This webinar primarily focuses on issues that physical therapy providers need to know in order to comply with Medicare rules and regulations in 2018. Final policies will be discussed as promulgated in the 2018 Medicare Physician Fee Schedule Rule, Home Health Prospective Payment System, Quality Payment Program implementation, Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM), and Hospital Outpatient Prospective Payment System final rules. Additionally, providers will learn the latest information regarding therapy cap and the targeted medical review process and the latest developments with local coverage determinations (LCD) and national coverage determination (NCD).

Meet our presenters

Kara Gainer joined APTA in 2017 and provides leadership and strategic direction to the regulatory affairs team on key programs, initiatives, and policy development in the federal regulatory space. She has extensive knowledge and experience working on policies related to Medicare, Medicaid, health care reform, and provider billing and reimbursement. Prior to joining APTA, Kara was a health care consultant with Drinker Biddle & Reath, where she developed and executed comprehensive public policy strategies for her clients that integrated legislative, regulatory, and communications efforts. She also served as attorney advisor for the US Department of Health and Human Services Office of Medicare Hearings and Appeals, and clerked with the US Senate Sergeant at Arms. Kara received her bachelor’s degree in psychology from the University of Montana and law degree from the University of Montana, School of Law, and is a member of the District of Columbia Bar.

Heather Smith, PT, MPH, currently serves as director of quality for APTA. In her current role, Heather coordinates quality initiatives for the association and develops and implements key member resources related to quality. Two areas of focus in her work include the physician quality reporting system (PQRS) and the functional limitation reporting (FLR) requirements for therapist services under Medicare. She also serves as staff lead on the Physical Therapy Outcomes Registry. Heather previously worked for New York Presbyterian Hospital and University of Pennsylvania Health System, where she served in quality improvement. Her transition into quality was facilitated in part by the acquisition of her master’s degree in public health from Drexel University. Previous to her role in quality improvement, she was a practicing clinician for more than 10 years, with the majority of her focus on orthopedics in the outpatient setting.

Sharita Jennings, JD is Senior Regulatory Specialist at American Physical Therapy Association, where she specializes in Medicaid billing and compliance, Medicare compliance, and health care innovation. Sharita's past experience also includes health care reform, prescription drug benefits, and fraud waste and abuse prevention strategy.

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Heather Smith, PT; Kara Gainer, JD

Learning objectives

  1. Develop an understanding of the need to transition to value-based payment models
  2. Develop an understanding of therapy cap/exceptions process and targeted medical review process
  3. Develop a better understanding of Medicare coding and billing updates


Veterans Administration (VA)

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1Medicare Compliance.mp4
Type:E-Learning Course
Domains:Kara Gainer, Heather Smith, medicare
Key Dates
Enrollment:Prior to  08/30/2019
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