At the end of 2017, when we learned that Humana would no longer require prior authorization for physical therapy, we rejoiced! But we heard – and have now confirmed – that Hawaii’s Humana administrator, MDX, can and still does require prior authorization for PT (except immediately after hospitalization and surgery). Read the attached chart for…
New bills have been introduced in the 2018 Legislative session offering solutions to health care problems, including ways to combat the opioid epidemic, changes to healthcare payment systems, and paving the road to telehealth. Here is a short summary of a few bills we will keep an eye on this session. HAPTA will continue to…
LAST UPDATED: December 6, 2017 Q: Who needs to submit the DHS 1139 Medicaid Provider application form? A: Individual providers with their own Medicaid provider ID number whose services are billed under that number need to fill out and submit DHS 1139 – this includes all private practitioners whether they are an owner or an…
November 22, 2017 (correction of November 20, 2017 posting) – In mid-October many (but not all) PT providers received a letter from the State of Hawaii Department of Human Services Med-QUEST division requesting completion of a re-credentialing/validation application. The letter asked that you submit this form by Oct. 30, 2017 and provided a link to complete it…
With recent news in Hawaii along with information provided during the Medicare class that HAPTA hosted in early October, we thought we should provide reminders about some Medicare billing areas that continue to cause problems for some providers: In order to bill for physical therapy, services need to be provided by a licensed physical therapist,…
PT practice is changing and much of it comes from external stressors. Especially as we step into new payment models such as bundled payment, we must come up with new solutions. Many physical therapy practices attempt to meet these demands by increasing productivity, driving down costs, and being selective with payers. We must ask ourselves…
HAPTA members Joanne Zazzera, Patti Taira-Tokuuke and I (Justin Ledbetter) recently traveled to Detroit, Michigan to attend the annual APTA State Policy and Payment Forum. In addition to Joanne receiving the APTA State Legislative Leadership Award, we learned a lot about what’s going on around the country. Here are some highlights. Federal Regulatory Affairs PTs…
With the recent end of the Hawaii 2017 legislative session, we would like to update our members on what HAPTA did this year and how our efforts turned out. We began 2017 with a contracted lobbyist and some strong strategies. Our plan was for legislators to become familiar with us and to have our voice…
In response to a recent member query, past HAPTA President and “Chapter Historian” Herb Yee provided this authoritative and comprehensive recap about the state of direct access in Hawaii. The issue of insurers continuing to require a physician referral is still prevalent in many if not most states, despite the passage of direct access in…
