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  Feb 18, 2018
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Legislative Alerts

Act Now on Any Current Legislative Alerts

Current Alerts Since Mar 5, 2018

ACT NOW - Legislative Alert from WVOTA
Sep 25, 2017


  • The Senate has revitalized efforts to restructure the Medicaid program and replace the Affordable Care Act.  This legislation could affect more than 80 million Americans, by some estimates. The American Occupational Therapy Association has grave concerns about the Graham-Cassidy Health Care bill and urges you to contact your Senators today. Our top five concerns with the bill include:

    1. Will insurance and Medicaid cover OT?

    2. What will happen to hospitals?

    3. Will children be affected? What about Medicaid funding in schools?

    4. Will people with pre-existing conditions or older individuals still be able to afford coverage?

    5. What will happen to the insurance market, including your own health insurance?

    It is important that your Legislators hear from you, their constituents. Protect the profession.  Protect the people we serve.  Act today!



    Heather Parsons

    Associate Chief Officer for Federal Affairs

    American Occupational Therapy Association



    For more details read:

    Five Ways the Graham-Cassidy Health Care Bill May Affect OT and Your Clients

ACT NOW - Legislative Alert from WVOTA
Jan 8, 2018


Medicare beneficiaries are now subject to the cap on rehab therapy services.  With no exceptions process in place, there is a $2,010 cap on occupational therapy (OT) services and another $2,010 cap on both speech-language pathology (SLP) and physical therapy (PT) services combined for the calendar year. 

While NASL had hoped that the bipartisan efforts of the House Ways and Means Committee, House Energy and Commerce Committee, and Senate Finance Committee would have permanently ended these arbitrary limits on beneficiary access to necessary PT, OT, and SLP services, Congress failed to act in December to repeal the cap - or even to extend the exceptions process, which expired on December 31, 2017.

NASL and our colleagues in the Therapy Cap Coalition sent a letter this week imploring Congress to act to repeal the cap by January 19th when the current Continuing Resolution expires - or at least to put the exceptions process back in place until Congress can reach an agreement on the policy moving forward.  We need YOU to contact your Representatives again and to tell Congressional leadership to repeal the therapy cap before January 19th - and BEFORE Medicare beneficiaries begin reaching the therapy cap limits.




ACT NOW - Legislative Alert from WVOTA
Feb 12, 2018


Dear AOTA Member,                                                                                             Friday Feb 9th, 2018

This morning the President signed into law a permanent repeal of the cap on Medicare outpatient therapy services. After 20 years of looming threat, the therapy cap will never again put beneficiaries at risk for being denied essential occupational therapy services.

Many of you have seen firsthand the devastating effects that a cap on occupational therapy services can have on the clients we serve. Like some of you, I lost my job when the cap first took effect in 1999. Today, because of you, this policy is no more! Over the years, you have written hundreds of thousands of letters to tell Congress to stop the cap. You have placed thousands of phone calls to tell Congress why occupational therapy is essential for our clients.

Because of your membership, AOTA was able to lobby and gather critical data that pushed the therapy cap over the finish line. Last year AOTA commissioned a study that demonstrated the positive impact of the current medical review process on patient access and overall costs. This information was instrumental in developing a bipartisan compromise for a permanent repeal. Your membership allowed AOTA policy staff to work with Congress to draft the repeal legislation and ensure Medicare beneficiaries can have access to occupational therapy when they need it.

Our profession has faced many challenges over the years, and there will be more ahead. Some new challenges were introduced in this same bill. For today, we must celebrate the end of a senseless policy that threatened the health and well-being of Medicare beneficiaries and our profession for 20 years.

Thank you for your membership, and thank you for your advocacy.

Amy Lamb, OTD, OT/L, FAOTA


For more information on provision included in Budget bill:

Permanent repeal of the Medicare therapy cap

Home Health changes for therapy

Changes to Medicare reimbursement for occupational therapy assistants


ACT NOW - Legislative Alert from WVOTA
Feb 12, 2018

Please be sure to come to the capital for legislative day TOMORROW  Tuesday Feb 13th.

We will be in the main retunda!!!! Come and support Occupational Therapy and participate to help explain what the OT profession is and how beneficial we are for the state of West Virginia!!!!

ACT NOW - Legislative Alert from WVOTA
Feb 12, 2018

 View a web version.


Dear AOTA Member,

As you know, last Friday Congress passed a $1.4 trillion budget package to keep the federal government running, increase spending on defense and domestic priorities, and extend multiple health and human services programs. Among these multiple provisions was a permanent fix to the hard cap on Medicare outpatient therapy services that had once again gone into place on January 1, 2018.

However, this massive budget package also included provisions that AOTA did not support. One of these provisions made changes to the way occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) are paid under Medicare Part B. Starting in 2022, after 2 years of data gathering, OTA and PTA services will be paid at 85% of what is paid for services provided by a therapist. This is similar to the current approach to payment for physician assistants (PAs) and nurse practitioners (NPs) who are in general paid 85% of what physicians are paid. AOTA successfully opposed this payment change when it was proposed in the past.

AOTA first learned of these provisions late on the evening of Monday, February 5th, when the House first released this massive bill (just as the Rules Committee began meeting on the bill) which included this provision as a pay-for, among many others. According to Congressional rules, bills that generate new spending must include some "pay-fors." These are policies that generate revenue or reduce government spending to offset, at least in part, the cost of other policy provisions that require additional revenue. Pay-fors are often kept quiet to prevent advocacy against them.

We were dismayed and concerned by the inclusion of changes to OTA and PTA payments at the last minute; this provision had not been included in previously released discussions or drafts of this budget bill. AOTA had been inquiring about pay-fors for months. Some pay-fors were rumored, but none included the OTA differential. Nor did we hear about the changes to therapy in home health. We did expect some changes to hospital and skilled nursing payments.

After the late-night release of the bill, the following day, Tuesday February 6, while the Senate was still creating its version of the budget package, AOTA reached out to our Congressional champions to oppose these provisions, and, alongside the American Physical Therapy Association, proposed alternatives to the OTA provision—alternatives that would have stopped its adoption or minimized its impact. Additionally, on Tuesday AOTA changed all grassroots advocacy messages related to the repeal of the therapy cap, to include details of the OTA payment changes. AOTA's position was to ask Congress to first study the issue and its effect on beneficiary access before implementing a change in OTA payment policy. Despite this lobbying, this alternative was not accepted, and the OTA payment changes were included in the final Senate legislation eventually signed by the President.

Repeal of the Medicare outpatient therapy cap was a significant achievement that protects all occupational therapy practitioners providing Medicare Part B services, as well as beneficiaries. Starting on January 1, 2018, all beneficiaries became subject to a hard cap of $2,010 for outpatient occupational therapy services, meaning Medicare would not pay for any services over this cap. In 2015, the last year for which there was data, 58% of occupational therapy Part B services occurred over the cap. This translates to $879,000,000 in claims.  Repeal of the therapy cap needed to happen to preserve access to occupational therapy services for Medicare beneficiaries. However, AOTA did not approve of or suggest the payment changes for occupational therapy assistants' services in exchange for the repeal. AOTA was not consulted about these changes—we opposed them as soon as we were informed, we let our members know they were part of the legislation, and we sought to change them.

With passage of this bill, we can and will continue to fight. Over the next 4 years, the Centers for Medicare & Medicaid Services (CMS) must implement this new OTA policy. Many questions must be answered about the legislative language, which is very confusing. We must also assure data is collected and examined to see whether there are geographic areas (e.g., rural) or settings (e.g., skilled nursing facilities) where beneficiary access to services may be negatively impacted by this shift in payment. We must also reach out to physician assistant and nurse practitioner colleagues to assess the impact the differential has had on them.

We must and will be able to influence the regulatory process through grassroots advocacy, calling on our Congressional champions and leveraging our relationships with CMS. We will make sure policy makers understand there can be unintended consequences from this change and try to narrow CMS's interpretation of the new law.


Christina Metzler

Chief Public Affairs Officer

The American Occupational Therapy Association, Inc.


P.S. Please watch for AOTA updates about other provisions, both positive and negative, included in this budget bill, such as the elimination of the use of a therapy threshold in the home health payment method (which AOTA opposed), and on the positive side, extension of the Children's Health Insurance Program and funding for Federally Qualified Health Centers, which we supported, and for information about a webinar on February 27, at 7:30 pm ET, with AOTA President Amy Lamb and Policy staff.

AOTA Website
American Occupational Therapy Association, Inc.
4720 Montgomery Lane Suite #200
Bethesda, MD 20814-3449

ACT NOW - Legislative Alert from WVOTA
Jun 26, 2017

Senate Health Care Bill Threatens Medicaid
On Thursday June 22, the United States Senate released a discussion draft of their health care reform bill, called the Better Care Reconciliation Act of 2017 (BCRA). While much of the healthcare reform discussion has been about fixing or repealing the Affordable Care Act (also known as Obamacare), the major provisions of the bill released yesterday relate to Medicaid. After careful analysis, AOTA is deeply concerned that BCRA would undermine the Medicaid program and put the millions of children and adults with serious disabilities, students receiving special education support services, people receiving home and community based services, individuals with mental health needs, those in nursing homes, and many others at grave risk of reduced or lost benefits.
BCRA would change Medicaid from a system where the federal government “matches” payments for all medically necessary services a state chooses to provide to beneficiaries, to one that provides states with a capped amount of money to spend for all beneficiaries. This will require hard choices by the states and inevitable cuts to Medicaid programs and services. Over time, the Federal government will pay less and less for Medicaid services and State Medicaid programs will have to make up the difference, or diminish services. As states are faced with difficult financial decisions they will have to reduce benefits such as rehabilitation benefits for adults and home and community based services, reduce reimbursement to providers, or find ways decrease or slow Medicaid enrollment. States may eventually be pressured to reduce services to children from the current broad mandate of Early and Periodic Screening, Diagnosis and Treatment services (EPSDT) which protects all children on Medicaid.
From early intervention and schools, to skilled nursing facilities, to community mental health programs these proposed changes will negatively affect occupational therapy practitioners and the people who are in need of our services. We urge you to call your Senate offices today (yes, even on the weekend!) and ask that they reject these dramatic changes to Medicaid.
AOTA’s legislative action center will walk you through the steps. You can call or write, but you need to take action before next week’s vote.
Heather Parsons
Director of Federal Affairs
The American Occupational Therapy Association, Inc.

ACT NOW - Legislative Alert!
Mar 23, 2017

Hello OT Activist,

AOTA has been closely tracking a bill in Congress, the “America Health Care Act”, that is meant to repeal and replace the Affordable Care Act. We have been concerned with provisions in the bill that would restructure Medicaid payment to states. However, new language being added to the bill today, would potentially do away with mandated Medicaid benefits such as those guaranteed to children under Early and Periodic Screening, Diagnostic, and Treatment benefit (EPSDT). We are deeply concerned about these changes that will most likely be incorporated into the bill before it is voted on by the House tomorrow.

Please take action to protect Medicaid benefits for those most in need. Write to your Members of Congress at "aota.org/takeaction" ahead of the tomorrow’s vote and ask them to protect Medicaid benefits.

Please let us know if you have any questions.

Happy Advocating!
Heather Parsons, Director of Federal Affairs
Jill Tighe, PAC/Grassroots Associate

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