June 06, 2019

Cardin, Young Move Forward Legislation to Expedite Home-Based Therapy Services for Medicare

WASHINGTON – U.S. Senators Ben Cardin (D-Md.) and Todd Young (R-Ind.) have introduced a budget-neutral measure that would provide Medicare beneficiaries more timely access to needed therapies. The Medicare Home Health Flexibility Act of 2019 (S. 1725) breaks down barriers for seniors by allowing occupational therapists to perform the initial home health assessment in cases in which occupational therapy is ordered by the physician, along with speech language pathology and/or physical therapy services, and skilled nursing care is not required. In underserved areas where access to physical therapy or speech-language therapy providers is limited, the ability of occupational therapists to perform the initial and comprehensive assessments would prevent delays in home health care and increased costs to Medicare.

“It’s commonsense that the earlier seniors can start needed therapies, the sooner treatments can start having a positive effect,” said Senator Cardin, a member of the Senate Finance Health Care Subcommittee. “Home health services are a critical part of our health care system, and I am proud to partner with Senator Young on this legislation that will help to streamline the process for initiating Medicare home health therapy services for Maryland seniors and others nationwide who need home care while recovering from injury or illness.

“Ensuring the health of our seniors begins with timely care,” said Senator Young. “I’m encouraged that the Medicare Home Health Flexibility Act will help the way we approach healthcare home services for patients in rural areas. Our bipartisan legislation would use Medicare to ensure our seniors are quickly and comprehensively assessed in their homes in order to receive proper treatment.”

Amy J. Lamb, OTD, OT/L, FAOTA, President of the American Occupational Therapy Association (AOTA), called the bill a “win-win” for beneficiaries, and the health care system: “As baby boomers continue to age, so does the increased desire to age in place,” said Lamb. “Simultaneously, the evolving health care system emphasizes increasing quality and efficiency, and decreasing costs. As a result, more patients are receiving care in their home or community where occupational therapy has a pivotal role in facilitating participation and engagement in their everyday life, and enhancing quality of life while aging in place.” 

The Indiana Occupational Therapy Association and Maryland Occupational Therapy Association both report that “home health therapy providers already face routine challenges related to scheduling services for patients, especially in rural areas, where a therapist can drive more than 100 miles per day visiting patients.”  They note that, “this bill would reduce unnecessary bureaucratic burdens that can delay the start of critical home health services for Medicare patients.”  

The full text of the Medicare Home Health Flexibility Act of 2019 (S. 1725) can be found here.

Occupational therapy is frequently ordered as part of a physician’s plan of care for patients requiring home health services, and, under certain circumstances, an occupational therapist is allowed to perform the comprehensive assessment to determine a Medicare beneficiary’s continuing need for home health therapy services. However, under current Medicare law, occupational therapists are not permitted to conduct the initial assessment for home health cases, even when occupational therapy is included in the physician’s order and when the case is exclusively related to rehabilitation therapy.

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