[Dysphagia] Outpatient FEES

[lobsterpam at aol.com (lobsterpam at aol.com)]

 By that standard, SLPs in PA cannot provide videofluoroscopy, either.
 
 My point is merely pointing out the inconsistencies in the interpretation of the lack of a state statute.
 
 Pam Smith
    
 -----Original Message-----
 From: blejeune at enduracare.com
 To: lobsterpam at aol.com; ronewman at columbus.rr.com; dysphagia at b9.com
 Cc: jdlemma at comcast.net; joanne.wisely at genesishcc.com
 Sent: Sat, 28 Apr 2007 6:05 PM
 Subject: RE: [Dysphagia] Outpatient FEES
 
  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  (This title act is fearfully outdated, and 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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