Bipartisan Bill Looks to Expand Occupational Therapy Home Health Coverage

WASHINGTON—The Medicare Home Health Accessibility Act has been reintroduced by a bipartisan coalition of legislators including Reps. Lloyd Smucker (PA-11), John Joyce (PA-13), Paul Tonko (NY-20) and Lloyd Doggett (TX-37). The bill would enable occupational therapy (OT) to be ordered as a stand-alone home health service for Medicare beneficiaries.

Currently, OT is the only therapy service that does not qualify as a primary benefit under Medicare’s Part A home health benefit. As a result, OT services cannot be provided in a beneficiary’s home unless nursing or other therapy services, like physical therapy or speech-language pathology, are also prescribed at the start of care.

“The Medicare Home Health Accessibility Act will help ensure beneficiaries receive the care they need in the setting they increasingly prefer—home,” said Smucker. “This commonsense measure improves the personalization of home health orders, empowering patients to thrive at home while reducing costly rehospitalizations. I appreciate my colleagues for joining me in introducing and advocating for this important legislation.”

“The Medicare Home Health Accessibility Act will play a key role in expanding access to high-quality home health care for seniors across the nation,” Tonko said. “By enabling occupational therapy to be included as a stand-alone home health service for Medicare beneficiaries, this legislation will help thousands of seniors avoid falls and other accidents that often result in their losing the ability to remain independently at home. This bill will help us better target home health services to meet patients’ specific needs, helping thousands of Medicare beneficiaries to recover from injury and illness in the comfort of their own homes.”

Praise From Advocates

“Occupational therapy services provided in a patient’s home environment enable OTs to address specific safety and other issues that are difficult to identify in a clinical setting. We are proud to endorse the Medicare Home Health Accessibility Act which would enhance access to OT services which can enable individuals to live safely at home by addressing issues that often result in costly emergency room visits, hospitalizations and even institutionalizations.” – Alyson Stover, MOT, JD, OTR/L, BCP, president of the American Occupational Therapy Association

“Occupational therapy is an essential component of positive health outcomes for individuals with home health care, yet current Medicare regulations create unnecessary barriers for beneficiaries in need of these services. That’s why the National Rural Health Association (NRHA) supports the Medicare Home Health Accessibility Act, which would allow occupational therapists to initiate home health care independently when appropriate. This bill would improve access to care, particularly in rural communities where provider shortages already limit options for patients. We commend Representative Smucker for his leadership in advancing policies that strengthen rural health care and urge Congress to act on this important legislation.” – Alan Morgan, NRHA CEO 

“Occupational therapy (OT) is a critical service to support the recovery and independence of countless older and disabled Americans. Access to home health OT can improve quality and reduce overall Medicare spending. Homebound patients often need OT services in their own homes, but OT is the only skilled home health service that cannot be ordered under current law unless a Medicare beneficiary also needs nursing, physical therapy, or speech therapy. This means that people can be denied essential OT services in the home unless other services are also ordered. The Medicare Home Health Accessibility Act, would correct that oversight, and it has the full support of the National Alliance for Care at Home.” – Steve Landers, MD, MPH with the National Alliance for Care at Home

“This legislation is a win for beneficiaries as this growing population wishes to age at home. The addition of OT as a qualifying service to start home care will allow them to receive these critical services to return to and thrive in their homes independently. As providers continue to grapple with staffing shortages, the more we can utilize all options when appropriate the better for beneficiaries.” – Kelly MacNeill-Cooney, president of the National Association of Rehab Providers & Agencies

“The Medicare Home Health Accessibility Act is a positive step forward in increasing access to essential care for seniors. Allowing occupational therapy to be ordered as a stand-alone home health service for Medicare beneficiaries will ensure equitable access to OT services and promote independence and quality of life for Medicare beneficiaries nationwide. This low-cost healthcare solution will eliminate unnecessary barriers to care, improve patient functionality and help reduce costly hospitalizations.” – Cynthia K. Morton, CEO of ADVION.