MiOTA - Advocacy Updates
New Obstacles in Proposed Rule for Hand Therapists
Occupational therapists and physical therapists have long been exempt from quality and accreditation standards for furnishing and fabricating prosthetics and custom orthotics for Medicare beneficiaries. On January 12, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (pdf) would lift that exemption.
The proposed rule would require OTs and PTs to meet Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) supplier quality and accreditation standards when they furnish and fabricate prosthetics or custom orthotics under the Medicare program. The proposal is an outgrowth of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (“BIPA”). Read a CMS fact sheet about the proposed rule.
In the new proposal, occupational therapists who furnish and fabricate custom orthotics must be “licensed by the state [as a qualified provider of prosthetics and custom orthotics], or…certified by the American Board for Certification in Orthotics and Prosthetics…or by the Board for Orthotist/Prosthetist Certification.”
AOTA is closely reviewing the Training Licensure and Certification requirements in the proposal to respond to concerns with occupational therapy training set forth by CMS.. In addition, CMS states that it will make changes to the quality standards, which will be handled only through sub-regulatory guidance, by posting on the CMS DMEPOS supplier enrollment website. AOTA will be monitoring any changes regarding orthotics quality standards. The proposed provisions could also have a harmful impact on facility settings, including skilled nursing facilities (SNFs).
CMS is accepting comments on the proposed rule until March 13, 2017. AOTA’s Regulatory Affairs staff will be commenting on the new proposed regulations and welcomes your feedback at firstname.lastname@example.org. You can also submit comments directly to CMS.
Public feedback sought on financing of Michigan’s efforts to better coordinate physical, mental health services
LANSING, Mich. – The public can provide feedback beginning today on draft financing models for the statewide effort to improve coordination of physical and behavioral health services.
The Michigan Department of Health and Human Services has posted on its website a survey that gives stakeholders a chance to play a role in determining financing for the initiative, which is known as Section 298.
The discussion on financing models is part of the next phase of the Section 298 discussion.
MDHHS collaborated with the 298 Facilitation Workgroup to develop the models, which are based upon 42 proposals the department received from a wide variety of stakeholders. MDHHS and the workgroup developed six categories of financing models and one category of non-financing models, which are listed below:
- Statewide Behavioral Health Managed Care Organization*
- Medicaid Health Plan or Prepaid Inpatient Health Plan Payer Integration
- Community Mental Health Service Programs (Provider) Capitation*
- Modified Managed Care Approaches*
- Current Financing Structure Enhancement*
- Local/Regional Integration Arrangements*
- Non-Financing Models
The 298 Facilitation Workgroup will be evaluating the five proposals that are marked with an asterisk.
The public input process for the financing models begins today and ends Feb. 28. MDHHS has established the following opportunities to gather public comments on the financing models:
- Stakeholders may complete an online survey to gather input on the draft financing models. A link to the survey is on the Section 298 stakeholder workgroup webpage.
- MDHHS will also host a public forum to gather comments from 9 a.m.-noon on Feb. 24. The forum will be held at the East Lansing Hannah Community Center, 819 Abbot Road. Individuals can RSVP to attend the public forum by through a link on the Section 298 stakeholder workgroup webpage.
MDHHS and the 298 Facilitation Workgroup will use public comments to refine and improve the draft financing models. The revised financing models will be incorporated into the Section 298 Final Report, which must be submitted to the Legislature by March 15.
For more information about the draft financing models or the Section 298 Initiative, visit www.michigan.gov/stakeholder298 or send an email to MDHHSemail@example.com.
We received word today that unfortunately Michigan was not selected as a CCBHC grant site by the federal department of Health and Human Services.
While we are disappointed by this decision, we continue to see opportunities to advocate for inclusion of Occupational Therapy Services as the state of Michigan moves forward in determining what pieces within its CCBHC proposal that they would like to maintain and/or continue to foster growth of.
I would personally like to thank the CCBHC committee for their hard work and dedication, as well as the membership of MiOTA who supported and participated in our grass roots efforts to contact legislators to educate and advocate for the inclusion of OT services in the proposed Michigan CCBHC plan. Your efforts were heard, and they secured us a place within the grant proposal.
I would also like to give thanks for Chuck and Chrissy with AOTA for their assistance and support, and Bret with MHSA for his direct contacts with the department to obtain feedback and information on our position within the grant.
Although we may have lost this battle at the federal level, I believe we have opened new doors for continued growth and opportunity at our state level. I look forward to continuing to work to advocate for OT in mental health in the new year.
Thank you all,
Kirsten Matthews, Co-Leader of the Executive Committee
Michigan Occupational Therapy Association
As many of you may know, the State of Michigan was awarded a planning grant for the Certified Community Behavioral Health Centers (CCBHC) by the Substance Abuse and Mental Health Services Administration (SAMHSA). Per the SAMSA Website: “The purpose of the CCBHC grant program is to support states to certify clinics as certified community behavioral health clinics (CCBHCs), establish prospective payment systems for Medicaid reimbursable services, and prepare an application to participate in a two-year demonstration program. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious substance use disorders, as well as others with mental illness and substance use disorders.”
Although Occupational Therapy is listed as one of the recommended providers in the CCBHC’s, there is no guarantee we will be included as one of the providers for the programs. We are requesting you advocate that Occupational Therapy be a REQUIRED provider within the CCBHC’s.
WE NEED YOUR HELP!
Currently, MiOTA’s CCBHC Workgroup has drafted a template of a letter you can use to contact your legislators to help educate them on the DISTINCT VALUE of Occupational Therapy and how our inclusion as a REQUIRED provider within the CCBHC’s will enhance the team. Click Here to download the letter.
Please contact your legislators as soon as possible! You can email or call them; or even stop into their coffee meetings should they have any scheduled for May.
You can find your Representatives at: http://house.michigan.gov/mhrpublic/
You can find your Senators at: http://www.senate.michigan.gov/fysbyaddress.html
Let’s make sure our voice is heard!
The CCBHC Planning Committee
Kirsten Matthews, Denise Justice, Chrissy Vogele (AOTA), Alissa Baker; Kelly Machnik; Cynthia Grapczynski, Denise Hoffman, and Bret Marr
**If you would like to participate in the CCBHC Planning Committee, please Click Here
to email Kirsten.
If you would like to learn more about the CCBHC Grant, you can visit the following websites below:
Board Certified Behavioral Analysis Licensure
MiOTA provided public comment at a working committee meeting on Board Certified Applied Behavioral (BCBA) Licensure in May, 2015. The bill has not passed at this time but MiOTA, PTA, and SLP representatives all collaborated and expressed the following concerns:
- a licensure bill that lacks a defined scope of practice
- allowing billing for non-licensed providers providing in home services
- lacking a defined ratio of non-licensed providers to licensed provider supervision (OTP:OTA is 1:4) current state of affairs with BCBA: non-licensed BCBA providers is reported as high as 1:15
BCBA representatives agreed with OT, PT, and SLP at this meeting defining the scope of practice was necessary. BCBA representatives announced a national scope of practice was released in May 2015 and they will highly consider adding it to this bill for more professional clarification. No further activity has been on this bill at this time due to summer session. More activity is projected September 2015
Senator Margaret O’Brian proposed a bill in May 2015 regarding Autism and timely treatment: