As the new Congress is sworn in today, we wanted to take a look back at the work of AOTA Federal Affairs in the previous Congress. Here is a list of some of the major legislation that AOTA supported during the 115th Congress (Jan 2017- Jan 2019) and a summary of some of the outcomes. We will be watching for the reintroduction of these bills in the new Congress, as well as looking for new legislation that affects the profession and those we serve. This list is not exhaustive but touches on some of our key issues from the previous session of Congress. For a more in-depth look at our legislative victories in the last Congress, please read this article.
Legislative Victories – Bills Signed into Law
- The Bi-partisan Budget Act of 2018 (H.R. 1892)
This bill included a provision that repealed the Medicare Therapy Cap once and for all and assured no beneficiary would ever again be denied needed therapy services as a result of the flawed policy. It also included provisions that made changes to OTA reimbursement in Medicare Part B and Home Health Payment Reforms. This bill also contained provisions that would expand allowable telehealth services under Medicare Advantage plans. The current CMS Proposed Rule included occupational therapy telehealth services in this expansion. For more information on this bill, please read our article breaking down all of the details affecting occupational therapy.
- The National Defense Authorization Act (NDAA) (H.R. 2810)
This bill directs the Depart of Defense to recognize occupational therapy and physical therapy assistants as providers under TRICARE. For more Information about this victory, please read this article
- The SUPPORT for Patients and Communities Act (H.R. 6)
This legislation was passed in response to the current opioids crisis. Many provisions focus on increasing access to non-pharmacological treatments for pain management, including occupational therapy, and best practices for treating both acute and chronic pain. Additionally, occupational therapy practitioners are included in a loan forgiveness program for substance use disorder professionals. For more information about this bill, please read this article
- Childhood Cancer STAR Act (S. 292)
The STAR Act is a comprehensive bill focusing on treatment for childhood cancers and quality of life for childhood cancer survivors. The bill requires the Secretary of Health and Human Services (HHS) to set out best practices for improving the long-term care of childhood cancer survivors, which may include occupational therapy.
- Amy, Vicky, and Andy Child Pornography Victim Assistance Act (H.R. 6845, H.R. 4963, S. 2152)
For more information on this bill, which includes occupational therapy, please read this article.
Key Bills Monitored by AOTA in the 115th Congress
- Medicare Home Health Flexibility Act (H.R. 3820, H.R. 6225, S. 977)
This bill would have allowed occupational therapists to open home health therapy cases under Medicare by conducting the initial assessment and comprehensive evaluation. AOTA will advocate for passage of similar legislation in the next Congress.
- Access to Frontline Health Care Act (H.R. 2042)
This bill would have amended the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program.
- Access to Inpatient Rehabilitation Therapy Act (H.R. 626)
This bill would have fully repealed the cap on Medicare Part B outpatient therapy services. A full repeal of the therapy cap and a replacement policy were included in the “Balanced Budget Act of 2018”.
- Lymphedema Treatment Act (H.R. 930, S. 497)
An act to require Medicare to cover compression supplies related to Lymphedema
- Concentrating on High-Value Alzheimer’s Needs to Get to an End (CHANGE) Act (H.R. 4957, S. 2387)
This bill is designed to provide better care and outcomes for Americans living with Alzheimer's disease and related dementias and their caregivers while accelerating progress toward prevention strategies, disease-modifying treatments, and, ultimately, a cure. The bill includes expanded access to occupational therapy services for people with Alzheimer’s disease and other dementias.
- Medicare Orthotics and Prosthetics Improvement Act (H.R. 2599, S. 1191)
This bill would refine how Medicare pays for orthotics and prosthetics and clarifies that licensed occupational therapists are exempt from other accreditation requirements.
- Medicare Telehealth Parity Act (H.R. 2550)
This bill would have expanded coverage of telehealth services provided to all Medicare beneficiaries, specifically including occupational therapy.
- NASISP week Resolution (H. Res. 823)
AOTA worked to have the week of April 16th, 2018 designated as “National Specialized Instructional Support Personnel Appreciation Week” through a Congressional resolution
- Ensuring Access to Quality Complex Rehabilitation Technology Act (H.R. 750)
AOTA has closely monitored and supported legislation that would exempt various types of complex rehabilitation technology (CRT), CRT accessories, and manual wheelchair accessories from Medicare competitive bidding requirements.
- Advancing Care for Exceptional Kids (ACE Kids) Act (H.R. 3325)
This bill would allow States with the option of providing coordinated care, including therapy services for children with complex medical conditions through a health home.
- The ADA Education and Reform Act of 2017 (H.R. 620)
This bill would have changed Title III of the Americans with Disabilities Act (ADA) by removing certain protections that allow people with disabilities to access public accommodations.
- Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 (H.R. 2556, S. 1016)
This bill, among other provisions would expand the ability of Medicare Advantage (MA) and Accountable Care Organizations (ACO) to offer expanded telehealth services, including the provision of occupational therapy. The bill would also allow waivers of many current telehealth restrictions under Medicare (including the provision of occupational therapy services at the discretion of CMS).
- Preserving Access to Affordable Student Loans (Multiple Bills)
AOTA lead or joined efforts to defeat multiple bills proposing to eliminate or cap loans and grants at inadequate levels, as well as eliminating a number of loan forgiveness programs aimed at making tuition at colleges and universities more affordable.
- Promoting robust funding for the Individuals with Disabilities in Education Act and other education programs (Multiple Bills)
AOTA championed the increases to funding for the IDEA and other education programs, bringing the funding levels closer to meeting the federal government’s pledge.
- Preserving Medicaid Coverage for Children and People with Disabilities (Multiple Bills)
Several pieces of legislation were considered in this Congress that would have dramatically changed Medicaid benefits. AOTA successfully fought to preserve occupational therapy benefits for children under Medicaid, changes that would have harmed people with disabilities, and changes that would have affected Medicaid funding for special education services in schools.
- Preserving Essential Health Benefits, Insurance Coverage for people with Pre-existing conditions, and bans on annual and lifetime insurance caps (Multiple Bills)
Several pieces of legislation were considered in this Congress that would have changed key portions of the Affordable Care Act (ACA) including required essential health benefits on the ACA marketplace (which currently include OT), requirements that insurance cover pre-existing conditions across all health insurance plans, and a ban on annual and lifetime insurance caps across all health insurance plans.
- Retention and Expansion of Occupational Therapy in Mental Health Workforce Programs (Multiple Bills)
AOTA was successful in achieving significant increases to funding in mental health workforce grant programs, which included occupational therapy. Additionally, newly created and existing mental workforce programs included occupational therapy.
Other Legislation introduced in the 115th referencing occupational therapy.
- The Medicare and Opioid Safe Treatment Act (MOST) Act (H.R. 5776)
Much of this legislation was included as part of the SUPPORT Act.
- Todd Graham Pain Management Improvement Act (H.R. 5722)
This legislation was included as part of the SUPPORT Act.
- Medicare Adult Day Services Act (H.R. 3098).
- Helping Expand Access to Rural Telemedicine Act of 2017 (HEART) Act (H.R. 2291)
- Expand and Improve Medicare for All Act (H.R. 676)
- Online Safety Modernization Act (H.R. 3067)
- Advancing Seniors and Kids (Ask) Act (H.R. 4820)
- Expansion of Telehealth Services to Urban Under-Served Areas (H.R. 766)
- Medicare Patient Empowerment Act (H.R. 4133)
- Chinese American World War II Veterans Congressional Gold Medal Act (H.R. 2358)
- Patient Choice and Quality Care Act (H.R. 2797, S. 1334)
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