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Tricare Reimbursement of Occupational Therapy Assistant Services Advances in Congress; Policy to be Signed into Law by End of 2017


12/12/2017

Updated 12/12/17

President Trump has signed into law the National Defense Authorization Act of 2017 which includes a provision that designates OTAs as providers under Tricare. More information can be found here.

11/10/17

Yesterday, the House and Senate released legislative language that marks a major victory for occupational therapy assistant services. The “must pass” National Defense Authorization Act for FY 2018 (NDAA), includes language that allows occupational therapy assistants and physical therapist assistants to provide services under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), or TRICARE.

In May, the American Occupational Therapy Association (AOTA) had confirmed that Tricare would not cover services provided by occupational therapy assistants (OTAs) as they are not authorized providers under CHAMPUS. The same discrimination has been applied to physical therapist assistants. During the last several months, AOTA and the American Physical Therapy Association have advocated strongly for Congress to fix this policy. 

The corrective language was included in the annual NDAA, which authorizes the existence of the United States Military and related programs including TRICARE. Authorization bills for the National Defense must be passed every year. On October 9, 2017, the House and Senate released their compromise NDAA language which included a section on “authorization of physical therapist assistants and occupational therapy assistants to provide services under Tricare.”

The House is scheduled to vote on the final bill next week, and the Senate intends to vote on the bill by early December. This will clear the way for the bill to be signed by the President before the end of 2017. Once signed into law, the Department of Defense will be required to update its policy manuals and regulatory guidance, and finally include occupational therapy assistants as TRICARE providers.

This is a great victory. AOTA is extremely pleased that Tricare will now recognize the value and importance of occupational therapy assistants as part of the health care team.