Traumatic Brain Injury Should be Recognized as Chronic Condition, Study Argues

How Can You Make a Difference? Build Relationships With Your Members of Congress!

It is important to get to know your member of Congress. This may appear intimidating, but members of Congress are people too.  Most members of Congress are professors, attorneys, and businesspersons. Some of them are physicians, nurses, and doctors of various professions that understand why we are so valuable. These are real people who come from all walks of life, who are public servants seeking to improve public policy.   Advocacy is not just sending a letter but actually building relationships, so when important issues come up, we have somebody that will listen and take action on our behalf.

Here are four ways to do this with the help and support of your APTA Home Health Federal Affairs Liaison:

• Join hundreds of other APTA members by advocating for physical therapy and our patients on Capitol Hill in Washington D.C. on July 24-25 for APTA Capitol Hill Day. Attend advocacy training on July 24^th and meet your House Representative and Senators to talk about important issues that will impact the future of the profession. Registration is open today! Don’t miss your chance to give your patients a voice!
  
  
• Schedule a district office meeting when your member of congress is home for recess. Meet with them in the district simply by making a phone call to their office and asking for an appointment. Being a constituent makes you an important person. Knowing the issues is equally important. Read our Federal Affairs Liaison Briefing Memo for the latest update.
  
  
• Attend a town hall meeting. Often members of Congress will hold a town hall meeting where they will discuss important issues that they see as important to their Congressional district. It is a great opportunity for you to attend and raise issues that you also believe are important.
  
  
• Organize a college visit if you are a student. Your campus can host a member of Congress who represents the Congressional district where the college presides. The member of Congress can discuss issues of importance to your University and get to know you. Trust me, they will be grateful for exposure to potential voters.

We have seen, through the years, the profound impact advocacy can have on the profession of physical therapy. APTA has always been able to count on an extremely “deep bench” of seasoned advocates, who have continued to move the needle in the halls of Congress, but now we turn to you. Learn, Educate Advocate, Our Patients & Physical Therapy are Counting on Us!

Dr. Eva Norman, PT, DPT, CEEAA
APTA Home Health Federal Affairs Liaison
[email protected]

Crisis Averted as Senate Sends Debt Limit Package to Biden

Roll Call
 
Senators staved off a financial crisis — and a weekend of voting in Washington — on Thursday night [June 1st] when the chamber signed off on a bipartisan deal to suspend the debt limit into 2025, giving the Treasury authority to borrow trillions of dollars more to pay its bills.

With only days to spare before a Monday deadline, the Senate cleared for President Joe Biden’s signature a measure that would suspend the statutory $31.4 trillion debt ceiling and impose two years of caps on discretionary spending.

The bill also would claw back unspent pandemic aid, redirect some IRS funding for other uses, streamline energy permitting, end a pause on student loan repayments and toughen some work requirements for certain recipients of food stamps and cash assistance.

Passage of the measure was virtually ensured after Biden and Speaker Kevin McCarthy, R-Calif., reached a bipartisan deal on the debt limit over the weekend to end months of partisan wrangling. It also ends fears of triggering what Treasury Secretary Janet L. Yellen warned could be an "economic catastrophe" if the debt limit were breached and government payments had to be delayed.

"It is so good for this country that both parties have come together at last to avoid default," Senate Majority Leader Charles E. Schumer, D-N.Y., said before passage.

The bipartisan Senate vote of 63-36 came after a day of backroom negotiating, as senators aired their grievances over the package and sought votes on amendments that were designed to lodge protests without blocking final passage.

The biggest threat to the bill erupted on the Senate floor around midday, when several Republican defense hawks and top appropriators said they could not vote for the measure without a commitment from leadership to take up a supplemental defense spending bill.

They said the 3 percent defense spending increase allowed in the debt limit deal for the coming fiscal year, and a 1 percent increase allowed the following year, amount to cuts after adjusting for inflation.

"We'll be here ’til Tuesday until I get commitments that we're going to rectify some of these problems,” said Sen. Lindsey Graham, R-S.C., who wanted to ensure there would be more money for the Pentagon, as well as for Ukraine, Taiwan and Israel.

Senate Appropriations Chair Patty Murray, D-Wash., said any supplemental bill would also need to include funding for domestic purposes such as border security and disaster relief.

To remove that obstacle, Schumer and Minority Leader Mitch McConnell, R-Ky., entered a statement into the record pledging that the debt ceiling package wouldn't preclude consideration of emergency supplementals, whether for defense and national security-related purposes or domestic needs.

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CMS Pulls Back COVID-19 Vaccination Requirement 

CHAP

The following final rule was posted on the Federal Register Public Inspection desk on 5/31/2023. 

This final rule from CMS withdraws the regulations in the interim final rule with comment (IFC) “Omnibus COVID-19 Health Care Staff Vaccination” published in the November 5, 2021, Federal Register.  The regulations in this final rule are expected to be published in the Federal Register on June 5, 2023, and are effective 60 days after publication, or on Friday, August 4, 2023. Until the effective date, the requirement for staff to be vaccinated against COVID-19 or documented as exempt is in effect and will be assessed during a compliance survey.

Specific provider-specific regulations that will be removed by the effective date include:

Home health: § 484.70(d) 
§ 484.70(d) Standard: COVID–19 Vaccination of Home Health Agency staff. The home health agency (HHA) must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine. 

Hospice: § 418.60(d) 
§ 418.60(d) Standard: COVID–19 Vaccination of facility staff. The hospice must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine.

Home Infusion Therapy: § 486.525(c)
§ 486.525(c) COVID–19 Vaccination of facility staff. The qualified home infusion therapy supplier must develop and implement policies and procedures to ensure that all staff are fully vaccinated for COVID–19. For purposes of this section, staff are considered fully vaccinated if it has been 2 weeks or more since they completed a primary vaccination series for COVID–19. The completion of a primary vaccination series for COVID–19 is defined here as the administration of a single-dose vaccine, or the administration of all required doses of a multi-dose vaccine.

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Denials of Health Insurance Claims are Rising—and Getting Weirder

Fierce Healthcare | By Elisabeth Rosenthal
 
Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ computer algorithms or people with little relevant experience to issue rapid-fire denials of claims—sometimes bundles at a time—without reviewing the patient’s medical chart. A job title at one company was “denial nurse.”
 
It’s a handy way for insurers to keep revenue high—and just the sort of thing that provisions of the Affordable Care Act (ACA) were meant to prevent. Because the law prohibited insurers from deploying previously profit-protecting measures such as refusing to cover patients with preexisting conditions, the authors worried that insurers would compensate by increasing the number of denials.
 
And so, the law tasked the Department of Health and Human Services (HHS) with monitoring denials (PDF) both by health plans on the Obamacare marketplace and those offered through employers and insurers. It hasn’t fulfilled that assignment. Thus, denials have become another predictable, miserable part of the patient experience, with countless Americans unjustly being forced to pay out-of-pocket or, faced with that prospect, forgoing needed medical help.
 
A recent KFF study of ACA plans found that even when patients received care from in-network physicians—doctors and hospitals approved by these same insurers—the companies in 2021 nonetheless denied, on average, 17% of claims. One insurer denied 49% of claims in 2021; another’s turndowns hit an astonishing 80% in 2020. Despite the potentially dire impact that denials have on patients’ health or finances, data show that people appeal only once in every 500 cases.
 
Sometimes, the insurers’ denials defy not just medical standards of care but also plain old human logic. 

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