (now the APTA Leadership Academy) and a former member of the HPA Bylaws committee. He was a private practice owner for 12 years out West and currently works for Dresher Physical Therapy in Ft. Washington doing Dresher PT @ Home.

Deborah Alexander, PT, DPT, AT-R, CHC, CHPC, PMP, DPT, MED, CSCS
Deb is a Payment Specialist for APTA-PA and a member of the APTA-PA Payment Committee.  Deb received her physical therapy training from Thomas Jefferson University, in 1985, Master of Education in Sports Medicine and Athletic Training from Temple in 1991, and her Doctorate in PT from Simmons in 2006.  Deb has 25 years of clinical experience in OPT orthopedics and private practice, acute care, and skilled nursing.  Over the past 15 years, Deb has worked as a compliance consultant providing consultative advisory services related to healthcare compliance, , HIPAA compliance, exclusions monitoring, coding and billing education and training, and authoring compliance, HIPAA, and OSHA policy and procedure manuals.  Deb currently serves as a Senior Consultant with LW-Consulting, Inc., providing compliance consultation and audit services to acute and post-acute care providers to ensure skill service provision, the reasonableness of the services, and medical necessity, conducting provider and payer audits under attorney privilege or in support of corporate integrity agreements, conducting compliance program assessments and gap analyses, and audits involving overpayment calculations and extrapolation.  Deb previously was the CEO of PT Compliance Group.  Deb is a member of the APTA, HealthCare Compliance Association, and Project Management Institute. 

Nuket Curran, PT, DPT, CHC
Nuket is a Payment Specialist for the APTA-PA, member of the APTA-PA Payment Committee and currently serves as the SWD Chair for the APTA-PA. She is certified in Healthcare Compliance and is currently the National Director of Clinical Services and Compliance for US Physical Therapy. She has owned and operated her own compliance consulting company, providing compliance consulting services to practice owners including program compliance, program development, assessment and preparation for merger and acquisition. Nuket has worked in compliance departments both as director and compliance officer for over 17 years, for organizations in multiple states. In addition, she owned two small outpatient PT practices in the greater Pittsburgh area and in Belfast, Northern Ireland (UK) providing orthopedic Part B services. She serves as an adjunct lecturer at Chatham and Slippery Rock Universities teaching compliance and business topics to students. Nuket completed her undergraduate degree at the University of Pittsburgh and her PT degree at the University of Ulster in Northern Ireland, UK. She attended Utica College to complete her transitional Doctorate in Physical Therapy where she also served as a faculty member.