April 2002

News

Rehab Company Loses Customers, Lawsuit
HealthSouth, Birmingham, Ala, a provider of outpatient surgery and rehabilitation services, has found itself dealing with a dual loss: not only did several of its employees leave the company in 1999, but in mid February the company also lost the breach of contract lawsuit it had filed against the deserters.

A US District Court in Minneapolis ruled on February 13 that Health Fitness Corp, Minneapolis, was not at fault when its employees quit their jobs and went to work for a nearby competitor the day after the company was bought by HealthSouth. The lawsuit was then dismissed, and Health Fitness was awarded a judgment of $43,156 for a counterclaim relating to accounts receivable.

"Obviously, we were very disappointed with this," says a spokesperson for HealthSouth. "However, we have seen an increase in patients since that time, and are now getting back to normal business, which is good right now." The former employees of Health Fitness could not be reached for comment.

When HealthSouth purchased Health Fitness in 1999, the Health Fitness workers immediately walked out, leading to the lawsuit. However, HealthSouth maintains that it is company practice to fire workers from a practice it has purchased, and then rehire them under its own terms. However, the Court ruled that the employees were under no contractual obligation to remain and work under HealthSouth.

Bill Could Lead To Repeal Of Therapy Cap
Legislation introduced in late February could pave the way for a permanent repeal of the $1,500 cap on outpatient rehabilitation therapy that has been part of Medicare since 1998.

The bipartisan Medicare Access to Rehabilitation Services Act is being sponsored by Representatives Phil English (R-Pa), Ben Cardin (D-Md), Roy Blunt (R-Mo), and Frank Pallone (D-NJ).

Supporters say the cap limits force vulnerable Medicare patients to choose between therapy and other expenses, and possibly even turn potential therapists away from the profession for fear of lack of reimbursement.

"This is the only cap on Medicare services," says a spokesperson for Phil English, the bill's chief sponsor and a member of the House Ways and Means health subcommittee. "It is an illogical cap."

Similarly, Barbara Kornblau, president of the American Occupational Therapy Association, refers to the cap as part of a "flawed policy that could deprive citizens of services that can enhance their ability to live functional lives." She adds that the bill, if passed into law, would "correct an ill-conceived policy that could harm the quality of life for those who need therapy services."

Congress initially enacted the cap in an effort to curb Medicare spending as part of the Balanced Budget Act of 1997. Congress is also considering several additional Medicare proposals this year, including a bill designed to increase physicians' reimbursement levels under the same program.

Letters to the Editor

I just finished reading your editor's message in the March 2002 issue of Rehab Management. I was a staff physical therapist at an acute care hospital where physical therapists still did chest physical therapy (CPT). I thoroughly enjoyed this and took over the CPT service. We started having complaints by surgeons in the intensive care and pulmonary step-down units that CPT was not being done in a timely manner.

For example, they would order it at midnight and a surgeon couldn't see the patient until morning. I tried to coordinate with respiratory therapists to do pm treatments, but that did not always work out. Surgeons started to complain again. It came down to the fact that physical therapists are not in the hospital 24 hours per day. Effective CPT on acutely ill patients does not always occur between the hours of 7 am and 6 pm.

I fought very hard to keep the practice with PTs, but I lost because the surgeons wanted, and I quote, "One butt to kick." They didn't like having two professions in charge of CPT; it was too confusing for them, and frankly for us as well. I agree that it is up to us to fight for what we believe in, but we need backup and research to prove that we give better treatments. Just saying we have more education is not enough, we have to prove our worth, and be able to dedicate the time to the practice. We also need to think about the fact that we are not in the hospital 24 hours each day. This is a difficult issue and very emotional for those directly involved.

Gina M. Oberle, MPT
Baltimore

I rarely find myself writing a letter to the editor, but I felt compelled to contribute my two cents on CPT. As a member of the American Physical Therapy Association cardiopulmonary section and a graduate of the University of Miami, I was astounded to discover the reality of pulmonary physical therapy in the workplace.

Cardiopulmonary physical therapy is what interested me most during school. Not the "glamour" of sports or aquatic physical therapy, as you put it (as a certified athletic trainer, I'd experienced the less than glamorous side of both), but the down and dirty role of cardiopulmonary therapists. To borrow a phrase from a T-shirt I saw at the gym, "What else is important if you can't breathe?"

Currently, I work as an acute therapist at a teaching hospital in Chicago. While I see orders for chest therapy almost daily, that role lies solely in the hands of our respiratory therapists. This fact both frustrates and amazes me. Simply speaking, why is it ordered as physical therapy if we are not the professionals providing this service? I graduated from school with the idealistic view that I'd be able to change cardiopulmonary therapy in the hospital setting. Our education and training demand that we provide this service, not respiratory therapists. In the current state of health care and the blurring of roles between various professionals, I do believe that chest physical therapy should be given back to the professional for whom it is named: the physical therapist. And let me know where I can find a position that would allow me to be treated as such.

Katie Spero, MSPT, ATC
Chicago

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