Ensure Beneficiary Access to OT Services After the COVID-19 Emergency Period Ends!
The ability of occupational therapy practitioners (OTs) to provide remote services via telehealth has never been more important than during the current COVID-19 pandemic. Temporary waivers enacted by CMS have enabled OTs to continue to provide essential therapy sessions despite closures and other service disruptions during the Public Health Emergency (PHE). This is especially important given the nature of COVID-19 risk to many Medicare beneficiaries who are older and often have other health conditions. The benefits of telehealth have proven, however, to be far greater than simply enabling people to maintain social distance during a pandemic.
When the pandemic struck, Congress enacted legislation that enabled the Centers for Medicare and Medicaid Services (CMS) to waive restrictions on the provision of OT and other therapy services via telehealth. CMS responded by issuing an emergency rule that added a series of therapy CPT codes to the telehealth services list, and then subsequently issued another rule that included occupational therapists as eligible Medicare telehealth providers. This effectively enabled OTs and OTAs to provide services via telehealth to Part B Medicare beneficiaries during the COVID-19 PHE.
The use of telehealth to provide a wide array of healthcare services including OT has grown exponentially during the PHE, and this has been of great benefit to Medicare beneficiaries who otherwise would have lost access to services. It has been even more beneficial for people in rural and other underserved areas and to those for whom travel to receive services was already a barrier to access including people with disabilities. OTs report that telehealth has reduced delays to care while making it easier to connect with beneficiary caregivers and enabling easier identification of home safety issues. This can be crucial in preventing falls, addressing functional decline, and avoiding costly emergency room visits and hospital admissions - which in turn can reduce the cost of care.
CMS has expressed an eagerness to implement permanent changes to ensure that telehealth services are not abruptly ended when the PHE ends; however, CMS has also noted that Congressional action is needed before it can allow OT and other therapy services to be provided to Medicare beneficiaries by OTs and other therapists after the PHE. CMS has the authority to add new OT/therapy telehealth codes without Congressional action, and it has already done so through the end of the PHE and proposed to do so in the 2022 Physician Fee Schedule through the end of 2023. However, without Congressional action, OTs and other therapists will not be able to provide services for these codes once the PHE ends.
In response, numerous bills have been introduced to enable CMS to make the necessary changes to continue telehealth access for Medicare beneficiaries including to OT and other therapy services. This includes the Telehealth Modernization Act (S368/HR1332) which was introduced by Senators Tim Scott (R-SC) and Brian Schatz (D-HI) and Reps. Buddy Carter (R-GA) and Lisa Blunt Rochester (D-DE) and the Expanded Telehealth Access Act (H.R. 2168/S.3193) which was introduced by Reps Mikie Sherrill (D-NJ) and David McKinley (R-WV) in the House and Senators Steve Daines (R-MT) and Tina Smith (D-MN) in the Senate. This bill would specifically allow occupational therapy as well as other therapy services to be provided to Medicare beneficiaries via telehealth after the PHE expires. Support for H.R. 2168/S. 3193 is important as this legislation addresses only therapy delivered via telehealth, while other House and Senate bills cover multiple other telehealth provisions.
Please urge your Representative and Senators to co-sponsor the Expanded Telehealth Access Act (H.R. 2168/S.3193) to ensure that Medicare beneficiaries will not lose access to occupational therapy via telehealth when the PHE ends. AOTA will continue to work with Congressional champions to ensure that occupational therapy is included when Congress addresses this issue.
Please note that there are multiple messages tied to this Advocacy Activity.