It’s Monday, January 22nd. Unless Congress was struck with a stroke of conciliatory behavior, the government is still shut down. First let’s look at some headlines from the PT world. The VA is leading the charge to be transparent with opioid prescriptions, home health patients on Medicare may not be getting the proper coverage they’ve been told they have, and prior authorization could get a “little” bit easier. Also, have you heard about this therapy cap? It’s kind of a big deal. Last but not least, we’re talking with guest Karen Litzy on the Graham Sessions.

We still need your voice on the Therapy Cap!

Shutdown won’t have a major impact on patient care

Medicare and Veteran’s Affairs remains unaffected, so that’s something to be thankful for. Speaking of Veteran’s Affairs…

Veteran’s Affairs becomes the first health care system to publish opioid prescription rates

Earlier this week, the VA became the first health system to publish the number of opioid prescriptions filled at their pharmacies across the country. The data spans a five year period, in which 99% of facilities showed a decrease in prescription rates. Feel free to view their interactive map of the data here.

Medicare patients may be denied home health care – even when its fully covered

While some government agencies are becoming more transparent, others are locked in a complicated battle that is making patient care more complicated. A recent report indicated that even though home health care is fully covered by Medicare, patients are often denied by the home health agencies themselves. Regulatory hurdles make it difficult to take on patients that may not show immediate signs of recovery, and Medicare has a habit of denying reimbursement to patients for whom they deem therapy unneccesary – which happened to a THIRD of claims in the last fiscal year. We’ll be covering this story closely, but check out some other coverage Talus has performed for home health.


Healthcare groups join forces to streamline prior authorization

If you treat patients that need prior authorization, here is some (potentially) good news. 6 major healthcare groups decided to provide relief from the myriad of prior authorization requirements in healthcare. These plans are preliminary, but will most likely involve a provider’s performance, dedication to evidence based care, or participation in value-based agreements with insurers. We’ll keep our eye on the story and be sure to inform you of any developments.

Graham Sessions with Karen Litzy–Check out the full episode and show note here!


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