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The popular CEEAA Course Series is coming to Milwaukee in 2014
Evidence for the benefits of effective exercise programs for the full spectrum of aging adults is overwhelmingly positive. The unique role of the physical therapist in providing these programs is unequivocal. Further education can enhance the ability of physical therapists to incorporate evidence into practice in order to appropriately examine and provide the quality of exercise that will yield optimal benefits for the aging adult. The Section on Geriatrics, in adopting the position that physical therapists should be the exercise experts for aging adults, will be a leader in providing physical therapists with a mechanism to develop and demonstrate expertise in the design and delivery of effective exercise programs for aging adults.

All PTs with the CEEAA credential will demonstrate expert clinical decision-making skills in (1) designing and applying an effective examination and exercise prescription and (2) measuring the effectiveness and reflecting the current evidence of exercise for all aging adults. The process to attain the credential of "Certified Exercise Expert for Aging Adults" is to complete formal didactic education, and to participate in supervised and mentored skills development, home-based reflection, and critical thinking. Three courses of two days each will address evidence-based examination and different and increasingly complex aspects of exercise design and delivery. The three courses are designed to build on each other; however, Courses 1 and 2 can be taken out of sequence.

Milwaukee dates are as follows:

Course 1: July 12-13, 2014
Course 2: Aug. 16-17, 2014
Course 3: Oct. 11-12, 2014
All courses will be held at Marquette University in Milwaukee.

For registration information, please click here.
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Manual medical review update
On April 1 recovery audit contractors began conducting prepayment or postpayment review for outpatient therapy claims exceeding $3,700. Eleven states, including Florida, California, Michigan, Texas, New York, Louisiana, Illinois, Pennsylvania, Ohio, North Carolina and Missouri, are subject to prepayment review. All other states are subject to postpayment review. In the prepayment review states, RACs will conduct the manual medical review within 10 business days of receiving the documentation and will notify the MACs of the payment decisions. MACs will then notify the providers. In the postpayment review states, the postpayment review process could take between 30 and 45 days; however, CMS has encouraged RACs to expedite the process.

APTA met with the Centers for Medicare and Medicaid Services on April 1 and on May 7, to discuss the MMR process and to clarify some points of confusion:
  • RACs will not be looking at claims below the $3,700 threshold.
  • RACs will have tracking portals. Providers can go to the portal and see if the documentation they submitted was received and view the status of the decision.
  • RACs will be accepting documentation by fax, mail, CD, DVD, and ESMD (electronic submission). Please note that only providers who are enrolled in Medicare's ESMD system can submit claims electronically.
  • If a provider is has more than one therapy clinic, the MMR will be completed by the RAC with jurisdiction over the region in which the provider's practice is headquartered.
  • In 2013 physical therapists must issue a valid Advanced Beneficiary Notice to patients to collect out-of-pocket payment from Medicare beneficiaries when Medicare deems services "not reasonable and necessary" after the therapy cap is exceeded. CMS further clarifies that PTs must not issue the ABN to all beneficiaries who receive services that exceed the cap amount, only to those whose services the PT believes do not meet the Medicare definition of "reasonable or necessary." If the PT submits a claim with the KX modifier for an exception to the therapy cap, he or she is attesting that the services are reasonable and necessary.
APTA will continue to have monthly meetings with CMS regarding the RAC audits and will be providing feedback on problems providers are seeing. If you have comments or are experiencing issues with the manual medical review process, email In order to provide accurate and timely information to CSM, APTA members need to let the Health Finance and Quality staff know how the MMR process is being implemented and the impact it is having on your patients and practice

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Section on Geriatrics Members to attend APTA's Development of Clinical Practice Guidelines and Appraisals Workshop
The three-day workshop in July will provide knowledge, skills, and tools for both beginner and advanced members to learn to develop evidence-based documents. Sections were asked to nominate members who are interested in working as a team to develop CPGs/CPAs in their area of clinical practice. We are happy to announce that Meri Goehring, PT, PhD, GCS and Tim Hanke, PT, PhD will represent the Section on Geriatrics.
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Functional Limitation Reporting: Updated resources
Outpatient therapy claims that are submitted without functional limitation reporting G codes will be returned to providers as unpaid beginning July 1. APTA has several new and updated resources available to help ensure that you are reporting the information properly to Medicare, including: the 2013 Reporting Patient Function to Medicare video, the Functional Limitation Reporting General Information, Documentation of the Functional Codes and G-Code Claims Submission FAQs, and 8 case scenarios on the website, including two new scenarios: skilled nursing facility, PT/OT; and two plans of care, same facility.

For more information about the Functional Limitation Reporting requirements, visit APTA's Functional Limitation Reporting Under Medicare webpage. The Section on Geriatrics also has a document designed for SOG members that provides resources for recommended outcome measures for Functional Limitation/Severity Reporting. This resource can be found here.

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Topics in Geriatrics: Volume 3 update
Good News! SOG is extending the deadline to receive contact hours until June 30. Topics in Geriatrics: Volume 3 will offer the course participant an increased depth of knowledge across several practice dimensions. The course begins with two niche practice areas; working with older adult drivers and older adults who are obese. Readers will understand how physical therapists can have a role in working with older adult drivers, even if we don't work in a setting with special equipment to specifically rehabilitate driving skills. Readers also will be introduced to the growing area of bariatrics across the health care continuum. In addition, there is an update on the role of the physical therapist in prevention of falls; what the latest research tells us and how we, as physical therapists, work with other team members. Readers also will gain insight into how physical therapists are successfully integrating public health in everyday practice and what physical therapists can offer in the public health arena. In the final 2 monographs, the reader will come away with a sound foundation to prescribe exercise for older adults and integrate the definition of "successful aging" into their practice. What does that mean for you and your practice area?

Educational Credit: 30 contact hours

Topics & Authors:
  • Physical Therapy Applications for Assessing and Counseling Older Drivers-Cheryl LaFollette Anderson, PT, PhD, MBA, GCS
  • Bariatric Geriatrics: Physical Therapy Management of Older Adults who are Obese-Michael L. Puthoff, PT, PhD
  • Fall Prevention-Celinda P. Evitt, PT, PhD, GCS
  • Health Promotions in Geriatric Care: The Collaboration Between Physical Therapy and Public Health-Kathryn K. Brewer, PT, GCS, MEd
  • Exercise Prescription for Older Adults-Dale Avers, PT, DPT, PhD and Patrick VanBeveren, PT, DPT, MA, OCS, CSCS
  • Successful Aging: Biopsychosocial and Environmental Implications for Physical Therapist Practice-Mary Thompson, PT, PhD, GCS

Learning Objectives
Upon completion of this home study course the participant will be able to:
  1. Understand the role of the physical therapist when treating the older driver.
  2. Evaluate and formulate treatment strategies including equipment needs for older adults who are obese.
  3. Provide evidence-based falls prevention strategies.
  4. Define the role of physical therapy in public health.
  5. Prescribe exercise to the older adult using evidence-based guiding principles.
  6. Define successful aging and incorporate this definition into physical therapist practice.
To order, please visit the Section Store.

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GeriNotes seeks editor
The Geriatrics Section seeks an editor for GeriNotes. Duties include publishing six issues of GeriNotes per year; soliciting articles and relevant Section news and publishing practical clinical tips. Please see the full job description here.

Interested parties should send a CV, letter expressing interest and qualifications and your vision for the magazine to Karen Curran. Deadline is June 1. The position will start in late 2013 or early 2014 and the editor does receive an honorarium of $1,000 per issue.

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Program Committee co-chair starting Feb. 6, 2014
As the important responsibilities for overseeing high quality Section education programming and meetings at the Combined Sections Meeting and Annual Conference have grown, our BOD has taken action to institute co-chairs for our Program Committee.

In total, responsibilities for these two individuals include:

Scheduling and coordinating all Section meetings at CSM and Annual Conference; For CSM (including pre-conferences), review of proposals, selection, contracts, handouts, registration, session moderators, food and meeting space; Coordination of the Awards Ceremony with the Awards Committee; Coordination of the exhibit hall booth with the Membership Committee; Related follow-up public relations in GeriNotes; Program Committee budget and related reports to our Board; attendance at BOD meetings at CSM and Annual Conference; Both co-chairs attend CSM and related workshops, but only one attends Annual Conference. As part of the training, the incoming co-chair would be involved in e-communications for CSM 2014 but would not have responsibilities for CSM 2014. Travel reimbursement and per diem will be provided.

Interested members should electronically submit a cover letter (describing basis for interest and related skills/experiences) and current resume to Tiffany Hilton, PT, PhD; Program Co-Chair at no later than June 3.

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Do 7 tips for improving work efficiency in your rehab therapy clinic
By Brooke Andrus
You've probably come across blog posts with advice for you and your clinic on conserving resources and becoming more environmentally conscious. But let's not forget about the most important resource of all — your time. You might assume you need a major systematic overhaul to improve work efficiency in your clinic. Not so. In this case, small investments pay big dividends. Here are some quick tips to help you get the most out of every minute.
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Holding steady
Essential tremor is less well known than Parkinson's disease, but it is eight times more common, according to the International Essential Tremor Foundation. An estimated 10 million Americans are affected by the condition, which does share symptoms with PD. The big difference between the two conditions is that people with essential tremor have noticeable shaking that intensifies as they move, while patients with PD have prominent resting tremors that become less obvious with activity.
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Injured survivors of Boston Marathon bombing begin next phase of their recovery
The Washington Post
Paul Norden needs a break. He is winded, sweating heavily after a stint on a stationary bicycle and the slow walk to a padded treatment table. It is hard work for Norden, who lost his right leg that Monday afternoon in April. "I used to say, 'I'll never go to a gym,'" he says with a weary smile. "Now I'm stuck here."
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Studies: Is economy less of a factor in slow health care spending growth?
Two studies recently published in the journal Health Affairs counter an earlier Kaiser Foundation report that had credited the sluggish economy for much of the slowdown in the growth of health care spending. While the newer studies offer a higher possibility that health care reform is behind at least some of the slow growth, they don't specifically say so.
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Physical therapy with FDS or AFO improves gait speed after stroke
PT in Motion
The use of a foot drop stimulator or an ankle foot orthosis coupled with initial physical therapy sessions significantly improves gait speed in stroke survivors, say authors of a study published in the journal Stroke. The authors found significant improvements in gait speed using either FDS or AFO, with a mean change of 0.14 m/s for FDS and 0.15 m/s for AFO.
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Geriatric ERs: Golden idea for golden years?
By Dorothy L. Tengler
Older patients visit the emergency department more than any other age group except infants, and the aging population will increase as baby boomers continue to enter the 65-and-older age bracket. For years hospitals have set up separate ERs for kids, but only in the past few years have hospitals begun to consider setting up EDs for elderly patients. So, why aren't geriatric EDs more common?
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