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Physical Therapy and Medicare
explained by Dr. Rhonda Cowern, DPT, CertDN

There has been lots of talk on capitol hill about Medicare insurance coverage and changes for all Medicare beneficiaries, including changes in physical therapy coverage. Medicare changes coverage limitations annually and you may have noticed your deductible has gone up over the years. A deductible is the portion of your insurance contract you must pay out of pocket before your insurance benefits ‘kick in’. On a side note, many patients have a supplemental insurance, mainly to cover their out-of-pocket costs. Not all supplement insurances cover the deductible. For 2018 the Medicare deductible is $183 dollars. Let’s say the deductible is met and your doctor just handed you a prescription for physical therapy.

What now? What will it cost? Medicare is willing to cover 80% of all medically necessary physical therapy fees. You are responsible for the remaining 20%. Again, this is where a supplement ‘kicks in” to pick up the 20% of allowable physical therapy expenses… but Medicare has implemented a cap. A cap refers to a therapy cap, which is the maximum amount of dollars your Medicare insurance plan will cover for out-patient physical therapy in a clinic each annual year. For the billing year of 2018 the current therapy cap = $2010 dollars in skilled, medically necessary physical therapy services.

What if I exceed the cap? The government tried to pass a law to implement a FIRM cap, meaning no exceptions to this dollar amount no matter your pre-existing complicated conditions. GOOD NEWS! This FIRM therapy cap was overturned in the late hours of February 9th- due to active lobbying on capital hill for your rights by APTA and its members who wrote their senators. I have been an active member since 2009 with the American Physical Therapy Association and proudly support advocacy for health and wellness.

What does this mean now? The repeal came with additional consequences, one being automatic audit of any physical therapist that exceeds the $2010 cap- but not a firm denial of payment, just an investigation into why this physical therapist or therapy company continued to treat you.

What is my point? Medicare patients need to educate themselves on insurance limitations and be given quality skilled physical therapy every session. At Moab Physical Therapy and Rehabilitation, we guarantee individual skilled therapy treatment to address your needs and help you reach YOUR goals. We do not drive up daily billing costs for unnecessary treatment or observe exercises that could be completed at home. You will work one on one with a licensed provider at each appointment and we do our best to keep you with the SAME licensed provider during your plan of care.

HOW does this help you? Patients at Moab PT and Rehab reach functional goals in fewer clinic sessions with lower billable insurance fees. Moab PT and Rehab strives to provide research-based techniques helping you maintain your functional improvements long after your plan of care ends.

Many of us live in Moab for the community and the recreational activities it affords us. I want to help you continue to enjoy the reasons you live in Moab. If you have further Medicare questions or would like to come in for an evaluation, contact your medical doctor for a physical therapy referral. Moab Physical Therapy and Rehabilitation is located on Center Street near the visitor center. Follow us on FACEBOOK @ Moab Physical Therapy and Rehabilitation, or Instagram & Twitter @MoabPT. We look forward to working with you! And be sure to mention you heard about it in the Moab Happenings.

Moab Local Michelle Peterson Created a Stable Future with USU-Moab

Confronted with the stresses of raising a family, a job that required a grant approval every year, and a shaky economy, Michelle Peterson decided to get a college degree that would guarantee a steady job. Unable to relocate for school, Peterson found a solution at Utah State University (USU).

“On a whim, I stopped by USU-Moab and spoke with an advisor there,” said Peterson. “I told him I liked helping people in need and wanted to obtain an education with a secure future.” It was immediately recommended she look into the nursing program. Now, seven years later, Peterson is the operating room nurse manager at Moab Regional Hospital (MRH).
To help pay for school, Peterson kept her job with Grand County, where she worked as a victim advocate, helping victims of sexual assault, burglary, and more. When she wasn’t at work, she was busy with school. “With two small children and a husband at home, USU-Moab’s student center and I became very good friends,” said Peterson. “The close location allowed me to do homework on campus after my full-time job, then return to my family in the evening.”

Staying in her hometown with family and friends was a major reason Peterson was able to successfully earn her degree. The nursing program is very strenuous and enforces very high standards. With time, her support system grew to include faculty and staff at USU-Moab. “The employees at the college knew me by name, they knew my family, and believed I would make a great nurse,” said Peterson. “When things got tough they were always there to lend a listening ear and give me the confidence boost I needed to succeed.”

Upon making it through school and earning her nursing degree, Peterson passed the licensure exam to become a registered nurse and was offered a job at MRH. Peterson said it has been a dream being able to work where she was born in and where she delivered her two children. USU-Moab works closely with MRH, sending students there for clinicals and hands-on training, then providing employment for a majority of the students once they graduate. Many of the nursing staff, including Peterson, serve as mentors to nursing students.

According to Peterson, the relationship USU has with MRH, along with the opportunities and environment provided by USU, helped prepare her for her current job. “The support from professors and advisors, the quality of the education, and the clinical experiences offered at USU all gave me what I needed to do the job I now love and appreciate every day.”

Peterson explains that nursing school is a rigorous journey leading to an amazing reward. “Nursing school isn’t easy by any means, and being a nurse isn’t easy, either. It’s a high demand, stressful job, but the benefits far outweigh the negatives.” USU’s nursing curriculum prepares students not only to pass the state’s licensure exam, but also to tackle the tough, everyday problems nurses face. Peterson is better able to face the challenges of her current job thanks to the difficult testing, clinicals at MRH, and other skills she acquired through nursing school.

Those who are thinking about a career in nursing, and whether or not USU’s nursing program is right for them, Peterson recommends talking to an advisor, like she did. “USU-Moab helped me every step of the way. They helped me fill out financial paperwork, enroll in needed classes, and they were invested in my success.”

If you are interested in USU-Moab’s nursing program, visit

Family Support Center

The Family Support Center at The Christmas Box House will be hosting once again the “Planting of the Pinwheels” in front of the Grand County Courthouse at the Children’s Garden on April 3, 2018 from 3:30pm-5pm.

April was first declared Child Abuse Prevention Month by presidential proclamation in 1983. Since then, April has been a time to acknowledge the importance of families and communities working together to prevent child abuse.

The pinwheel serves as the national symbol for child abuse prevention. It is a reflection of hope, health, and safety---what PCAU (Prevent Child Abuse Utah) and the parent organization, Prevent Child Abuse America, desire for children throughout Utah and everywhere. Pinwheels for Prevention is a nationwide public awareness campaign that puts of new spin of prevention.

So please come and join us at the Grand County Courthouse on April 3, 2018 to plant a pinwheel for a child that isn’t able to do so for themselves. This year we will add your name on the pinwheel you plant if you choose. Enjoy a PB&J, chips, and a drink as well! Bring a blanket and have a picnic! Tourist welcome.

Often times parents are under a lot of different stresses that cause them to just need a respite break. That is one of the many services the Family Support Center @ The Christmas Box House provides. A respite break for parents sometimes needing one. Please call our center 24/7 days a week at 435.259.1658.

To report suspected cases of child abuse or neglect in Utah the toll free number is 1.800.323.3237. An intake worker will take the information down and forward it to the local DCFS office.

Time To Kiss Intimacy Goodbye?

Increasing numbers of couples these days are giving up on intimacy. Many just no longer have any interest. They chalk up their lack of desire to “old age”—even at 50! While there are a variety of causes for this disinterest, the good news is that they are all fixable!

Upon further discussion with a partner who has given up on sexual activity, we often learn, however, that it’s not for lack of interest. Rather, it stems from resignation. When a man is no longer able to perform, it’s a lot less embarrassing to simply say, “Our relationship has matured beyond that stage and we no longer need sex to express our love.”
Fortunately, it doesn’t have to be this way! Believe it or not, both lack of desire and inability to perform have real physical causes.

Conventional wisdom used to be that most erectile dysfunction was related to performance anxiety and other emotional factors. While we have found this to be true in the very young, once men get into their thirties and beyond, the majority of cases stem from testosterone deficiency, vascular disease, or both.

Yes, sadly, we find increasing numbers of very young men with low testosterone, and it has everything to do with our environment and our Western diets and lifestyles. But this is not all: As men move into their forties and beyond, the many factors that cause cumulative damage to their arteries often begin to catch up with them. This group in particular responds well to drugs like Viagra. These drugs work by temporarily increasing a substance called nitric oxide in the blood vessel walls, causing the vessels to relax, open up, and increase blood flow.

In the penis, this action makes erection possible when there is enough testosterone and appropriate stimulation of the brain. In the rest of the body, these drugs lower blood pressure, which can cause headaches, lightheadedness, and other side effects, especially in men who are already taking blood pressure medications.

Because Viagra and similar drugs work by opening up narrowed arteries, this is why your doctor should be evaluating the condition of other arteries as well. One valuable test for this is called digital pulsewave analysis, which we routinely perform in our offices. Others, performed in hospitals, include coronary calcium scoring, carotid intimal thickness, stress testing, and of course, angiography (e.g. heart catheterization).

Your need for Viagra is also a warning that whatever you are doing to prevent or treat vascular disease (such as heart disease or stroke) isn’t working. The penile artery is the same size as the arteries in the heart, and subject to the same damage. In other words, if you need a drug in order to have an erection, chances are really good that you also have heart disease but don’t know it yet. For this reason, in our offices, we test for a large number of causes of vascular disease that are missed using standard cholesterol testing. Our goal is to help you reverse the damage early rather than wait until you have that heart attack or stroke and then have to take a bunch of prescription drugs.

Meanwhile, we have the most advanced technology available for breaking up the plaques that have made intimacy a thing of the past for too many couples. It breaks our hearts when we learn of couples who have given up on intimacy long before their time, simply because they don’t know that effective treatments are within their reach.

Our painless treatment can breathe new life into your relationship. Don’t buy into that old worn-out phrase, “You’re not getting any younger.” Nonsense! That’s no excuse for fading into the sunset of life, giving up on so many activities that make life meaningful and enjoyable. Whether it’s testosterone you need, better blood flow, or both, we’ve got you covered.
And you don’t have to settle for taking an overpriced drug and hoping conditions are right before it wears off. Talk about killing the mood! Who wants to schedule their intimacy?

Even if the drugs don’t work for you, there is still hope. You should never have to kiss intimacy least not until one of you dies!

If you have lost hope, or are tired of having to put intimacy on your calendar, give us a call. We can help you.
Prestige Wellness Institute (435) 259-4008
And be sure to mention you read about it in Moab Happenings.

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