[Dysphagia] Outpatient FEES

[blejeune at enduracare.com (Bob LeJeune)]

Whether it is call practice or title my position remains:  the "act" does not specifiy that FEES is a service SLP's in PA can provide.

	-----Original Message----- 
	From: lobsterpam at aol.com [mailto:lobsterpam at aol.com] 
	Sent: Sat 4/28/2007 5:59 PM 
	To: Bob LeJeune; ronewman at columbus.rr.com; dysphagia at b9.com 
	Cc: jdlemma at comcast.net; joanne.wisely at genesishcc.com 
	Subject: Re: [Dysphagia] Outpatient FEES
	
	
	The statements in the below posting are not entirely true.  The state of PA does not HAVE a practice act.  It has a TITLE act. This act does not mention endoscopy at all, but it also does not mention videofluoroscopy at all. Therefore, in PA, we have no more so-called "authorization" to do videofluoroscopy than we do FEES.  Our statutes mention neither.  Misinterpretation of the LACK of legislation has led many to think that the SLP in PA cannot pass the scope, but there are PA SLPs who do endoscopy!  In many cases the decision of either "Yes, you can" or "No, you can't" is made by administrators (who have the right to state facility policy) regardless of what the statutes do not mention. Or, the decision is made because this is a relatively new procedure and people are checking the statutes, and, finding nothing, decide to play it safe.  (This title act is fearfully outdated, and efforts are underway to revise it; these efforts have been going on for a few years now). Many would rather be cautious, but that doesn't mean they are following what the law - or lack thereof - supposedly says.  Interestingly, people are not so cautious about videos although our state title act doesn't mention those, either.
	
	The ability to bill Medicare has, I believe, more to do with independent practitioner status than state practice acts.  To my knowledge, there is nothing in PA statute to prevent a PA SLP to do FEES in a nursing home, bill the nursing home in a contractual arrangement agreed upon by both, and the facility bills Medicare.   
	
	Pam Smith, Ph.D.
	Bloomsburg University
	Bloomsburg, PA 
	
	 
	 
	-----Original Message-----
	From: blejeune at enduracare.com
	To: ronewman at columbus.rr.com; dysphagia at b9.com
	Sent: Sat, 28 Apr 2007 5:10 PM
	Subject: Re: [Dysphagia] Outpatient FEES
	
	
	My understading is that before we think about Medicare you have to check the 
	state practice act.  For instance in the state of PA there is a concensus that 
	an SLP can not do a FEES and bill Medicare.
	
	    -----Original Message----- 
	    From: dysphagia-bounces at dysphagia.com on behalf of robert newman 
	    Sent: Sat 4/28/2007 1:05 PM 
	    To: dysphagia at b9.com 
	    Cc: 
	    Subject: [Dysphagia] Outpatient FEES
	    
	    
	
	    
	
	    I have been working with a few SLPs who recently completed a course on FEES. 
	
	    They were told that an SLP could pass a scope in an acute care setting 
	    without a physician present in the room, however, a physician must be 
	    present during an outpatient procedure. The reasoning was that it would be a 
	
	    given that there are physicians in hospitals, but not necessarily in 
	    outpatient clinics all the time. Their presenters reported that this was a 
	    recent Medicare change for reimbursement, maybe in the past year. 
	
	    
	
	    I did try to get on the Medicare website, but my internet navigational 
	    skills are not the best and so I could not find anything, if it was there. 
	    Does anyone know anything about this? Any information would be helpful. 
	
	    
	
	    Thanks in advance, 
	
	    
	
	    Kelly L. Newman, CCC-SLP 
	
	    Columbus, Ohio 
	
	    
	
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