MiOTA - Advocacy Updates Federal Advocacy Update
- Possible Change in Reimbursement of OT services for service to patients with Medicare. Bipartisan Budget Act 2018: Starting in January 1, 2020, Medicare Part B providers will report with a modifier indicating whether OT services were provided in whole or in part by an OTA.
- Beginning in 2022, any services provided by OTA will be reimbursed at 85% of the typical payment rate. AOTA is working on this issue.
- Bipartisan Budget Act of 2018 also included permanent repeal of the cap on Medicare outpatient therapy service. Advocacy works.
- Humana Insurance Policy limits significant therapy codes such as aquatic therapy, group therapy, sensory integration, community/work reintegration, and work hardening. AOTA is review this policy and will be advocating against these exclusions.
- Tricare insurance company currently will not reimburse for service provided by OTA’s. AOTA has been in discussion with them and a formal consideration by Tricare to occur.
Advocacy in Action: Home Modification Committee
Karen Koch, OTRL
The most significant funding source for home mod OT's in Michigan is Auto No-Fault. The Auto No-Fault landscape is projected to change. The MiOTA Home Mod OT's are following the Auto No-Fault legislation and are vying for a seat at the table to represent OT during the Auto No-Fault reform to ensure we are written into the law. The Home Mod Ad Hoc Committee is working on a video of how people injured in auto accidents benefit from OT services and home modifications and how these services reduce hospital readmission and caregiver costs. Anyone who has a story, video or touching photo of how OT success stories please send them to Karen Koch
Home Mod OT's are hoping to address the Legislators in Lansing regarding making educated, responsible decisions based on how changes in Auto No-Fault:
• • Will affect our Medicaid/Medicare system if auto accident hospital costs are defrayed onto the Medicaid/Medicare system instead of the Auto No-Fault system.
• • Home modifications vs nursing home costs.
• • OT services are required for acute care, rehab and long-term needs.
The Home Mod Ad Hoc Committee meets online on the first Thursday of every month at 7:00 pm. Please email Karen Koch at: Service@functionalhomes.net to join us and to be included on the email list for the Home Mod Ad Hoc.