Help Make OT an Initiating Service: AOTA's Home Health Leave Behind 2009
The Medicare Home Health Flexibility Act (H.R. 1094)
AOTA Position:
AOTA is working to gain inclusion of the purpose of The Medicare Home Health Flexibility Act (HR 1094) into the final health care reform legislation. 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 other services provides home health agencies and Medicare beneficiaries with improved access to the most appropriate skilled service to meet their needs.
This legislation would improve efficiency and effectiveness of home health for Medicare beneficiaries by allowing occupational therapists to open and conduct the initial and comprehensive home health assessments when occupational therapy is listed on the physician’s order along with a qualifying service. The provision would specifically allow home health agencies the flexibility to use the most clinically appropriate skilled service to open cases and conduct the initial assessment. This change in policy would be limited to rehabilitation only cases; nurses always conduct the initial assessment when they are involved in a home health case and this bill does not change that policy. It also does not expand coverage or costs.
Current Status:
AOTA is working with Rep. John Lewis (D-GA) to get the purpose of the bill included in the House health reform legislation before it goes to the floor. Mr. Lewis is committed to getting this bi-partisan and cost-neutral provision included, but your support in this effort would be extremely helpful. Please contact Michaeleen Crowell in Mr. Lewis’s office to support this effort. In the Senate, AOTA is working with two Senate offices to introduce the bi-partisan provision as an amendment to the health reform bill when it moves to the Senate floor. AOTA is awaiting a final CBO score for the proposal but it is drafted as cost neutral because it neither expands eligibility nor services. It only rearranges the order existing services can be provided based upon increased flexibility and utilization of clinical expertise.
Medicare Home Health Flexibility Act (H.R. 1094):
Reps. John Lewis (D-GA) and Lincoln Diaz-Balart (R-FL) introduced the Medicare Home Health Flexibility Act that would make occupational therapy an initiating service for Medicare home health beneficiaries. The bill is also actively supported by the National Association of Home Care and Hospice (NAHC), The American Physical Therapy Association (APTA) and the American Speech-Language Hearing Association (ASHA). Michaeleen Crowell, Legislative Director for Rep. Lewis is the best contact for co-sponsorship of the bill. Please sign on to this legislation today.
Please cosponsor HR 1094 to express support for this common sense improvement for Medicare beneficiaries.
For more information about this issue please contact AOTA’s Federal Affairs Department at: fad@aota.org