Maintenance Therapy A Blueprint for Success

1. Be familiar with the history of the Jimmo v. Sebelius cases, the clarification of the No Improvement Standard that occurred under a court-ordered Corrective Action Plan and its impact on the provision of therapy care to Medicare beneficiaries.
2. Identify regulatory requirements for coverage of maintenance therapy care services and the definitions of what constitutes skilled care.
3. Create a framework for patient assessment to assist in identifying beneficiaries who may qualify for coverage under the No Improvement Standard.
4. Be able to define the terms Therapy Cap, KX Modifier, Additional Development Request (ADR)Therapy Threshold and TPE (Targeted Probe and Education).
5. Be familiar with the primary purposes for documentation and common errors identified through the Medicare CERT Program for outpatient therapy claims.
6. Become proficient in strategies to assist with demonstrating skill in documentation including documentation of clinical judgement and goal writing techniques.
7. Effectively use action verbs to demonstrate skill in documentation and treatment notes.
8. Provide management strategies to respond to a Targeted Probe and creating a summary report using a Legal Brief and research/literature that supports long term care.

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Approval of continuing education credit by a regulatory board or authority does not constitute endorsement of the course material or content. This course is not intended to serve as a substitute for legal or other professional advice.