Healthcare Reform
I want to share with you my thoughts on the historic health care reform legislation recently signed into law by the President, and update you on the impact of this measure on occupational therapy and those who can benefit from our services. AOTA, with your help, has achieved significant victories for the profession in this legislation. We should be proud of what we all have accomplished through your advocacy efforts with phone calls, letters, participation in lobbying during our Capitol Hill Days, and the work of our leaders and staff.
Whether you welcome or have concerns about the new law, AOTA worked hard to protect the profession as the legislation was being considered by Congress—and we succeeded. We now have new opportunities before us because we have done the hard work and laid the groundwork.
Beginning with discussions in the AOTA Representative Assembly last year, through five major Capitol Hill lobbying days throughout the year, through waves of grassroots advocacy by AOTA members, our collective efforts paid dividends with several legislative victories included in the final version of reform. These victories include:
· A one-year extension for the Medicare therapy cap exceptions process, even as other Medicare provisions were not included in the final bill. While it may seem as though Congress understands the policy error of the cap, it is still an uphill battle to maintain the commitment and to find the money to fund the therapy cap exceptions process. Recall that AOTA also worked to assure that an interim extension of the exceptions process was passed to cover the first three months of this year while the health care debate continued.
· The specific inclusion of “rehabilitation and habilitation” services in the essential health benefits package that will be offered and required to be obtained individuals. This is a significant gain over current insurance language that usually denies habilitation to children with disabilities. No specific professional services were identified at all in the bill, but this language assures recognition of occupational therapy and other important services that will now be available to all, including the eventual 32 million newly insured that will receive coverage under the new law. This provision was originally included in the House bill but it took work and aggressive lobbying by AOTA to gain inclusion in the Senate bill and thus in the final proposed package.
· The specific inclusion of occupational therapists in the definitions of health care workforce and health care professionals in the “Innovations in the Health Care Workforce” section of the legislation, making them eligible for state workforce grants, for slots on the national commission on workforce established in the bill and other programs. The original bill language did not include OT, but AOTA lobbying assured its addition.
Some items not in the bill are also victories for occupational therapy. AOTA was successful in addressing two specific amendments offered during the process. The first would have allowed physical therapists direct access to patients in rural areas without a physician’s prescription. AOTA worked with members of the Senate Finance committee to insure that occupational therapists would be included in the amendment if it advanced and worked with the Senator offering the amendment to include occupational therapists or revise the amendment. Ultimately this amendment was changed to authorize a study of the issue that can encompass both physical and occupational therapy.
The second was an amendment promoted by the orthotists and prosthetists that would have significantly restrained the OT scope of practice and Medicare reimbursement, as well as eliminated competition among credentialing bodies. AOTA successfully worked with members of the Senate Finance Committee in opposing the amendment, which ultimately was never brought forward for consideration.
While the future is always unpredictable, I am certain about one thing: no matter what changes come, occupational therapy will thrive. I believe our Centennial Vision is giving us our own goals, regardless of the health care system, that we are pursuing. I also believe that our power to make change that supports our Vision has made this new law favorable in many ways to occupational therapy. I want to salute each and every member of AOTA who has expressed their views to Congress. The current dialogue on OT Connections about health care is just what I envisioned for that network: creating a community in which we could all participate, share, think and then act.
This law will not go into effect all at once. Many decisions will be made about implementation and AOTA, with your continued support, will be working to assure those decisions serve the interests of occupational therapy and our clients. Your voice and your views will continue to spur AOTA’s advocacy. There will be change, but I know as a profession we can adapt and grow. We always have. Whether through Medicare cuts, licensure battles, or tough financial times, occupational therapy has been and I believe will continue to be on a growth trajectory. We will move forward with change that we participate in and influence toward our Centennial Vision, modifying our environment, considering what our capabilities are, and then pursuing active engagement to Live Life To Its Fullest through our profession.
Keep watch on the AOTA website for updates and opportunities for you to work with the coming change to make occupational therapy a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society’s occupational needs.
Let’s move toward it together.
Penny Moyers Cleveland
AOTA will continue to work hard on implementation that is positive for the profession. Your voice and your views will continue to spur AOTA’s advocacy.