The Medicare Home Heath Flexibility Act (H.R.3820) was introduced in the House of Representatives on September 25. This bill would allow occupational therapists to open home health therapy cases by conducting the initial assessment and completing the required comprehensive assessments under Medicare, which they are currently barred from doing by the Centers for Medicare & Medicaid Services. The legislation was introduced by Representatives Pat Meehan (R-PA), Lloyd Doggett (D-TX), Ryan Costello (R-PA), and Paul Tonko (D-NY) and is identical to a bill introduced in April (S.977) by Senators Ben Cardin (D-MD) and Dean Heller (R-NV).
The bill was introduced to coincide with AOTA’s Centennial Hill Day, when 547 occupational therapy advocates held 248 meetings with members of Congress and their staff members in support of legislation, including the Home Health bill. In addition, AOTA has urged the House Ways and Means Committee to consider the home health bill as part of its formal Medicare Red Tape Relief Project. The committee’s current focus on eliminating burdensome Medicare regulations creates an outstanding opportunity for passage of this bill.
If the Home Health Flexibility Act were signed into law, occupational therapists would be able to open home health therapy cases, including conducting the initial assessment and completing the first comprehensive assessment. This would allow occupational therapists to be the first ones in the door, when they are the most appropriate profession, and reduce home health service delays in areas where access to physical therapy and speech-language pathology clinicians is limited. This would help to reduce Medicare costs related to service delays and ensure that clients have early access to occupational therapy when needed.
Based on their proven expertise in optimizing outcomes for clients and improving efficiency, occupational therapists are already well qualified to conduct the initial and comprehensive home health assessments for Medicare, and they already perform these assessments for Medicaid and private insurance home health therapy cases. Among other things, the new requirements for the comprehensive assessments include assessing a client’s functional, cognitive, and psychosocial status—all key domains for occupational therapy. This assessment is then used to develop the client-centered plan of care.
The bill would not alter Medicare’s criteria for establishing eligibility for the home health benefit, and it would apply only to rehabilitation cases. In addition, it has received a zero score from the Congressional Budget Office, which means it would not create added costs for the Medicare program. In Washington, legislation that has no cost is always easier to enact than legislation for which Congress must identify a funding source or “pay for.”
Broad support for H.R.3820/S.977 from groups including the National Association of Home Care and Hospice, the American Physical Therapy Association, and the American Speech-Language-Hearing Association also increases the chances that Congress will address this issue.
Members can help by contacting their representatives and senators to urge them to support H.R.3820/S.977. For more details, including contact information and suggested phrasing, visit the Legislative Action Center at https://goo.gl/Y7MaFi.
Andy Bopp is AOTA’s Senior Legislative Representative.