In a somewhat refreshing tone the Government Accounting Office issued a report that showed the US government made $18.6 billion in erroneous payments to Medicaid providers in 2008 but admitted that most of these payments are due to 'procedural glitches' and not fraud.Deborah Taylor, acting director and chief financial officer of the Centers for Medicare & Medicaid Services at HHS told a panel of See the original post: Medicare recognizes that PT documentation errors are not fraud

The Case of Mr. SpoonerSome readers of this blog have posited that you should never, ever use the OPTIMAL scale because it is "crap" and not a useful tool for clinical decision-making.The shortcomimgs of the OPTIMAL have been previously discussed here and are well-known.OPTIMAL is a 'setting-specific' tool for activity limitations affecting the upper body, lower body and trunk.That is, OPTIMAL is Read this article: When should you use the OPTIMAL Scale?

Should physical therapists complete a full neurological screening for every patient with lower back pain?Over 12 years ago, Richard Deyo, MD, MPH asked the question... "Should the physician complete a full neurological examination of every patient - even those who present with no leg pain?"I almost always believe that, as specialists, physical therapists should 'step up to the plate' and screen See original here: Should orthopedic physical therapists always test for nerve root injuries?

In "Why 'Quality' Care is Dangerous" Jerome Groopman, MD complains the definition of 'quality' is too narrow, eg: only 'quality' that conforms to consensus standards set by Medicare experts is of sufficient 'quality'. Consensus means measurement of simple clinical procedures that fail to capture the complexity of medical decision-making, such as diabetic management.But 'quality' in P4P is meant Go here to read the rest: Why 'Quality' Care is Inevitable