A national class action lawsuit, Jimmo v. Sebelius, currently being reviewed by a federal judge in Vermont, may have serious implications for broadening the therapy services available for Medicare patients. The case argues that the current “Improvement Standard” was unfairly used to deny Medicare beneficiaries treatment because they were not expected to make long-term improvements with their medical conditions.
Even if patients aren’t improving, if they are maintaining their condition, then therapy may certainly prevent future hospitalizations. APTA President Paul Rockar Jr., PT, DPT, MS responded by stating, “We strongly believe that allowing Medicare beneficiaries to receive physical therapy in skilled nursing facilities and home and community-based settings will result in significant cost savings in the long term, as well as help bolster the triple aim of health care reform to improve care for individuals, improve health for populations, and lower spending growth.”
How will this case affect your practice? It may soon open the door for you to treat new and existing patients with chronic conditions such as Alzheimer’s disease, cerebral palsy, multiple sclerosis, Parkinson’s disease, and paralysis.
If the lawsuit is successful, you will still be required to show the need for skilled care by documenting the diagnosis and treatment for these medical conditions in your reports.
With the proper documentation software, you should be justifying the necessity of your treatment now. If you are not, you should consider BMS Practice Solutions’ RevFlow Electronic Medical Records tool, and you will be compliant now for these proposed changes as well other types Medicare health reform.