Email1:

To:KatieKelan
Subject:QuestionsinregardstoMedicaidandMedicareReimbursement

Ms.KatieKelan,
IamwritingtoyouinregardstoseveralquestionsIhaveaboutthenewchangesinMedicaidand
Medicarereimbursements.
Myquestionsareasfollow:
1. Isthereagraceperiodforcompliance?
2. SincetheminimumeducationrequirementforapatientcoveredbyMedicaidand
MedicarehasincreasedtoaBachelorsinPT,doesthatincreasetheamountof
reimbursementsincepatientsarenowseenbyahigherdegreeemployee?

Thankyouverymuchforyourtime.Ihopetohearbackfromyousoon.

JeannetteRodriguez
HumanResourceDirector
RGVTherapeutics,L.L.P.
jrodriguez@rgvtherapeutics.com
9569999999

Email2:

To:ManagingPartner1ManagingPartner2
Subject:UrgentChangesinMedicaidandMedicarereimbursementiseffective
immediately

GoodAfternoonManagingPartner1andManagingPartner2,
IamwritingtoinformbothofyouthatIreceivedaletterfromHHSinregardstothenew
changesthatareeffectiveimmediatelywithMedicaidandMedicarereimbursements.
DuetothechangesthathavebeenmadeforMedicaidandMedicarereimbursements,thewaywe
dobusiness,isinmyopinionnolongereffective.
Inordertobeincomplianceseveralthingshavetochange.
1. WehavetoincreasethenumberofPTsandMPTsonstaffanddecreasethenumberof
PTAs.
2. Themodelinwhichweareusingtoassignclientsisalsonolongereffective,hencewe
needtorestructureit.
IhavepreparedamemorandumthatstatesthechangesthatIthinkwouldbebestsuitedinthis
situation.Pleaselookoveritandletsplanonmeetingtomorrowmorningtofinalizeanychanges
thatarenecessarytobeincomplianceforMedicaidandMedicareReimbursements.Oncewe
havefinalizedthenecessarychanges,wewillthensendoutthememorandumtoallofour
employees.

JeannetteRodriguez
HumanResourseDirector
RGVTherapeutics,L.L.P.
jrodriguez@rgvtherapeutics.com
9569999999
RGVTherapeutics,L.L.P.
5000N.McColl
McAllen,TX78504


Letter1:

March3,2015

Health&HumanServices
200IndependenceAvenue,S.W.
Washington,D.C.20201

Subject:Licensing&Medicare/MedicaidReimbursement

DearDr.ClarkManji:

Iamwritingtoyoutoacknowledgereceiptofyournotice.Thankyouforcordiallyinformingus
aboutthenewchangesinMedicareandMedicaidReimbursements.

Asrequestedinyourletter,thebreakdownofthestaffinourclinicisasfollows:
FivePhysicalTherapyAssistants(PTAs)
ThreeBachelorsdegreePhysicalTherapists(PTs)
OneMastersdegreePhysicalTherapist(MPT)
OneHumanResourceDirector/ManagingPartner
PleasenotethatthenumberofPTsandMPTswillbeincreasingtobettermeettheneedsofour
patientsandensurethatcomplianceismaintained.

RGVTherapeutics,L.L.P.hasmaintainedanoutstandingrecordwithcomplianceinallmandates
andwillcontinuetodosowiththesenewchangesaswell.Ihavetakenthenecessarystepsto
assureyouthatweareincompliancewiththenewchangesinreimbursementforMedicareand
Medicaid.Ifyouhaveanyquestions,pleasefeelfreetocontactmeat
jrodriguez@rgvtherapeutics.com

SincerelyYours,

JeannetteRodriguez

JeannetteRodriguez
HumanResourceDirector
ManagingPartner

c:ManagingPartner1SouthLocation
ManagingPartner2CentralLocation

Memo1:

RGVTherapeutics,L.L.P.

INTEROFFICECOMMUNICATION

Date:
March1,2015
To:
AllStaff
From:
JeannetteRodriguez,HumanResourceDirector
Subject:
ChangesinMedicareandMedicaidReimbursements

ThepurposeofthismemoistoinformyouofthechangesthatRGVTherapeutics,L.L.P.willbe
implementingeffectiveimmediatelyinordertobeincompliancewiththerecentchangesof
MedicareandMedicaidReimbursements.

Summary
Currently,ourgroupofPhysicalTherapyAssistants(PTAs)handlesthemajorityofourpatients,
includingthosewithfederalassistance.However,inordertocomplywiththenewchangesfor
MedicareandMedicaidReimbursementthemannerinwhichpatientsarehandledandassigned
hasbeenrestructuredintoadualmodel.Furthermore,thesechangeswillaffectourteamsince
newadditionsandreductionstoourstaffwillbemadetoeffectivelyhandlethecareofpatients.

BackgroundInformation
RecentchangeshavebeenmadetoMedicareandMedicaidReimbursements.Thechangesare
asfollow:
AllpatientscoveredbyMedicareandMedicaidmustbetreatedbysomeonewiththe
minimumqualificationofabachelorsdegreeinPhysicalTherapy(PT),underthe
supervisionofaMasterinPhysicalTherapy(MPT).
Patientsnotmeetingtheaboverequirementwillnotbeeligibleforreimbursement.

RestructuredPatientAssignmentModel
OurcurrentpatientassignmentmodelhasbeentoassignmostpatientstoPTAsandasthe
patientsneedsincreased,ahigherdegreedemployeewillseethem.Thismodelisnolonger
suitedforpatientsthatarecoveredbyMedicaidandMedicare.

Effectiveimmediatelytherestructureddualpatientassignmentmodelisasfollows:
PatientsthatareprivatepayorhavehealthinsurancethatisnotMedicaidorMedicare
PatientswillbeseenbyPTAsandaspatientsneedsincrease,theyareassignedto
ahigherdegreedemployeesuchasaPTorandMPT.
PatientswhoMedicaidandMedicarewillfollowthenewmodel:
PatientswillbeseenbyaPTthatisunderthesupervisionofaMPT.
Aslevelofcareincreasesforpatient,patientwillbepassedonfromPTtoMPT.

Date:
March1,2015
To:
AllStaff
From:
JeannetteRodriguez,HumanResourceDirector
Subject:
ChangesinMedicareandMedicaidReimbursements
Page
2

EffectsonOurTeam:
DuetothechangeinMedicareandMedicaidreimbursements,aswellasthenotedfactthatthe
majorityofourpatientsarecoveredbytheseentities,ourteamwillbeaffectedinseveralways.

First,PTsandMPTswillhaveahighervolumeofcaseloads.Thismaybeoverwhelmingatfirst
duetoourteamnotbeingequippedwiththerightamountofPTsandMPTs.Restassuredthat
newtemporaryPTsandapermanentMPTwillbeaddedtoourteam.Theoverwhelming
caseloadsisonlytemporary,reliefisonitsway.

Secondly,thenumberofPTAsonstaffwillbereducedforthetimebeing.PTAsthatare
affectedbythisreductionwillbeofferedseveralcareeradvancementopportunitiesthatcould
leadtobeingalicensedPTinthefuture.EachPTAhasreceivedaseparateletterexplainingin
detailwhatoptionsareavailable.

InConclusion:
ThechangeinreimbursementforMedicaidandMedicareareeffectiveimmediately.Hencein
ordertoremainincomplianceseveralchangeshaveoccurredinordertostayincomplianceand
betterserveourpatients.Thewayweassignpatients,aswellasthenumberofPTs,MPTs,and
PTAsthatwehaveonstaffhavechanged.Inaddition,restassuredthatallchangesthathave
beenmadeareinthebestinterestofourpatientsaswellasouremployees.Itmaybedifficultto
adapttothenewchanges,however,intime,theflowofthingswillbemuchsmoother.

Letter2:

RGVTherapeutics,L.L.P.
5000N.McColl
McAllen,TX78504

March3,2015

Ms.orMr.EmployeesName,PhysicalTherapyAssistant
HomeAddress
City,State,Zipcode

DearEmployeesName,

RGVTherapeuticshasbeeninbusinessforfiveyearsandhasprovidedanoutstandinglevelof
caretoeachoneofourpatients.Thiswasmadepossiblebythecontributionsofeachofour
employees,especiallyourPhysicalTherapyAssistants(PTAs).Iwouldliketotakethis
opportunitytosincerelythankyouforallofyourefforts.Asyouhavebeeninformedina
previousmemo,areductioninourPTAgroupisnecessarytocomplywiththenewchangesin
reimbursementforMedicaidandMedicare.Withaheavyheart,Iinformyouthatourcliniccan
nolongercontinuetoemployyouasaPTA.

AlthoughwecannolongeremployyouasaPTA,wedohoweverlookforwardtohiringyouin
thefutureasalicensedPhysicalTherapist(PT).Westronglyencourageyoutocontinueyour
educationasaPT.IfyouweretoobtainaBachelorsinPhysicalTherapy,RGVTherapeutics
wouldgladlyofferyouajobatanyofourexistinglocationsasaPT.

Ifcontinuingyoureducationisnotanoptionforyou,thenpleaseknowthatyouhaveourfull
supportinhelpingyoufindanotherjobinthePTAindustry.Icanassistyouwithjobreferralsas
wellasprovidenecessaryrecommendationstopotentialemployers.Also,knowthatyouare
eligibleforunemploymentbenefitsaswell.Donothesitatetoseekmeoutforhelp.Iwilldo
everythingIcantohelp.

BestWishes,

JeannetteRodriguez

JeannetteRodriguez
HumanResourceDirector