Michigan Occupational Therapy Association


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.
Updated 5/20/18

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 at service@functionalhomes.net.

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.
Updated 5/20/18
Phone(517) 267-3918
Fax(517) 484-4442
124 West Allegan
Suite 1900
Lansing, MI 48933
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