2008 OSLHA Convention Health Care Caucus Report

March 8, 2008

Facilitator: Healthcare Representative, Martha Coen-Cummings

Attendance: 21 members

Topics Discussed:

Use of V Codes in pediatric care

CPT Codes must support the ICD-9 diagnostic code to demonstrate medical necessity, but limitations of insurance coverage will ultimately be determined by the employer’s agreement of an insurance package offered, which can often be altered when several employees voice their insurance needs to the Human Resources department. Coverage of treatment for specific diagnostic codes can vary greatly across Insurance companies.  Therefore, there is not a universal software package used by insurance companies that determines the “match” of acceptable ICD-9 codes to the CPT code

Ø  OSLHA should be working with ASHA toward universal acceptance across insurance companies of which ICD-9 codes are covered and then working with the software development companies that create the programs used by the insurance companies to insure the coding matches are accurate.

Ø  OSLHA should offer a mini-seminar for new graduates at next year’s convention covering coding.

Current legislative action on Medicare Payments

Introduced OSLHA STARS: Michelle Burnett and Katrina Zeit who were in attendance. Reviewed legislative status at the time of the caucus

Ø  OSLHA should send email alerts to the membership when legislative contact is needed to support the repeal of the therapy caps and split with PT.

Advantages of retention over recruitment (see caucus powerpoint)

Ø  OSLHA should research productivity standards across the state and mandate productivity standards (across settings) Suggestions should be provided to the membership on how to organize caseloads to ethically to meet those standards.

Ø  OSLHA should offer a mini-seminar directed on retention strategies, that includes the “pay for performance” model

Ø   OSLHA should offer a mini-seminar at convention on business writing for the SLP that addresses the formulation of written correspondence and oral presentations framed to consider the viewpoint of the employer’s bottom line rather than the needs of the SLP.

Provided handouts of interest:

Website list of professional practice issues in health care (can also be printed from Healthcare page on OSLHA’s website)

Website listing of efficacy documents per clinical diagnosis

1^st draft of website list of clinical and parent-friendly information sorted by pediatric diagnoses (healthcare members are requested to submit additional sites, which will be added and posted on the healthcare page of OSLHA’s website

Ø  Members were asked to email Martha Coen-Cummings with websites that provide clinical information for adult diagnoses for compilation into an additional list that will be posted on OSLHA’s website

Medicaid issues

            Discussed present legislative Medicaid Issues.

Ø  Introduced Donna Edwards, OSLHA’s Medicaid Reimbursement Rep. who instructed members to email her questions or concerns in bullet-list format, which she will then compile and give to OSLHA’s  lobbyist. Members should not directly contact the lobbyist themselves.

Presentation by OSLHA President, Katrina Zeit, of the WCPO public awareness television ad on Communication Disorders, created through an OSLHA grant that was written by Patti Fisher and Katrina Zeit.

Ø  Any OSLHA member who is willing to approach their local television station(s) to request the segment’s airing, is welcome to use it.