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  • 8 Apr 2019 8:08 AM | Chuck Felder - iPT Exec Dir (Administrator)

    iPTCA & CPTA Announce Work Comp Legislation to Control the Middlemen.

    SB 537 (TPA/Middlemen Workers' Compensation Reform Bill)
    will be heard in the Senate Labor, Public Employment and Retirement Committee on Wednesday April 10, 2019 at 9:30 am, State Capitol, Room 2040.

    SB 537 would:

    • Provide that contracted Workers' Comp reimbursement rates shall not be less than the applicable Medicare fee schedule payment
    • Prevent middlemen from illegally meddling with treatment decisions made by treating physicians and PTs
    • Force middlemen to post the names of contracted PT clinics and their phone numbers on the MPN internet directory
    • Prohibit middlemen from upcoding PTs' bills
    • Allow the Administrative Director to investigate and punish middlemen for non-compliance with Labor Code statutes

    Watch your email for calls to action to support this much needed legislation.

    This legislation will focus on limiting the interference that TPAs & Middlemen (bill review companies) can exert on the work comp system along with providing limits to how much they can discount the fee schedule.

    Many PTs are not even aware of the extent of the changes in the work comp fee schedule as the middlemen have rigorously guarded how much they take out and pressured clinics to accept low paying contracts while also increasing your administrative burden.

    Learn just how much the fee schedule has changed since 2014 by downloading the Excel workbook 2019 Calculator...for your locality.

    Members just need to log in at www.iptca.org, choose MEMBERS > MEMBER ONLY > CALCULATORS to download the Excel calculator for their locality to be able to run their own examples. There are also two short videos on how to get the most out of the workbook.


  • 13 Mar 2019 4:31 PM | Chuck Felder - iPT Exec Dir (Administrator)

    Anthem is supposed to implement the pre-authorization requirement with AIM on 3/25/2019 but Anthem reps appear to be unaware of it based on feedback we've received from some PT clinics. AIM reps are a bit confused also, and one said it starts April 1, 2019 (or is that an April Fool?). 

    See the attached document from Anthem.  Anthem Prior Auth begins March-25-2019.pdf

  • 29 Aug 2018 8:50 PM | Chuck Felder - iPT Exec Dir (Administrator)

    Summary-Notice-1 provides a summary of the settlement from the One Call suit.

  • 17 Feb 2018 2:18 PM | Paul Gaspar (Administrator)

    On December 22, 2017, iPTCA won a federal lawsuit settlement with Align Networks.  Both sides were confident that the business practices Align pledged to change would be beneficial to PTs and their patients.

    For the full compliance dispute process agreement, click HERE

    Since then, iPTCA has received dozens of communications regarding the process of compliance with the settlement and potential complaints, moving forward.

    In short, a top level executive at One Call has been appointed to handle the complaints individually.  If the complaint cannot be resolved, a PT may contact the Compliance Dispute Officer chosen by iPT during the settlement process.  PTs may do this independently OR by contacting Chuck Felder, Executive Director, iPTCA for assistance (cfelder@hcsconsulting.com).  

    In accordance with the settlement terms, One Call must pay for the costs of the compliance officer for all compliance disputes made in good faith.

  • 22 Dec 2017 5:33 AM | Chuck Felder - iPT Exec Dir (Administrator)

    Headline Story

    iPTCA and One Call/Align Networks Settle Federal Lawsuit!

    On December 22, 2017, The Independent Physical Therapists of California (iPTCA) announced it reached a resolution of the lawsuit brought in April 2017 by the iPTCA regarding One Call’s business procedures.

    Per the terms of the settlement agreement, One Call will make various changes to certain of its business practices in California, which iPTCA believes will result in improved service to the state’s injured workers and physical therapists. These changes include:

    • Modifications to One Call’s patient referral and authorization process;
    • Increased transparency of how One Call ranks and scores the quality of physical therapists;
    • An enhanced electronic billing and payment system for physical therapists.

    For a summary of these practice changes, please click here for the Summary-Notice-1.pdf

    We are pleased with the resolution of this case and the improvements it promises for injured workers, PTs, and employers.

    We will be setting up an iPTCA meeting after the first of the year to discuss this settlement. Thanks for all your support! Here's to your excellence and patient advocacy!

    Merry Christmas!

    Paul D. Gaspar, DPT, President, iPTCA
    Chuck Felder, DPT, Treasurer, iPTCA
    Simon Gibson, PT, Director, iPTCA
    Sandy Sheklow, PT, Director, iPTCA

     


 
       

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