Join a State Exchange Plan
Act now to be included as a provider as states prepare coverage guidelines and select plans to be included in health insurance exchanges under the Affordable Care Act. The ACA requires that state exchange plans include 10 categories of essential health benefits—including habilitation, rehabilitation and preventive services, all of which reference speech-language pathology and audiology services. Because the law gives states flexibility in establishing exchanges, however, it's important to make sure that your services are named specifically, with coverage policies that meet consumer and patient needs and expectations.
Clinicians can take these steps:
Contact the state health exchange representatives. Use two ASHA-developed documents that provide the details you need:
- A letter [PDF] advocating for the inclusion of habilitation and rehabilitation services in ACA state health exchanges.
- A fact sheet [PDF] that explains essential health benefits and includes definitions of services and devices, and examples of coverage language.
For more information or answers to specific questions, contact Laurie Alban Havens, MA, CCC-SLP, ASHA director of private health plans and Medicaid advocacy, at firstname.lastname@example.org, or Janet McCarty, MEd, CCC-SLP, ASHA private health plans advisor, at email@example.com.
Service Streamlines Applications to CSD Programs
A single-application service for students applying to communication sciences and disorders programs has grown from 34 participating academic programs to 81 programs since its launch four years ago.
The Web-based Communication Sciences and Disorders Centralized Application Service (CSDCAS) allows prospective students to apply to any or all of the 21 participating AuD programs or 60 speech-language pathology master's programs with just one application. The system gives program faculty, advisors and administrators a convenient and organized way to complete recommendations and review applications, with 24-hour access and no need for paperwork or envelopes.
According to self-reported data from ASHA's Higher Education System, the 222 reporting master's programs received almost 46,000 applications, and the 71 reporting AuD programs received more than 3,750 applications in the 2010–2011 academic year.
In addition to managing individual program admissions, the system also tracks participating programs' admissions data, offering immediate, accurate and comprehensive data from the participating programs.
The system gives participating programs ongoing tracking capabilities and other specific abilities that enhance their internal efficiency. For more information, visit the CSDCAS page or contact Richard Hurtig, chair of the program's committee, at firstname.lastname@example.org.
Medicare Changes Home Health Therapy Reassessment, Fees and Survey Visits
Patient assessment schedules, reimbursements rates and survey visit rules change in 2013 for home health care agencies that provide speech-language treatment or occupational or physical therapy to Medicare-eligible patients.
In general, the per-episode base fee under the 2013 prospective payment system for home health agencies remains virtually unchanged—despite inflationary and wage index increases—in an ongoing effort to correct Medicare overpayments that resulted from widespread inaccurate patient health status coding by home health agencies from 2000 to 2008. Payments, based on the number of therapy visits for a particular patient, are made for 60-day episodes.
Therapy reassessment schedule
In its 2013 rules for home health agencies, the Centers for Medicare and Medicaid Services clarified previous rules about the frequency of required therapy reassessments. CMS requires reassessments at the 13th and 19th visits, and clarifies that the 13th-visit reassessment be completed during the 11th, 12th or 13th visit, and during the 17th, 18th or 19th visit for the required 19th-visit reassessment.
Unannounced survey visits
State health departments or other state agencies contract with CMS to visit patients to determine whether the care being provided by home health agencies meets the patients' assessed needs. These visits are performed only with the consent of the patient or legal representative. In 2013, visits to consenting patients will take place without prior notice.
Each home health agency undergoes patient surveys every 36 months, and more frequently if information indicates higher risks to the agency's quality of care.
Payments per visit
Under the home health agency prospective payment system, reimbursement for patients who require fewer than five total home care visits is not based on an episode of care, but is instead a fixed per-visit payment. The rate is different for each discipline and is based on historic per-visit costs. The 2013 per-visit rate (also known as low-utilization payment adjustments) is $135.86 for speech-language pathologists. The rate is $125.03 for physical therapists and $125.88 for occupational therapists. These figures represent a 1.3 percent increase for each discipline.
For more information, contact Mark Kander, ASHA director of health care regulatory analysis, at email@example.com.
Michigan Audiologist Brings 'Hearing Bus' to Rural Communities
Gyl Kasewurm has created a Mobile Audiology Center—the "Hearing Bus"—to bolster rural communities' access to hearing testing services.
Kasewurm, owner of Professional Hearing Services in St. Joseph, Mich., bought and outfitted the bus to bring her private practice to people who would be otherwise unserved in the state's southwest. The bus also acts as a vehicle for spreading hearing awareness throughout Southwest Michigan.
"The Hearing Bus is an example of the ever-expanding mobile services industry," said Kasewurm. "You can't come to us? No problem, we'll come to you."
At the Professional Hearing Services clinic, Kasewurm strives to create a comfortable experience for her clients. While they wait for appointments, clients can enjoy a gourmet coffee bar, a warm cookie fresh out of the oven, and a sofa in front of a fireplace, or take advantage of the virtual theater to see how hearing aids are made, watch a movie or play a video game.
"We have become renowned as a center for exceptional patient care and we have won awards for customer service," said Kasewurm. "Our goal is to deliver the same level of patient experience on the Hearing Bus."
The Mobile Audiology Center visits Allegan and Niles, Mich., one day each week, and Kasewurm accepts insurance that covers her services. For more information, visit the Hearing Bus website or Facebook page.