Medicare Home Health: The Medicare Home Health Flexibility Act (H.R. 1094) - Help Make OT an Initiating Service
AOTA Position:
AOTA fully supports introduction and passage of The Medicare Home Health Flexibility Act 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.
Medicare Home Health Flexibility Act (H.R. 1094)
Representative John Lewis’s (D-GA) introduced legislation that would improve utilization occupational therapy as a home health service under Medicare The bill is actively supported by the American Occupational Therapy Association (AOTA), the American Physical Therapy Association (APTA), the American Speech Language Hearing Association (ASHA) and by the National Association of Home Care and Hospice (NAHC). Michaeleen Crowell, Legislative Director for Rep. Lewis is the best contact for co-sponsorship of the bill. Please sign on to this legislation today.
