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Take Action! Reverse Medicare Part B Cuts & Preserve Telehealth Access

If Congress does not take action by March 14th on telehealth and cuts in the Physician Fee Schedule:

  • Telehealth Therapy Services under Medicare Part B WILL END on March 31st.
  • The full -2.83% reduction in the Physician Fee Schedule’s conversion factor will continue in 2025 and impact providers nationwide.

 

Help Reverse Medicare Part B Payment Cuts and Preserve Telehealth Access for Medicare Beneficiaries

On December 21, 2024, Congress passed the American Relief Act, 2025, extending telehealth services until March 31, 2025, but left out provider relief from the 2.83% cut in the Physician Fee Schedule Conversion Factor, which was effective January 1, 2025. Congress also continued government funding until March 14, 2025.  Without further Congressional action by March 14th, rehab therapists will no longer be able to serve their Medicare beneficiaries using telehealth services! It is imperative that Congress hears from their constituents that they must address provider relief and pass a permanent telehealth authority before March 14th! 

If Congress does not take action on telehealth and the cuts in the Physician Fee Schedule by March 14th:

  1. Therapists’ ability to use telehealth to deliver services under Medicare Part B will end on March 31st.
  2. The full -2.83% reduction in the Physician Fee Schedule’s Conversion Factor will continue for the rest of 2025 and impact providers across the country.    

We urge you to contact your Members of Congress NOW to tell them to pass provider relief legislation, such as the Medicare Patient Access and Practice Stabilization Act (H.R. 879) which will mitigate Medicare payment reductions for 2025 and to continue the telehealth authority.

We urge you to contact your Members of Congress NOW! Tell them to pass provider relief legislation to mitigate Medicare payment reductions for 2025 and continue the telehealth authority.

Click here to Take Action now.

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Navigating the CMS 5-Claim Probe and Educate Initiative

The Centers for Medicare & Medicaid Services (CMS) launched the 5-Claim Probe and Educate initiative in 2023 and it is ongoing in 2025. This CMS Program Integrity Initiative is a targeted effort to lower the SNF improper payment rate. This program directly impacts Skilled Nursing Facilities (SNFs) by reviewing randomly selected claims and providing valuable feedback to strengthen billing practices.

 

What is the 5-Claim Probe and Educate Initiative?

Under this initiative, CMS reviews five claims for every Medicare-billing SNF in the country. The SNF will then be offered education to address any errors identified, helping them avoid future claim denials and adjustments. This process offers SNFs an opportunity to learn from the findings and strengthen their internal systems to avoid future issues. 

Any claims for SNF services that took place on or after October 1, 2019, are eligible for the review except for those that contain a COVID-19 diagnosis, which will be excluded from this review.

 

Is this Review Similar to a TPE?

Similar to the current Targeted Probe and Educate (TPE) medical review strategy, the SNF 5 Claim Probe & Educate Program includes one-on-one provider education at the completion of a small sample of claim reviews. However, instead of the 1-3 rounds of review a provider receives through TPE, each SNF will undergo only 1 round of review.

  • MACs will review 5 claims from each SNF.
  • MACs will complete one (1) round of probe and educate for each SNF, not the potential three (3) rounds that may occur in the traditional TPE program.
  • Education offered will be individualized based on the claim review errors identified in the probe. Review results letters will detail the denial rationales for each claim, as appropriate.

 

What Do You Do If Your Facility is Selected for the 5-Claim Probe and Educate Initiative?

Ensure that your facility staff is well informed about the procedures and expectations when a review occurs. Communicate with your therapy staff to ensure the HTS Regional Director is promptly notified. HTS partners with Proactive LTC Consulting to serve as our third-party denials management team, and once timely notice is provided, they can efficiently manage the process on our behalf. 

The 5-Claim Probe and Educate initiative is a valuable opportunity for SNFs to refine their processes, reduce compliance risks, and improve the accuracy of claims. By working together, we can ensure your facility is prepared and positioned for success.

For more information or support, please reach out to your HTS Regional Director. We’re here to help you navigate this initiative with confidence.

 

Written by:

Sheena Mattingly, M.S., CCC-SLP, RAC-CT  |  Executive Vice President of Quality & Compliance, HTS

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Stay Active & Heart Healthy

Your heart is the hardest-working muscle in your body, beating around 100,000 times daily to pump oxygen and nutrients to every cell. Like any muscle, it needs exercise to stay strong and efficient. For older adults, staying active is key to maintaining a healthy heart. Regular movement improves blood flow, strengthens the heart, and reduces the risk of heart disease. The best part? You don’t need intense workouts; simple, consistent daily activities like taking a 10-minute walk, gentle stretching, or dancing to your favorite music can make a difference.

Health Benefits to Staying Active

  • Better Blood Flow: Regular exercise strengthens your heart, allowing it to pump blood more easily and improve circulation.
  • Lower Blood Pressure: Physical activity helps reduce high blood pressure by improving blood vessel flexibility.
  • Less Stress: Exercise lowers stress hormones and releases feel-good endorphins, helping reduce the risk of heart disease.
  • Healthier Cholesterol: Moving your body helps raise good cholesterol (HDL) and lower bad cholesterol (LDL).
  • Longer Life: Active people tend to live longer and have healthier hearts.

If moving feels difficult or uncomfortable, don’t hesitate to speak with your doctor. Physical and occupational therapy can provide strategies to reduce pain and help you move more comfortably. The key is to stay consistent. Every little bit of movement counts! With just a little effort each day, you can keep your heart strong and healthy.

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Telehealth Flexibilities Extended: Victory for Advocacy & Patient Care

We are excited to share some great news: telehealth flexibilities originally set to expire on December 31, 2024 have officially been extended until March 31, 2025! This means we can continue providing critical care to our patients remotely, ensuring they receive the services they need without unnecessary interruptions.

This milestone is a testament to the power of collective advocacy. Your voices, combined with those of other rehabilitation professionals across the nation, played a vital role in convincing policymakers to recognize the importance of telehealth in rehabilitation. We are deeply grateful for your efforts—whether you contacted legislators, shared your stories, or educated others on the value of telehealth, you made a difference.

Why This Matters

Telehealth has proven to be a lifeline for so many of our patients, particularly those in rural areas or with mobility challenges. It’s not just a convenience; it’s a necessity. Extending these flexibilities allows us to continue:

  • Delivering High-Quality Care to Patients in the Comfort of Their Own Homes.
  • Supporting Continuity of Care in Extenuating Circumstances.
  • Enhancing Access to Therapy Services Across Diverse Populations, Especially Those in Rural Areas.

Looking Ahead

While we celebrate this extension, we know questions remain about what will happen after March 2025. The Centers for Medicare & Medicaid Services (CMS) and other stakeholders will continue evaluating the impact of telehealth on patient outcomes, access to care, and cost-effectiveness. We remain hopeful that these flexibilities will become permanent, but we must stay engaged in advocacy efforts to make that a reality.

We promise to keep you informed every step of the way. As soon as we receive any updates about telehealth’s future beyond March 2025, we will communicate them to you promptly.

Thank you for everything you do, every day.

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Predict Your Expected Discharge Function Score

Are you ready to streamline patient care and elevate your CMS quality ratings? At HTS, we’ve developed an exclusive, one-of-a-kind calculator designed specifically for expert MDS Coordinators. This tool calculates the complex formula CMS uses to determine the Expected Discharge Function Score. With this insight, your team can align patient care strategies, ensure compliance, and optimize outcomes for higher-quality ratings.

Watch a short demo video

 

Quality Rating Implications

The discharge function score isn’t just a number in a chart; it is the cornerstone of how CMS determines if patient function is progressing in a manner that is expected and is used in the SNF Quality Reporting Program. The final Discharge Function Score for a given SNF is the proportion of that SNF’s stays where a resident’s observed discharge score meets or exceeds their expected discharge score. According to CMS, SNFs with low scores are “not producing the functional gains they could be for a larger share of their patients.”

 

Ready to See this Tool in Action?

Our calculator is available exclusively to HTS partners. If you’re not an HTS partner yet, let’s remedy that! We’re committed to supporting our partners well beyond the delivery of therapy services, delivering cutting-edge tools and insights that drive financial and clinical success.

HTS Partners, you can access the calculator in the PartnerHQ Portal here.

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Pain-Free Living this Winter

Winter can be especially tough for older adults. As we age, our joints and muscles lose flexibility, making it harder to cope with the cold. Arthritis symptoms can worsen, and shorter days often lead to less physical activity. When you’re stiff and in pain, resting may seem like the best option, but inactivity can actually make things worse. Staying active and moving regularly is key to feeling better throughout the season.

 

Tips for Staying Active & Pain-Free in Winter:

  • Be Active Indoors: Gentle exercises, like stretching, yoga, or chair exercises help keep your muscles strong and joints moving even when it’s too cold to go outside.
  • Dress in Layers: Cold weather can make joints stiff. Dress warmly and consider heating pads or warm baths to soothe pain and stiffness.
  • Walk Around: Taking short walks around your home can keep your blood flowing, boost energy, and improve mobility.
  • Proper Footwear: Wear supportive shoes with non-slip soles to reduce the risk of falls, especially on icy surfaces.

 

How Therapy Can Help:

If you’re dealing with chronic pain, talk to your doctor about physical and occupational therapy. A therapist can create a personalized plan to reduce pain, improve movement, and make daily activities easier, helping you stay active and enjoy the winter months.

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Revolutionizing Fall Prevention with AI-Powered Motion Analysis

OneStep, the AI-powered digital care platform, today announces an exciting partnership with Healthcare Therapy Services, Inc. (HTS), a leading provider of contract therapy services. This collaboration brings OneStep’s innovative technology into HTS partner skilled nursing, CCRC and outpatient sites, empowering therapists with advanced tools to proactively prevent falls and improve care outcomes for older adults.

This partnership reflects the shared commitment of OneStep and HTS to enhance quality of life and longevity by integrating innovative technology into senior care. The collaboration leverages OneStep’s smartphone-driven gait analysis to address one of the most critical challenges facing all seniors and senior living communities – fall prevention. Falls are still the leading cause of injury and death among people aged 65 or older. The partnership between HTS and OneStep has the potential to set a new standard for proactive care.

The pilot program, launched at Bethel Wellness Community in Evansville, IN, has already shown promise in helping therapists identify fall risks early and intervene in a timely manner. By leveraging OneStep’s AI-powered motion analysis, HTS therapists can seamlessly monitor residents’ mobility, stability, identify areas of muscle and skeletal weakness. A therapist can monitor even the slightest changes in stability and balance and make timely interventions to prevent falls and major injuries. These capabilities align with HTS’s mission to provide innovative, high-quality therapy services.

“HTS is proud to collaborate with OneStep to bring the brilliant combination of AI along with cutting-edge balance technology to our communities,” said Amanda Green, Executive Vice President of Marketing & Strategy at HTS. “This partnership enables us to offer proactive solutions that reduce fall risks and enhance the overall care experience for our residents.”

OneStep provides a comprehensive digital care platform that uses smartphone sensors to transform real-life movement into clinical insights. This platform includes tools for real-time data collection, AI-driven insights, telehealth capabilities, remote therapeutic monitoring and administrative management. OneStep utilizes a remote monitoring solution that allows for therapists to continue to guide and oversee patients even after they complete therapy and return home.

“Our partnership with HTS demonstrates the transformative potential of motion analysis in empowering care teams to proactively address fall risks and improve residents’ quality of life.” Patrick Tarnowski, Chief Commercial Officer OneStep.

The success of the pilot program paves the way for broader implementation across all HTS partner communities. By incorporating OneStep’s technology into their offerings, HTS strengthens its position as a leader in senior care innovation, helping communities promote their services and attract new residents.

 

About OneStep

OneStep is an AI-powered digital care platform that uses smartphone sensors to transform real-life movement into clinical insights, helping healthcare providers assess, treat, and monitor patients from anywhere. Gait (i.e. human motion) is a leading indicator of health, and by making gait analysis as simple as stepping on a bathroom scale, OneStep empowers clinicians with actionable data to improve mobility, reduce falls, and enhance patient engagement. Our FDA-listed technology eliminates the need for wearables, delivering lab-quality gait and motion analysis in seconds.

With a focus on personalized, proactive care, OneStep serves rehabilitation providers, health systems, and medical device manufacturers, helping them optimize clinical decision-making, streamline operations, and increase revenue through Remote Therapeutic Monitoring (RTM). We’re committed to transforming gait into a vital sign and making healthcare more precise and connected- improving quality of life for millions.

 

About HTS

Healthcare Therapy Services, Inc. (HTS) partners with senior care communities to provide contract therapy solutions that improve outcomes and elevate care standards. With a focus on quality care delivery and innovation, HTS delivers proactive therapy services that meet the unique needs of older adults. HTS has therapy partnerships in Indiana, Kentucky, Michigan and Ohio and rehabilitates an estimated 24,500 patients per year.

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Strong Bones, Stronger You: Tips for Bone Health

As we age, our bones can sometimes feel less strong than they used to, and that’s completely normal! Bones are living tissue, constantly building up and breaking down. However, as we get older, this process slows down, and our bones lose some of their strength. This makes them more susceptible to fractures, especially if osteoporosis is a factor. But here’s the thing—your bones are key to staying active and independent, so keeping them strong and healthy is more important than ever.

How Therapy Can Help

Physical therapy helps strengthen muscles, improve balance, and keep you moving. An occupational therapist can assess your home and daily activities to make sure you can safely do everything you enjoy and need to do. Therapy isn’t just about treating injuries—it’s about preventing them and helping you stay active and healthy for as long as possible.

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Posture Check-Up

Good posture is more than just how we sit or stand; it plays a big role in how we feel. Maintaining a straight position helps our bodies function better. But what exactly happens when we neglect our posture, and how can we prevent these issues as we age?

Adults often experience stiffness in their muscles and joints, making it harder to stay upright. Slouching puts extra pressure on the spine, leading to neck and back pain. It can also restrict lung expansion, making it difficult to take deep breaths. Additionally, improper body alignment can impact balance and increase the risk of falls.

Improving your posture doesn’t require drastic changes.
Small adjustments can make a big difference.

 

Here are a few simple tips:

  • Check-ins: Check your posture throughout the day. Roll your shoulders back, keep your spine straight, and ensure your chin is leveled. Stretching can relieve tightness and improve flexibility.
  • Move Regularly: Avoid sitting for too long. Take breaks to stretch and walk around.
  • Watch Your Weight: Excess will strain your back muscles and impact your posture.
  • Sleep Smart: A supportive mattress and a pillow helps your neck’s natural curve.
  • Supportive Shoes: Choose comfortable footwear to maintain balance and alignment.

 

How Physical Therapy Can Help

If you have trouble with your posture, Physical Therapy can help! A Physical Therapist can assess your posture and determine what muscle weaknesses might be causing issues. Therapy will focus on exercises for core strength, flexibility, and balance. Ask your doctor about Physical Therapy.

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Move It or Lose It

It can be tempting to slow down and take things easy as we age. However, staying active is one of the most important things you can do for your health and longevity. Regular physical activity is linked to numerous health benefits and a higher quality of life.

Simple Ways to Stay Active at Home

Even small amounts of activity can make a big difference in how you feel and how well you age. Here’s a list of easy ways to incorporate more activity into your daily routine at home:

  • Take Standing Breaks: Set a reminder timer to move every 30 minutes. Use this time to walk around, do light stretches, or march in place.
  • Chair Exercises: Do leg lifts, seated marches, or arm circles while watching TV or reading. Chair exercises are great for maintaining strength and flexibility without leaving your seat.
  • Dance Around the House: Dancing is a fun way to get your heart rate up. Put on your favorite music and dance while doing tasks like folding laundry or tidying up.
  • Walk While on the Phone: Instead of sitting during phone calls, walk around. It’s an easy way to add steps to your day without thinking about it.
  • Sit Less, Move More: Limit prolonged sitting by incorporating movement into your routine. Stand up while doing tasks like sorting mail or folding laundry.

 

Therapy Can Help You Stay Active

Physical and occupational therapy can help older adults become more active and improve their overall physical function. Therapy can ease pain associated with sitting too much, address postural issues, and create strategies to get you moving more and sitting less.

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