MEDICARE PATIENTS ARE LOSING BENEFITS: TAKE ACTION!

Unbeknown to many of their constituents, Congress has failed to prevent the implementation of an arbitrary therapy cap for all Medicare patients. As of January 1, 2010, all Medicare patients seeking speech, occupational, or physical therapy in an outpatient setting (under Part B) are subject to a cap of $1860 per calendar year. Physical and speech therapy have a combined $1860 cap and occupational therapy has its own $1860 cap. As a result, if you (or someone you know) needs physical therapy after a surgical procedure or suffers from a debilitating injury (i.e. total knee replacement or stroke, respectively) Medicare will likely only cover approximately 14-20 physical therapy visits. As a result, if a patient were to attend 3 sessions of physical therapy per week, they would be covered for less than 2 months of care prior to reaching their maximum Medicare benefit. After reaching their maximum benefit, patients are left to either go to a hospital for therapy (which is covered under Part A) or pay out of pocket.

What this means for the patient is that the United States Congress has limited the choices available to patients regarding their own medical care; forcing them to attend only hospital clinics should they need therapy beyond their cap. This is a significant obstacle for patients who reside in rural areas who do not find it convenient to travel to hospitals for their therapy services 2-3 times per week. Additionally, even if a patient is making significant progress in a local physical therapy clinic and has developed a fruitful relationship with the physical therapist of their choosing, Medicare will not continue to cover therapy services with that therapist, forcing the patient to pay "out-of-pocket" or change therapists.

Since 1999, the United States Congress has acted to prevent the implementation of these caps by initially passing several moratoria and later authorizing an exceptions process to allow patients to continue to receive rehabilitative services beyond the $1860 cap so long as the services were deemed "medically necessary". To date, Congress has not acted, and the caps are now in place. The American Physical Therapy Association (APTA) states in a recent press release:

"The lack of action by Congress is troubling, especially as it had the opportunity to attach a temporary extension to the caps exceptions process to the Department of Defense Authorization Act as it did with physician and provider payments, including those to physical therapists. APTA is discouraged and disappointed that Congress is allowing an arbitrary annual cap on outpatient rehabilitation services to be placed on Medicare beneficiaries on January 1, 2010. This is clearly inconsistent with efforts by President Obama's administration and the Democratic majority to reform health care by eliminating arbitrary limits imposed by private insurance companies. Congress must hold the Medicare program to the same standard. Ensuring payments to providers, including physical therapists, while allowing this cut to rehabilitation services for seniors and people with disabilities during the health care reform debate is gravely disconcerting."

If you are bothered and troubled by our legislators inaction, or you are angered over the obstacles now placed before Medicare patients in attaining proper rehabilitative care, Mary Lou Corcoran Physical and Aquatic Therapy encourages you to take action and contact your United States representatives at both the senate and congressional levels. The APTA has provided a simple online format to allow you to contact your senate and congressional representatives regarding the Medicare Part B rehabilitation caps here.

The only way that you can let Washington know that they need to do what is right for patients with Medicare is contact them. Do not allow your voice to go unheard!

Posted by Keith P. Waldron PT, DPT

Dizziness and Physical Therapy

Have you ever stood up and experienced the sensation that the room is spinning around you? Most often this is a result of standing too quickly, standing too long, or low blood sugar. Usually the symptoms pass quickly, and there are no long term implications. Unfortunately many individuals endure these sensations on a daily basis as a result of a more complex diagnosis. The good news is many causes of dizziness are successfully treated by physical therapy.

Anyone who experiences dizziness on a regular basis, experiences dizziness in conjunction with a loss of balance or sickness, or becomes dizzy after any injury to the head should contact their doctor to discuss these symptoms. Once a Doctor determines the specific cause, an appropriate treatment plan may be developed.

Let’s begin with the most severe cause, a traumatic event such as a brain-stem injury, concussion, or whiplash. A motor vehicle accident that leads to a neck injury can result in cervical vertigo. Along with dizziness, cervical vertigo symptoms may include neck pain, decreased neck range of motion, pain in the shoulders or into your shoulder blades and headache. By treating the cause of the neck pain and headaches, along with improving neck range of motion, patients experience a decrease in occurrences of dizziness.

Another common condition is Begign Paroxysmal Positional Vertigo (BPPV), a result of debris collecting in the inner ear. Commonly referred to as “ear rocks”, this debris causes a disturbance to the neurons located inside the canals when it moves¹. Dizziness will occur with position changes such as getting in and out of bed, rolling over in bed, straightening up, leaning forward, turning your head while walking or sitting in the car. A physical therapist is able to create an exercise program to habituate certain head movements, improve balance, reposition the debris in the canal, and treat additional symptoms like neck pain¹.

Lesions in the vestibular system may impact the messages sent to the brain regarding your body’s position in space resulting in decreased balance, reduction in the ability to focus on an object, and a lower tolerance to motion². Physical therapy treatment will include exercises to improve balance, habituate head with body motions, and stabilization of visual focus on both moving and stationary objects.

Physical therapy had proven to be an effective treatment for many causes of dizziness. A prescription from a Doctor for a physical therapy evaluation is all you need to get started on the path to reduce dizziness caused by one of the above diagnoses. During the evaluation the physical therapist will obtain a complete medical history, perform tests to assess your balance and other symptoms. With the development of a treatment plan, your therapist will help you to overcome these conditions, allowing you to return to your normal daily living.

References:

1. Herdman S. Treatment of Benign Paroxysmal Positional Vertigo. Phys Ther. 1990;70:381-388.
2. O’Sullivan SB, Schmitz TJ. Physical Rehabilitation Assessment and Treatment: 4th edition. F.A. Davis Company, Philadelphia, 2001.

Posted by Jessica A. Knapp PT, DPT

Welcome to the new MLCPT.com

Mary Lou Corcoran Physical and Aquatic Therapy is very happy to roll-out our brand new website! The new MLCPT.com is a new start for MLCPT in utilizing the resources of the internet to improve our patient's overall therapy experience; with its new features and design, MLCPT.com now serves as a virtual extension of our office.

It is our hope that patients, physicians, and community members will continue to find all the great information that our previous website design had to offer (practice philosophy, staff bios, and contact information) while enjoying the enhanced features of the new site (Blog, online patient forms, updated content).

The MLCPT blog will be an important part of Mary Lou Corcoran Physical Therapy's community outreach and educational program. It will be utilized to answer common and frequently asked questions, post news and updates about our practice, and provide information about the role that physical therapy and MLCPT staff has in improving the health, prevention and wellness of our community.

In the days, weeks and months to come we hope to be posting on the blog consistently, so we recommend that you stop by often, bookmark us or follow us via our RSS feed. There is sure to be some great information available in the near future!

But until that time...take a peak at, and become familiar with, the new MLCPT.com. We hope you like it as much as we do!

Posted by Keith P. Waldron PT, DPT