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To:KatieKelan
Subject:QuestionsinregardstoMedicaidandMedicareReimbursement
Ms.KatieKelan,
IamwritingtoyouinregardstoseveralquestionsIhaveaboutthenewchangesinMedicaidand
Medicarereimbursements.
Myquestionsareasfollow:
1. Isthereagraceperiodforcompliance?
2. SincetheminimumeducationrequirementforapatientcoveredbyMedicaidand
MedicarehasincreasedtoaBachelorsinPT,doesthatincreasetheamountof
reimbursementsincepatientsarenowseenbyahigherdegreeemployee?
Thankyouverymuchforyourtime.Ihopetohearbackfromyousoon.
JeannetteRodriguez
HumanResourceDirector
RGVTherapeutics,L.L.P.
jrodriguez@rgvtherapeutics.com
9569999999
Email2:
To:ManagingPartner1ManagingPartner2
Subject:UrgentChangesinMedicaidandMedicarereimbursementiseffective
immediately
GoodAfternoonManagingPartner1andManagingPartner2,
IamwritingtoinformbothofyouthatIreceivedaletterfromHHSinregardstothenew
changesthatareeffectiveimmediatelywithMedicaidandMedicarereimbursements.
DuetothechangesthathavebeenmadeforMedicaidandMedicarereimbursements,thewaywe
dobusiness,isinmyopinionnolongereffective.
Inordertobeincomplianceseveralthingshavetochange.
1. WehavetoincreasethenumberofPTsandMPTsonstaffanddecreasethenumberof
PTAs.
2. Themodelinwhichweareusingtoassignclientsisalsonolongereffective,hencewe
needtorestructureit.
IhavepreparedamemorandumthatstatesthechangesthatIthinkwouldbebestsuitedinthis
situation.Pleaselookoveritandletsplanonmeetingtomorrowmorningtofinalizeanychanges
thatarenecessarytobeincomplianceforMedicaidandMedicareReimbursements.Oncewe
havefinalizedthenecessarychanges,wewillthensendoutthememorandumtoallofour
employees.
JeannetteRodriguez
HumanResourseDirector
RGVTherapeutics,L.L.P.
jrodriguez@rgvtherapeutics.com
9569999999
RGVTherapeutics,L.L.P.
5000N.McColl
McAllen,TX78504
Letter1:
March3,2015
Health&HumanServices
200IndependenceAvenue,S.W.
Washington,D.C.20201
Subject:Licensing&Medicare/MedicaidReimbursement
DearDr.ClarkManji:
Iamwritingtoyoutoacknowledgereceiptofyournotice.Thankyouforcordiallyinformingus
aboutthenewchangesinMedicareandMedicaidReimbursements.
Asrequestedinyourletter,thebreakdownofthestaffinourclinicisasfollows:
FivePhysicalTherapyAssistants(PTAs)
ThreeBachelorsdegreePhysicalTherapists(PTs)
OneMastersdegreePhysicalTherapist(MPT)
OneHumanResourceDirector/ManagingPartner
PleasenotethatthenumberofPTsandMPTswillbeincreasingtobettermeettheneedsofour
patientsandensurethatcomplianceismaintained.
RGVTherapeutics,L.L.P.hasmaintainedanoutstandingrecordwithcomplianceinallmandates
andwillcontinuetodosowiththesenewchangesaswell.Ihavetakenthenecessarystepsto
assureyouthatweareincompliancewiththenewchangesinreimbursementforMedicareand
Medicaid.Ifyouhaveanyquestions,pleasefeelfreetocontactmeat
jrodriguez@rgvtherapeutics.com
SincerelyYours,
JeannetteRodriguez
JeannetteRodriguez
HumanResourceDirector
ManagingPartner
c:ManagingPartner1SouthLocation
ManagingPartner2CentralLocation
Memo1:
RGVTherapeutics,L.L.P.
INTEROFFICECOMMUNICATION
Date:
March1,2015
To:
AllStaff
From:
JeannetteRodriguez,HumanResourceDirector
Subject:
ChangesinMedicareandMedicaidReimbursements
ThepurposeofthismemoistoinformyouofthechangesthatRGVTherapeutics,L.L.P.willbe
implementingeffectiveimmediatelyinordertobeincompliancewiththerecentchangesof
MedicareandMedicaidReimbursements.
Summary
Currently,ourgroupofPhysicalTherapyAssistants(PTAs)handlesthemajorityofourpatients,
includingthosewithfederalassistance.However,inordertocomplywiththenewchangesfor
MedicareandMedicaidReimbursementthemannerinwhichpatientsarehandledandassigned
hasbeenrestructuredintoadualmodel.Furthermore,thesechangeswillaffectourteamsince
newadditionsandreductionstoourstaffwillbemadetoeffectivelyhandlethecareofpatients.
BackgroundInformation
RecentchangeshavebeenmadetoMedicareandMedicaidReimbursements.Thechangesare
asfollow:
AllpatientscoveredbyMedicareandMedicaidmustbetreatedbysomeonewiththe
minimumqualificationofabachelorsdegreeinPhysicalTherapy(PT),underthe
supervisionofaMasterinPhysicalTherapy(MPT).
Patientsnotmeetingtheaboverequirementwillnotbeeligibleforreimbursement.
RestructuredPatientAssignmentModel
OurcurrentpatientassignmentmodelhasbeentoassignmostpatientstoPTAsandasthe
patientsneedsincreased,ahigherdegreedemployeewillseethem.Thismodelisnolonger
suitedforpatientsthatarecoveredbyMedicaidandMedicare.
Effectiveimmediatelytherestructureddualpatientassignmentmodelisasfollows:
PatientsthatareprivatepayorhavehealthinsurancethatisnotMedicaidorMedicare
PatientswillbeseenbyPTAsandaspatientsneedsincrease,theyareassignedto
ahigherdegreedemployeesuchasaPTorandMPT.
PatientswhoMedicaidandMedicarewillfollowthenewmodel:
PatientswillbeseenbyaPTthatisunderthesupervisionofaMPT.
Aslevelofcareincreasesforpatient,patientwillbepassedonfromPTtoMPT.
Date:
March1,2015
To:
AllStaff
From:
JeannetteRodriguez,HumanResourceDirector
Subject:
ChangesinMedicareandMedicaidReimbursements
Page
2
EffectsonOurTeam:
DuetothechangeinMedicareandMedicaidreimbursements,aswellasthenotedfactthatthe
majorityofourpatientsarecoveredbytheseentities,ourteamwillbeaffectedinseveralways.
First,PTsandMPTswillhaveahighervolumeofcaseloads.Thismaybeoverwhelmingatfirst
duetoourteamnotbeingequippedwiththerightamountofPTsandMPTs.Restassuredthat
newtemporaryPTsandapermanentMPTwillbeaddedtoourteam.Theoverwhelming
caseloadsisonlytemporary,reliefisonitsway.
Secondly,thenumberofPTAsonstaffwillbereducedforthetimebeing.PTAsthatare
affectedbythisreductionwillbeofferedseveralcareeradvancementopportunitiesthatcould
leadtobeingalicensedPTinthefuture.EachPTAhasreceivedaseparateletterexplainingin
detailwhatoptionsareavailable.
InConclusion:
ThechangeinreimbursementforMedicaidandMedicareareeffectiveimmediately.Hencein
ordertoremainincomplianceseveralchangeshaveoccurredinordertostayincomplianceand
betterserveourpatients.Thewayweassignpatients,aswellasthenumberofPTs,MPTs,and
PTAsthatwehaveonstaffhavechanged.Inaddition,restassuredthatallchangesthathave
beenmadeareinthebestinterestofourpatientsaswellasouremployees.Itmaybedifficultto
adapttothenewchanges,however,intime,theflowofthingswillbemuchsmoother.
Letter2:
RGVTherapeutics,L.L.P.
5000N.McColl
McAllen,TX78504
March3,2015
Ms.orMr.EmployeesName,PhysicalTherapyAssistant
HomeAddress
City,State,Zipcode
DearEmployeesName,
RGVTherapeuticshasbeeninbusinessforfiveyearsandhasprovidedanoutstandinglevelof
caretoeachoneofourpatients.Thiswasmadepossiblebythecontributionsofeachofour
employees,especiallyourPhysicalTherapyAssistants(PTAs).Iwouldliketotakethis
opportunitytosincerelythankyouforallofyourefforts.Asyouhavebeeninformedina
previousmemo,areductioninourPTAgroupisnecessarytocomplywiththenewchangesin
reimbursementforMedicaidandMedicare.Withaheavyheart,Iinformyouthatourcliniccan
nolongercontinuetoemployyouasaPTA.
AlthoughwecannolongeremployyouasaPTA,wedohoweverlookforwardtohiringyouin
thefutureasalicensedPhysicalTherapist(PT).Westronglyencourageyoutocontinueyour
educationasaPT.IfyouweretoobtainaBachelorsinPhysicalTherapy,RGVTherapeutics
wouldgladlyofferyouajobatanyofourexistinglocationsasaPT.
Ifcontinuingyoureducationisnotanoptionforyou,thenpleaseknowthatyouhaveourfull
supportinhelpingyoufindanotherjobinthePTAindustry.Icanassistyouwithjobreferralsas
wellasprovidenecessaryrecommendationstopotentialemployers.Also,knowthatyouare
eligibleforunemploymentbenefitsaswell.Donothesitatetoseekmeoutforhelp.Iwilldo
everythingIcantohelp.
BestWishes,
JeannetteRodriguez
JeannetteRodriguez
HumanResourceDirector