Advocate for AOTA's Home Health Bill

Make Occupational Therapy an Initiating Service

Health care reform has created a perfect storm of opportunity that has the potential to allow passage of the Medicare Home Health Flexibility Act (HR 1094) and remove a long standing problem for the profession. We can do this now, but we need YOUR help! Passage of HR 1094 cannot and will not wait another year!

“As a part of the Centennial Vision, we are pushing forward to strengthen occupational therapy’s role in enhancing the well-being and functional status of older adults so they are more likely to remain safely in their homes. Passage of the Medicare Flexibility Act and gaining initiating service status in Medicare home health will go a long way to raise the profile of occupational therapy and would be a great victory for the profession. Due to the current emphasis on the ‘medical home’ as part of the thinking behind healthcare reform, the time for passage of this bill has come and we need everyone’s help to make that happen. If any healthcare service belongs in the home, it is occupational therapy with its emphasis upon performance and participation in context.”                                                                                                                                                             --- AOTA President Penny Moyers Cleveland

Please personalize and send a message using the form letter provided, also PLEASE call your Member of Congress and ask them to support the Medicare Home Health Flexibility Act. Multiple contacts with Congressional staff is necessary to make sure they know how important this bill is to you and the profession.

The Medicare Home Health Flexibility Act (HR 1094)

Representatives John Lewis (D-GA) and Lincoln Diaz-Balart introduced legislation that would improve utilization of occupational therapy as a home health service under Medicare on February 13, 2009. The Medicare Home Health Flexibility Act (H.R.1094) is also actively supported by the National Association of Home Care and Hospice (NAHC), the American Speech-Language Hearing Association (ASHA) and was previously supported by the American Physical Therapy Association in the last Congress. 

AOTA is working with our Congressional champions and previous supporters of the legislation to build support for passage during the 111th Congress. AOTA is pleased to work with Representative John Lewis again this Congress as he is a well respected member of the Ways & Means Committee that has jurisdiction over Medicare law. Representative Lincoln Diaz-Balart is a leader among moderate Republicans and has been a valued long-time supporter of occupational therapy on this home health issue. Their leadership and support is greatly appreciated.

We ar also activel working in the Senate with Senator Carding (D-MD) to have the intent of the language from HR 1094 offered as an amendment to the Senate's health care reform proposal.

AOTA Position:

AOTA fully supports passage of The Medicare Home Health Flexibility Act (H.R. 1094) to make occupational therapy an initiating service for Medicare home health services. Current Medicare law creates an imbalance among skilled therapy services and restricts efficient staff utilization for home health agencies and must be corrected. Limiting access to occupational therapy in the home health setting causes agencies to provide care according to restrictions rather than what is in the best medical interest of their patients. Placing occupational therapy on a more equal footing with the qualifying services provides home health agencies and Medicare beneficiaries with improved access to the most appropriate service to meet their needs. This legislation would improve efficiency and effectiveness of home health for Medicare beneficiaries by allowing occupational therapists to conduct the initial home health assessments when occupational therapy is listed on the physician's order along with a qualifying service. This change in policy would be limited to rehabilitation only cases.

 
Background:

The inequality of occupational therapy not being an initiating service for Medicare home health benefits has been a problem for over thirty years. Occupational therapy was included in Medicare as a free standing benefit in 1987 but is not eligible as an initiating service for home health service. This problem must be addressed through legislation. Current law limits the appropriate use of occupational therapy in the home health setting and negatively impacts outcomes for home health care recipients by barring clinically indicated and physician authorized services. As an important step forward, the newly proposed legislation would allow occupational therapists to conduct the initial assessment when there is a qualifying service on the physician order. This will allow home health agencies to more efficiently use their occupational therapists to meet patient needs. The proposal is budget neutral as it does not expand Medicare eligibility or services but improves the flexibility of home health agencies to use the most appropriate skilled therapists to open cases.

Contact:  Tim Nanof, AOTA Federal Affairs Manager, fad@aota.org, 301-652-2682

                 Ralph Kohl, AOTA Legislative Representative, rkohl@aota.org, 301-652-1682

Please contact your Members of Congress today!

Click Here to access a 1 page Fact Sheet and Talking Points.