Advocate for OT as an Essential Health Benefit: Listening Sessions Near You
AOTA has been working hard with Congress, federal agencies, and key stakeholders like the National Association of Insurance Commissioners (NAIC) and the Institute of Medicine to educate them about occupational therapy and advocate for occupational therapy to be an essential health benefit under the Affordable Care Act.
Now is your chance to advocate for your profession. AOTA encourages you to make the time to attend and participate in a Listening Session near you. While you are of course welcome to present whatever you feel most appropriate, if you would like draft testimony that AOTA has prepared please contact Jeremy Farris at email@example.com. He will provide you with draft comments that you can personalize and customize to help your advocacy along.
Inclusion in the essential health benefits package is critical to ensuring comprehensive coverage of occupational therapy under private insurance plans.
Read the invitation letter from the Department of Health and Human Services and select a session near you.
AOTA Member Jeff Tomlinson Testifies at Department of Health and Human Services Listening Session on Essential Health Benefits in the Affordable Care Act
The Department of Health and Human Services (HHS) has been holding regional listening sessions regarding essential health benefits in the Affordable Care Act. AOTA worked closely with Jeff Tomlinson, AOTA member and Legislative Coordinator for the New York State Occupational Therapy Association (NYSOTA), to craft testimony focused on the need to include rehabilitation and habilitation in the final list of required benefits. Mr. Tomlinson attended the November 14, New York session, and provided testimony focusing on the need to include rehabilitation and habilitation in the final list of required benefits.
The ACA establishes a minimum standard of coverage, known as "essential health benefits" that must be satisfied by individual and small group health plans sold in both exchange and non-exchange markets, as well as by any qualified health plan sold in the state exchange market. The essential benefit statute sets forth a series of broad benefit classes that the Secretary's definition must include, and also sets forth important rules for developing essential benefit standards.
- The following benefit classes are identified as essential benefit classes
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Click here to view Mr. Tomlinson's full testimony.