Week 3 extra questions

Question 1

Who can receive home health services?

Answer 1

Pts who can receive home health services if:
- they have impairments & functional limitations
- pt is homebound

Question 2

In palliative care, is the pt terminally ill?

Answer 2

No. In palliative care a pt may have life-threatening or life-limiting illness not necessarily intermittently dying but in a physical decline.

Question 3

What is the homebound status criteria?

Answer 3

Homebound status criteria is:
1. Homebound due to illness, injury, need AD, needs transportation, needs assistance to leave the home
OR
leaving would medically contraindicate condition

2. Have normal inability to leave home AND leaving home takes taxing effort.

Question 4

Describe the pt’s ability to leave the home when they are homebound.

Answer 4

When the pt is homebound the amount of time the pt is out of the home is infrequent (haircut, groceries, other drs apts).

Question 5

Name a few facilities/clinics in outpatient rehab settings.

Answer 5

• Contemporary outpatient
• Telehealth
• Cash-based practice / Private practice

Question 6

What is a POPTS? What are different examples?

Answer 6

POPTS is Physician Owned Physical Therapy Service. POPTS can be when
- a physician has ownership interest in a PT practice to which they refer.
- A physician or the physician’s practice employs or contracts with PTs to provide PT services within the Physician practice.
- Financial relationship exists between a physical therapist and a referring practitioner.
- Person gains financially from the referral

Question 7

What is Private Practice?

Answer 7

Private Practice is a solo PT practice, a partnership, group practice, partnership, contract services (hospital, nursing homes, school districts, outpatient clinics), and cash-based.

Question 8

Does the APTA support POPTS?

Answer 8

NO. The APTA opposes POPTS.

Question 9

What is IDEA (Act)?

Answer 9

The Individuals with Disabilities Educational Act is a public law based off the education for all handicapped children. This is free for those with disabilities.

Question 10

Under IDEA, what do the interventions focus on?

Answer 10

Under IDEA, interventions focus on educations needs of the child.

Question 11

What is IDEA Part B?

Answer 11

IDEA Part B is a School-based service for those 3-21 yo with various disabilities or impairments.

Question 12

What is IEP under IDEA Part B School-Based Services?

Answer 12

Under IDEA Part B School-Based Services, IEP is Individualized Educational Plan. Any services the child receives is included in this plan.

Question 13

What happens to those who aren’t covered under IDEA Part B?

Answer 13

If someone isn’t cover under IDEA Part B, they may be covered under Section 504 of the Rehabilitation Act of 1973.

Question 14

What is Section 504 of the Rehabilitation Act of 1973?

Answer 14

Section 504 of the Rehabilitation Act of 1973 is for PT or OT services for individuals who have physical or mental impairments that limit 1 or more major life activities.

Question 15

What is the main difference between IDEA and Section 504?

Answer 15

The main difference is IDEA focuses on educational goals and Section 504 focuses on physical and occupational goals.

Question 16

What is IDEA PART C?

Answer 16

IDEA Part C is Early Intervention Services provided to those 0-3 yo who have developmental needs. Those with a disability must have a dx that has a highly probability of developmental delay. OR will develop a delay if they don’t receive the service.

Question 17

What type of plan is used under IDEA Part C Early Intervention Services?

Answer 17

An Individualized Family Service Plan is used under IDEA Part C Early Intervention Services

Question 18

What is the focus of PT early intervention services?

Answer 18

PT Early Intervention Services focus on assisting families with their child’s development and ability to participate in age-appropriate and meaningful activities.

Question 19

What is referral for profit?

Answer 19

Referral for profit is a relationship between a physical therapist and a physician in which a physician refers a patient for PT & derives financial benefit from the PT services provided.

Question 20

What is Stark Law?

Answer 20

Stark Law prohibits a physician from referring a Medicare patient to any organization for certain designated health services if that physician holds a financial interest in that organization.

Question 21

What are the exceptions to Stark Law?

Answer 21

The exception to Stark Law is if there were ancillary (related) services in a physician’s office or the patient receiving PT must be a patient of the physicians for medical services.

Question 22

What is the Anti-kickback Statue?

Answer 22

The Anti-Kickback Statue prohibits the offer or receipt of any kickback (illegal payment), bribe, or rebate or indirectly in the form of cash or in kind for referrals by physicians or their recommendations to purchase or lease supplies and services of patients who are insured under Medicare and Medicaid.

Question 23

What is Telehealth?

Answer 23

Telehealth is electronic communications that are used for health related-information and health care services.

Question 24

What barriers does Telehealth address?

Answer 24

Barriers that Telehealth addresses are distance, unavailability of specialists, and impaired mobility.

Question 25

What is Direct Access in an outpatient setting?

Answer 25

Direct Access in an outpatient setting is when the physician referral, that is mandated by law, is removed. Which means a pt is able to see a PT without a referral. All 50 states have some sort of direct access.

Question 26

What is Unrestricted Patient Access?

Answer 26

Unrestricted Patient Access means there is no restrictions or limitations for treatment. This is in 18 states.

Question 27

What is Patient Access with Provisions?

Answer 27

Patient Access with Provisions means a pt has access to evaluation and treatment with some provisions. Referral requirement for specific treatment intervention and the length of time. 26 states.

Question 28

What is Limited Patient Care

Question 29

What type of access does Florida fall under?

Answer 29

Florida under the care of patient access with provisions. Pt can be seen by a PT for 30 days without a referral. A POC can be sent to the Physician & signed to continue PT services.

Question 30

Is Direct Access a good thing or bad thing?

Answer 30

Direct Access is a good thing, because it saved money, there were fewer visits & the pts were still safe