I read that Medicaid will be expanded, everyone will be covered no matter the pre-existing condition, children can stay on their parents insurance until 26, businesses with over 50 employees must provide coverage, and everyone (with exceptions) must purchase insurance coverage... What does all this mean for our profession?? Will we finally be able to conduct the initial assessment if occupational therapy is in the plan of care prescribed by the physician referring the patient to home health??What other implications are included in the bill that will affect me?
It's too early to see how this will play out, but don't assume we will have things any easier. I've heard home health will be cut within the next few years. Medicare will also get some kind of panel that will make recommendations about keeping costs below the inflation index according to a site that I just read a few minutes ago. If Congress has no qualms about cutting reimbursement to doctors, what will they do to us?
The senate still has to accept the changes made by the house. Let your senators know how you feel.
(I lost my job after the Balanced Budget Act of 1997 when Medicare cuts were made. The agency I worked for, contracting to nursing homes, did not get the reimbursement it needed and it closed in 1999. It took me 3 yrs to return to full time work. I am very wary when any changes are made to Medicare.)
Joanne
Joanne, Thanks for your input, it is helpful to hear from those who have been working in the field to get a better clinical perspective. I'll definitely be further researching home health and Medicare panels...If you find any helpful websites or discussion forums, please feel free to pass them my way.
Hi Autmn - I agree with Joanne that it is too early to tell how health care reform will impact us as practioners but, I do believe we will be impacted. I too was around during the balanced budget act changes back in 1997 and unfortunately as an employeer did see numerous colleagues laid off and changes in the way we deliver care. My suggestion to you as a new practioner is to stay active in your National and State organization to keep abreast of the latest trends, use the professional organizations to expand your network of OT and OTA's. You never know when one of those contacts may be your next employer. Also, stay flexible and continue to expand your skill set. So many therapist that I interview have such a tight definition of what they will or will not do that those are the individuals that unfortunately have a harder time finding employement. Be willing to be flexible and to learn new skills. One good thing about this profession is that unfortunately/fortunately there always people with medical issues that require our services and OT is so diverse we are always expanding our roles. You have selected a great profession.
Hope this helps...
Lynda Jennings, OTR
There are no clearcut answers as to now OT, or any other profession, are to be affected by this law. However, we can be certain that there will be limits and exclusions on the use of OT. How, when and where is yet to be determined.
Ron Carson MHS, OT
Hi Autumn,
Thanks for your post. I wanted to give you a quick response regarding our efforts to protect and advance the interests of occupational therapy during this debate and to urge you to visit AOTA's legislative action center where you will find OT specific analysis, links to additional resources regarding the health reform legislation and a timeline for the implementation of specific provisions. Hope this is helpful.
· 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.
Most notable affect at this time is that Medicare CAPS with exemptions were extended until 12/31/10. Without exemptions, it would be difficult to treat CVA and neurologically impaired Medicare patients beyond 12 visits.without strong secondary coverage on an out-patient basis.