A lot is going on with occupational therapy advocacy and policy initiatives every day. A majority of that work is being done by AOTA, volunteers, and state associations. Learn more about how being an AOTA Member makes you the ultimate OT Advocate HERE.
**When it comes to policy, things change quickly, and information may have changed by the time you read this.
Send me your advocacy updates to be considered for this post!
November Occupational Therapy Advocacy & Policy Update
Allied Health Workforce Diversity Act was passed out of the Energy and Commerce Committee in the House of Representatives. A big win for OT, the bill was amended to include a provision to expand Behavioral Health SWorkforce Education and Training Program (BHWET) to OTD as well as MSOT programs. Read more here
- The Medicare Physician Fee Schedule was released for 2022 at the beginning of November. This PFS was much anticipated because it includes the final rule for the PTA and OTA modifier.
- CMS released their final rule for the 2022 Home Health Prospective Payment System and Value-Based Purchasing program. This rule includes a big win for OT by finalizing the rule that allows OTs to initiate and complete the comprehensive start of care for Home Health part A. AOTA’s Article. Here’s my article about the ins and outs of when OT is able to initiate the OASIS
- CMS is requiring vaccines for healthcare workers for facilities that bill Medicare and Medicaid.
“Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 6, 2021. All eligible staff must have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by January 4, 2022. The regulation also provides for exemptions based on recognized medical conditions or religious beliefs, observances, or practices. Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law.”CMS Press Release
October Occupational Therapy Advocacy & Policy Update
- AOTA introduced the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act in the House of Representatives. If passed, this legislation requires that CMS delay implementation of the OTA modifier, provides exemptions for rural and underserved areas, AND would eliminate the direct supervision requireement for OTAs under Medicare Part B. AOTA’s Article
- Allied Health Workforce Diversity Act: Now is the time to take action! Check out my article to learn about the importance of this legislation.
- The Energy and Commerce Committee in the House held a hearing on the Allied Health Workforce Diversity Act where Dr. Victoria Garcia Wilburn spoke on behalf of the bill. Watch Victoria Garcia Wilburn’s 5-minute opening statement. (You can hear some of the questioning at the 2:53:00, 3:33:45, and 3:53:46 marks)
- Pfizer vaccine approved for 5 and up
September Occupational Therapy Advocacy & Policy Update
Lots of news from AOTA this month, per usual. They have been busy at work promoting the profession of OT. If you aren’t a member, read this to see why you should be. There is obviously much news from DC regarding the debt ceiling, the infrastructure bill, etc. There are some healthcare components in the big bills on the table and once we figure out what is in the bill we will be sure to share any information that impacts OT here.
Healthcare workers approved for Pfizer booster: Read more here
AOTPAC is hosting AOTA Member ONLY events. You can view those HERE
OTA Payment Modifier Reduction
AOTA posted a really great overview article of this issue. You’ll want to read this article to learn about how to implement the OTA modifier. Per AOTA, the final Medicare Rule is expected in November! Now is the time to start preparing for the cut and consider how this will impact the flow of your clinic. As a reminder, this payment cut only impacts Medicare Part B. Humana advantage and regular plans require use of the modifier but does not yet carry a payment reduction.
Occupational Therapy Licensure Compact
The OT compact has been signed into law in 8 states. This means we are only 2 away from the Compact becoming viable. The compact legislation requires 10 states to pass the legislation before the initial panel can be assembled. This means that for the states who pass it, the days of unnecessary paperwork and regulatory burden may soon be coming to an end. Or at least significantly lessened! As someone who just applied for a new license in a new state, the paperwork was a nightmare. Check out AOTA’s article about what states passed the compact and what states have the bill in the works! If your state is interested in sponsoring compact legislation, email Chuck Wilmarth at firstname.lastname@example.org. I’m also happy to talk to you about the process as I initiate and facilitate the legislative process in Missouri.
August Occupational Therapy Advocacy & Policy Update
OTA Payment Modifier Reduction
OTA Payment Modifier Reduction: Submit your comments today to stop the OTA Payment Modifier Reduction set to take effect in 2022. Read more about the OTA modifier and how to submit a comment to CMS in our latest article.
AOTA’s Annual Hill Day
AOTA’s Hill Day will be virtual this year but that doesn’t mean it will be any less effective! Hill Day is perfect for individuals of all experience levels to advocate for occupational therapy. The virtual event will take place over three days and is flexible around your work schedule. I’ll be there and I hope to see you there too! Sign up at aota.org/hillday. It’s free!
The Housing and Urban Development Department (HUD) grants are funding the Older Adult Home Modification Program (OAHMP). This program requires an OT Practitioner to supervise the home mods and address the client’s goals to promote full participation in daily activities. AOTA advocacy made this type of opportunity available to practitioners and resulted in HUD awarding 32 community-based orgs grants totaling $30 million dollars. AOTA has partnered with Rebuilding Together and they earned 4 grants from HUD. To read more about this awesome news, visit AOTA’s article.
AOTA’s Summer Series
AOTA has some great sessions available to members and non-members covering a variety of hot topics. I listed the ones below that stood out to me. If you haven’t attended an AOTA session before, I highly recommend it. I have never left feeling disappointed or uninformed.
- Private Practice Essentials for Reimbursement Webinar—Navigating Medicare for Private Practice Success. On September 14 from 2:00 pm to 3:30 pm ET
- Development and Application of the AOTA Knowledge Translation Toolkit (recorded 1.5 hrs)
- AOTA is RoOTed in Diversity: Applying a Toolkit to Address Diversity, Equity, Inclusion, and Occupational Justice – On September 16 at 2pm EST – 1.5 hrs
- Knowledge Webinar—A Call to Action: Innovation, Workforce Capacity Building, and Branding of OT– On September 23 from 10:00 am to 11:30 am ET
- Private Practice Essentials for Reimbursement Webinar—What if You Don’t Want to Deal With Insurance? Tips for Private Practitioners. – On September 28 from 2:00 pm to 3:30 pm ET
July Occupational Therapy Advocacy & Policy Update
Amplify OT Update
The Adult Rehab Guide is finally here! The Rehab Guide was created to help YOU advocate for OT and understand your role in the healthcare system. Each setting has different reimbursement and keeping it straight can be challenging. So, what are you waiting for??
Adult Rehab Guide: Reimbursement and the Role of Occupational Therapy
The Centers for Medicare & Medicaid (CMS) published the 2022 Medicare Physician Fee Schedule (MPFS) on July 13th, 2021. The MPFS may be ringing bells since this is where CMS finalized a 9% reimbursement cut to therapy services for 2021. Congress stepped in last year to reduce the 9% reduction to approximately 3%. CMS has
OTA Modifier: The 15% payment reduction for services provided by an OTA will start January 1, 2022, as required by the BBA of 2018. The CO modifier has been used to identify OTA services since 2020. This cut also applies to PTAs.
OT Eval Codes: AOTA advocated for a correction of CMS calculations that will result in higher reimbursement for eval codes starting in 2022.
Read AOTA’s analysis for more information on the regulatory changes and others that impact your practice.
SNF Payment Update: PDGM was implemented with the intent of being budget neutral. However, CMS found that spending increased by approximately 5% or $1.7 billion in the fiscal year 2020. As a result, CMS has adjusted reimbursement to meet the budget-neutral standard under PDPM.
OTA Confab: The OTA Confab is taking place on August 19th. The focus of this meeting is to learn how to advocate for your value as an OTA! This is a great place for OTAs and OTA students to discuss issues in the field and support each other. Free for AOTA Members and $5 for non-members Register HERE
Other Healthcare News
- Healthcare.gov Special Enrollment Period will end August 15th. Over 2 million individuals have signed up for healthcare coverage as part of the special enrollment.
- CMS proposed an increase in the penalty for hospitals that do not publically share their price lists as required under the Hospital Price Transparency rule. A full year of noncompliance would result in between $109,500 – $2,007,500 per hospital.
- The VA will now require COVID-19 vaccinations for all patient-facing providers.
- Multiple courts have sided with hospitals that require employees to receive the COVID-19 vaccine giving other facilities the support they need to implement such policies.
June Occupational Therapy Advocacy & Policy Update
Policy/ Legislation Updates
Mental Health Professionals Workforce Shortage Loan Repayment Act (H. R. 3150/S. 1578) Is reintroduced in the 117th Congress. When this bill was originally introduced in the 115th Congress, it did not list OT practitioners as mental health providers. Thanks to AOTA’s advocacy, the bill listed OT practitioners as eligible providers when it was reintroduced. This legislation aims to set up a fund to provide loan forgiveness for mental health professionals. TAKE ACTION
CMS published the proposed rule to permanently allow OT to initiate and complete the comprehensive initial evaluation for home health. After the passage of the Medicare Home Health Flexibility Act in December or 2020, CMS finally issued the proposed rule that permanently issues OTs the ability to initiate the OASIS under Medicare Part A in therapy-only cases. This rule puts OTs on equal grounds with PT and SLP in regards to the OASIS. Of note, the current PHE allows OTs to initiate the OASIS in all cases even those including nursing. The final rule will take effect on January 1, 2022. It is expected that the PHE will be continued through the end of the year. So, we do not expect a gap between the PHE and the final rule to take effect. So, be sure to start utilizing your OTs to complete start-of-care visits!
AOTPAC is seeking Board Directors – Applications due July 28! Seeking applications for Region II, III, IV, and V. Terms are 3 years starting January 1, 2022. – Looking for slightly less commitment? Consider applying to be an AOTPAC Ambassador!
May Occupational Therapy Advocacy & Policy Update
Medicare/ Adult Rehab
Private Practice: AOTA is hosting a specialty seminar, Private Practice Essentials for Reimbursement. Sessions are live on June 15 and June 17. Topics include documentation, billing, coding, and tips for success.
OASIS Update: Check out my latest article with Karen Vance on the Medicare Home Health Flexibility Act passage. We discuss what is next for OTs and the OASIS and what steps AOTA is taking to ensure this bill is implemented. You can also read more HERE.
Health Care Reform Update – AOTA Members Only: Laura Hooper, AOTA State Affairs, breaks down the latest updates in healthcare reform in the latest OT Practice. Read all about how the American Rescue Plan Act (ARPA) expanded benefits for the ACA Marketplace and how these expansions can help occupational therapy. It’s a great summary of all that is going on in the world of health care reform. These changes impact our patients and us as individuals!
Diversity, Equity, and Inclusion
The Allied Health Workforce Diversity Act (HR 3320/ S 1679) has been reintroduced! AOTA started supporting this legislation after its first introduction in 2019. This legislation would provide funding to improve diversity in allied health professions, including occupational therapy. The legislation would also help reduce provider shortages.
AOTA DEI Toolkit: A fabulous new tool from AOTA consisting of online resources and guides for faculty, practitioners, and students. “The toolkit is intended to provide instruction and guide you through recommended action guides, exercises, and assessments. It comprises four toolsets to expand knowledge in the areas of DEI and promote further discussion. There are several suggested activities and assessments within the toolsets for additional discovery and opportunities to adapt instructional materials for scenarios.” -AOTA
Assistive Tech for Amputees: AOTA endorses the Access to Assistive Technology and Devices for Americans Study Act (Triple A Study, HR2461/ S1089). This legislation would improve funding for research regarding access to assistive tech and devices for people with limb loss and limb difference. The Government Accountability Office (GAO) would also be charged with developing a report regarding coverage of health care services for people with limb loss of limb difference, including occupational therapy.
IDEA: The American Rescue Plan (S. Con. Res. 5) includes $3 billion to fund IDEA. $2.5 billion for K-12 special ed under Part B and $450 million for early intervention covered under Part C, Part B, and Section 619.
Licenses and Continuing Education
Licensure Compact: The Licensure Compact has been passed in 4 states (Ohio, Virginia, Maryland, and Georgia), and many other states have legislation waiting for the Governor’s signature. AOTA is hopeful we will have the 10 states required to activate the Compact within the first year.
April OT Advocacy & Policy Update
Medicare Sequester: The House and Senate passed an extension of the 2% Medicare sequester moratorium through December 31, 2021. It needs to be signed by the President.
CMS Proposed Rules FY 2022: CMS released its new rules. AOTA is reviewing them now. If you have a concern, email them at email@example.com – keep in mind they can only respond to members due to many emails.
Post-Acute Care: In a study funded by AOTA and APTA, occupational therapy and physical therapy were found to provide significant value to patients. The study looked at 1.4 million Medicare cases across acute care. Therapy utilization correlated to improved quality of life and decreased hospital readmissions. Read more here: www.aota.org/tops. Look for an article on this from Amplify OT in the future.
Telehealth: Rep Mikie Sherrill (D-NJ) and David McKindley (R-WV) reintroduced the Expanded Telehealth Access Act (HR 2168). This bill would allow OT practitioners to provide OT services to Medicare patients after the expiration of the PHE. Use the take action page linked below to encourage your Representative to co-sponsor the legislation today!