If a new bill introduced in the U.S. Senate becomes law, OTs would be able to conduct initial assessments in the home health setting, according to a news release.
The Medicare Home Health Flexibility Act, S. 2364, introduced Dec. 8 by Sens. Ben Cardin, D-Md., and Dean Heller, R-Nev., would allow home health agencies the flexibility to use the most appropriate skilled rehabilitation professionals to open cases and conduct initial assessments when related exclusively to rehab cases and when skilled nursing care is not provided.
Currently, OTs are unable to conduct initial assessments in the home health setting.
“This discrepancy causes unnecessary inefficiencies and barriers to providing patients with effective, timely and appropriate therapy services in the home health setting,” Christina Metzler, chief public affairs officer for the American Occupational Therapy Association, said in the release.
Occupational therapy has long been a valued component of the home healthcare team because of therapists’ expertise in identifying home safety issues and in establishing routines to maximize client compliance with the plan of care, according to the release. The proposed legislation recognizes those contributions and seeks to address the existing arbitrary restrictions.
“As our healthcare system continues to evolve and our country’s population ages, we must strive to maximize individuals’ ability to live fuller, more independent lives,” Metzler said in the release. “Patients are increasingly receiving care in home and community settings where occupational therapy plays a pivotal role. We are grateful for Senators Cardin and Heller’s leadership in recognizing the value of addressing this discrepancy for Medicare beneficiaries.”
Existing regulation allows for the initial assessment to be made by the appropriate rehabilitation skilled professional only when the need for that service establishes home health eligibility. Because occupational therapy is not a qualifying service for home health eligibility, practitioners are prohibited from performing the initial assessment, according to the release.
“Delays in therapy can mean delays in recovery for seniors in need,” Cardin said in a prepared statement. “By permitting occupational therapists to perform initial home health assessments in limited circumstances, the Medicare Home Health Flexibility Act can help prevent delays in Medicare beneficiaries receiving essential home health therapy services. This is especially important in areas where access to physical therapists and speech language pathologists may be limited.”
Bill co-sponsor Heller said in the statement, “In states like Nevada with many rural communities, Medicare beneficiaries depend on in-home occupational therapy. Unfortunately, there are barriers prohibiting them from receiving needed treatment. The Medicare Home Health Flexibility Act is a simple fix that eliminates barriers, increases access and reduces costs for those dependent on in-home health services.”
The Medicare Home Health Flexibility Act would not alter Medicare’s criteria for establishing eligibility for the home health benefit, would apply to rehabilitation only cases, and be limited to instances in which skilled nursing is not identified by the ordering physician.
AOTA is committed to supporting efforts to advance the Medicare Home Health Flexibility Act in the 114th Congress. The bill enjoys bipartisan support and previously has received a zero score from the Congressional Budget Office.