October 2018 Newsletter

PRESIDENT’S COLUMN
CARRIE ABRAHAM PT, DPT, MPH
CONTENT
PRESIDENT, WVPTA
 President’s Column
Happy National Physical Therapy Month!
 Tonkin Distinguished I hope that you all are planning
Service Award: It is something fun for your clinicians and
patients to celebrate the most wonderful
Time to Nominate a profession in the world! Please take a
Colleague look at the article submitted by Krissy
Grubler from the Education Committee
 #WVPTA Virtual Walk about an event that we are planning at
the end of this month to bring the profession together across the state for a
 Insurance Updates virtual walk! It is our first time trying this (thanks Rhonda!), but I am excited
about the opportunity to bring us all together at the same time – if even in
 APTA National virtual fashion. Please participate if you can – and have fun with it, it is
Student Conclave: Re- Halloween!
Discovering My “Why”
I recently participated in the WVPTA Payer Forum which was organized by our
Payer Relations Committee and Executive Staff. It was informative, evidence
based, modern and relevant to the world of pain neuroscience and our
evolving thoughts on how we manage pain in our patients. The forum was
very well done and I commend all involved for putting together such an
impressive event to advocate for access to PT services for patients with painful conditions. It is a quality of life
issue, and as we know, if it is mismanaged can have tragic consequences. We will continue to keep this
dialogue as a focus looking forward to our annual conference in the spring which will also focus on the
management of pain – across all settings. So, plan to attend!

Nationally, we are gearing up for CSM 2019 in Washington, DC. The plan is to have the groundbreaking for the
new APTA headquarters during that conference, so there is much to celebrate! Registration is open and
programming is available, click here to be directed to the APTA site for information on this conference. This
location is a quick drive for us here in WV – it would be great to see you there!

2019 is the 50th Anniversary of the Physical Therapist Assistant and we are putting together an ad hoc
committee to plan events to recognize the value that the PTA adds to providing physical therapy services
across the lifespan and throughout the continuum of care. We need to blow this up! If you are a PTA or PT
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who would like to sit on this committee – please let me know! The time commitment is a conference call a
month or so – that will be determined by the committee when it gets started up. I am looking forward to
getting to know many more of the PTA professionals in the state to honor them and share in their challenges.

I wish you all a very Happy Physical Therapy Month and thank you for what you do every day. You are a
valuable member of the health care team in your community and you change lives with every encounter!
What a privilege we have to do that. See you soon!

Tonkin Distinguished Service Award: It is Time to Nominate a Colleague

D. Scott Davis PT, MS, EdD, OCS
WVPTA Vice President

Please consider nominating one of your colleagues for the Nancy Tonkin Distinguished Service Award.
This award recognizes and honors an outstanding West Virginia Physical Therapy Association member
who has provided exceptional and enduring value to the Physical Therapy profession. Eligible candidates
must have been a member of the WVPTA (PT or PTA) for no less than 10 years and have made a
significant contribution to the profession in one or more of the following areas: 1) Leadership, 2) state or
national recognition, 3) service to the physical therapy profession through education, practice, research,
or advocacy, 4) served as a role model or mentor to help a WVPTA member reach their highest potential.
Please see the full nomination instructions at https://www.wvpta.org/ The nomination deadline is
December 1, 2018.

WVPTA 2018 ANNUAL CONFERENCE UPDATE

KRISSY GRUBLER, PT, DPT
WVPTA Education Committee Chair

#WVPTA Virtual Walk

The West Virginia Physical Therapy Association is holding at Virtual Walk on Wednesday, October 31, 2018 at 12:30
pm to celebrate National Physical Therapy month! We hope that all physical therapists, physical therapist assistants, staff,
faculty, students, and clients participate in the fun to celebrate physical therapy!

All you have to do to participate is agree to “walk” at 12:30 on October 31st! No specific distance is required. You can get
creative and make it a team effort, coordinate a costume if you choose (it will be Halloween!), or choose to walk a
specific distance!

Tag Us!

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However, and whenever, you complete your walk, be sure to take some pictures and post them on social media! Please
tag the West Virginia Physical Therapy Association, the APTA, and your friends by posting with #MembershipMatters,
#PhysicalTherapy, #APTA, #PTMonth, and #WVPTA.

INSURANCE UPDATES
SALLY OXLEY, PT, OCS, CHT, CMDT
WVPTA Payer Relations Committee Chair

Payer Forum – The 2018 Payer Forum was a big success. There were 21 attendees plus 7 speakers and 4
additional PTs to interact with our guests and participate in the networking lunch. It was held at the
University of Charleston, Tuesday September 25th, 9:00-3:30. We provided 5 CEUs for nurses and case
managers. The program, “Physical Therapy vs Opioids for Treatment of Chronic Pain and Pain
Management” was well received by the attendees. A big part of the program was Pain Neuroscience
Education for clinicians and patients. The evaluations of the program were excellent. A couple of
participants said this was their favorite CE that they attended. To maintain continuity and relationships
with the payers it should probably be done every two years.

Aetna – As of September 1st Aetna started a new authorization process for physical therapy in New York,
Delaware, Pennsylvania and West Virginia. The authorizations go through NIA/Magellan Health. They
are not authorizing visits, but units of certain CPT codes. It has been a very rocky start. APTA got
involved in the beginning and representatives from Aetna and Magellan had a call with APTA and Payer
Chairs from PA, NY and WV August 28th. We asked that they delay the launch of the program while all
providers received training and they refused. There has been massive confusion regarding what patients
were covered under the new program and which were not. Initially we were told only self-insured ASO
participants would be excluded. All Aetna patients were not loaded on the Magellan system initially
which caused more confusion. There have been delays of up to 14 days getting authorizations after the
initial visit. Sharon Dunn, APTA President, has written a letter to the Medical Director of Aetna outlining
all the problems. Collen Chancler, President of the PPTA, wrote a complaint letter to the Pennsylvania
Insurance Commissioner. Be sure and pay close attention to your Aetna EOBs to be sure you are paid
correctly and they do not deny for lack of authorization when you have it. Do not expect them to retro
authorizations, so patients should not be seen until they are authorized. Having to put patient care on
hold is a major problem.

Medicare – MIPS (Merit-based Incentive Payment System) still appears to be on target for January of
2019. It looks like it will be similar to PQRS. Functional reporting will no longer have to be reported on
claims when MIPS begins.

The reporting is a consolidation of (MU) Medicare's Meaningful Use program, (PQRS) Physician Quality
Reporting System, and (VM) Value-Based Payment Modifier program.
Reporting categories include Quality (50%), Improvement Activities (15%), Advancing Care Information
(25%) and Cost (10%). You may be excluded from participating in MIPS during your first calendar year
participating with Medicare Part B, if you are billing under $90,000 or providing care for less than 200
patients in a 12-month calendar period.
Three options are available to report. Individual (single TIN); Group (single TIN with 2 or more
providers) and Virtual Group (Group created with 10 or more eligible providers that agree to report
together for period of one year.)

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Physical Therapy is to report a total of 6 measures. Measures currently available to report:
128 BMI; 130 Current Meds; 131 Pain Assessment; 154 Fall Risk; 155 Falls POC and #182 Function
Outcome Assessments. CMS should offer training webinars soon.

Highmark- Highmark has so many ”a la carte” plans it is difficult to tell what will be covered even after
verifying insurance. It is now necessary to verify the codes that each plan pays for when the insurance is
verified.

APTA National Student Conclave: Re-Discovering My “Why”

BRANDON BROUSSARD, SPT
WVPTA Student Scholarship Recipient

As a second year DPT student, providing answers to various questions posed by professors, CI’s, and
exams has become common practice. Though I may not always know the answer to the challenging
questions, I have a sense of reassurance that at least I know where to find the answer. Reading through
textbooks, research articles and past notes will surely be able to provide the answer I am looking for.
During my time at the 2018 APTA National Student Conclave in Providence, RI, I began to realize under
all the enthusiasm and opportunity provided by the conference, there were some questions that I was
unable to answer about my very own passions and goals related to the Physical Therapy profession. Had I
lost my sense of “why” during the last two years of late-night studies? Had it evolved to something more
than I ever imagined? My time at the 2018 NSC exposed the lurking unanswered questions while also
shedding light on the possible solutions.

I was fortunate to be one of two students chosen from Marshall University School of Physical
Therapy to attend the National Student Conclave in Providence, RI. My overall lack of knowledge of the
event, gave me a sense of excitement and wonder as I entered the conference venue. Each student I
encountered had a sense of passion and excitement about the profession that was extremely contagious.
To catalyze the excitement even more, the conference began with a ‘Thursday Night Ignite.’ It featured
APTA President, Dr. Sharon Dunn and other professionals and students exclaiming their passions and
visions of our wonderful profession. Each speaker poured out their ideas and enthusiasm, igniting an
excitement in the ‘future of our profession’ sitting in the audience. I was fortunate to hear Dr. Dunn speak
multiple times at the conference and the phrase, ‘future of our profession’ was a common theme. As
students, we are the future of the Physical Therapy profession. We are called to keep the torch lit and
continue to progress our profession along the positive trajectory provided by those that have come
before us. It is a responsibility that should be taken with precision and innovation, focused on the service
of our future patients. This responsibility was evident in the Student Assembly Board of Directors. The
Student Assembly is a collective group of students in association with the APTA governing body, whose
prime focus is on student relations. They serve as a ‘voice’ for students around the country in physical
therapy and physical therapy assistance programs. Prior to my experience at the NSC, I was unware of
their existence. As I began to converse with the candidates for the Student Assembly Board of Directors, I
was reassured about the future of our profession. Each candidate was bright and courageous, filled with a
passion for the Physical Therapy profession that is unmatched. Witnessing the fervor of the candidates
and students attending the NSC, re-ignited my passion for service that was dampened by the studious
responsibilities of a physical therapy student. It provided the ambition to become more involved as a
student leader and discern my candidacy for a position on the Student Assembly Board of Directors in the
next year to come. Networking with the passionate NSC attendees helped me to realize that each student
has a common goal. That common goal is to learn about the profession of Physical Therapy while helping
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to advance the profession continuously towards optimal patient care. I look with anticipation in working
with my newly acquainted colleagues as we strive to propel the profession forward in the years to come.

The NSC provided multiple days of Educational Breakout Sessions. These sessions provided
students the opportunity to witness leaders in our profession explain their own paths, while also
providing advice for the next generation of Physical Therapists. One session that resonated with me was
given by Efosa Guobadia, PT, DPT and Josh D’Angelo, PT, DPT. They titled their presentation, “Sparking
Your Passion Through Service, Travel, and Innovation.” As their presentation began, they continuously
asked the audience, “what is your ‘why’?” I began to find myself unable to truly answer the question. Why
had I started Physical Therapy school? Was that ‘why’ enough to get me through an entire career? These
questions forced me to look at the root of my choices to become a Physical Therapist. I realized that at the
core of my career choice was service, compassion, empathy, and professionalism. The presenters’ words
and examples allowed me to ignore the outside noise of potential salary, student debt, and prestigious
respect. My vision and ambitions were once again motivated by the life changing service that this
profession has to offer. As future physical therapists, we are equipped with the skills and knowledge to
enhance the lives of our patients in both a physical and personal way. This is both our duty and privilege.
My ‘why’ is and always has been service. Keeping service at the center of my career, will allow me to
always put the patient first, in all that I strive to accomplish.

The probing questions continued with the Key Note Speaker presentation. My ‘why’ had been
rediscovered but there were other questions waiting to be answered. For example, as Dave Davlin looked
out over the crowd and delivered his keynote presentation, he asked a very simple but complex question
that left me puzzled. He asked, “If you could choose your dream job and all you had to do was say, ‘Yes’,
and it would be yours, what would that dream job look like?” My mind was blank. I knew that I was being
called to serve my patients through the profession of Physical Therapy, but I had no idea about the actual
details. The presenter continued and asked, “What is the ONE THING that you can’t not do?” “What is the
ONE THING that drives you?” As my mind pondered his questions, my thoughts began to slowly drift back
to ‘service.’ He continued, “When was the one time you felt most alive?” My mind searched for distant
memories, but the recent ones flooded my thoughts. I began to reflect back on the moments when I was
treating patients at my recent clinical rotation. It was in my daily sacrifice of self for another person that I
felt most alive. However small that service was, it gave me great joy when it benefitted the patient. I
concluded that it was acceptable to not have a concrete idea of my ‘dream job.’ The important idea to
understand is that ‘service’ would be the foundation of which ever ‘dream job’ I choose. A strong
foundation of service will equip me to build a career that is filled with fulfillment, not just selfish
ambitions.

My time at the 2018 APTA National Student Conclave is something that I will always appreciate. I
am grateful for the relationships that I made with my fellow students and distinguished presenters. My
experience at the conference gave me a sense of purpose once again. It renewed my faith in the Physical
Therapy profession and I look forward to whatever the future holds. I am confident in the current
leadership we have in the profession and the ones to follow, that we will continue to see Physical Therapy
prosper. I will look for ways to do my part and seek out other student leadership roles to promote this
wonderful profession. I would like to thank Marshall School of Physical Therapy and the West Virginia
Physical Therapy Association for this invaluable experience. My purpose and passion will continue to
align with one another as I continue this special journey of Physical Therapy.

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THANKS TO OUR SPONSOR!

THANKS TO OUR SPONSOR!