The American Occupational Therapy Association continues to be an undaunted leader in the battle surrounding the importance of occupational therapy on a non-rehabilitative basis for all Medicare recipients. Under current Medicare Part B regulations, eligibility for occupational therapy coverage is only granted by a physician’s order citing the patient’s need for occupational therapy on a rehabilitative basis. Rehabilitative basis restricts need for occupational therapy to follow-up care resulting from stroke suffrage or joint-replacement surgery.

Since 2005, AOTA has been urging all Americans to contact their congressional and senatorial representatives regarding passage of the proposed Medicare Home Health Flexibility Act(HR2468). The primary purpose of the flexibility act is to gain inclusion of payment for non-rehabilitative occupational therapy coverage under Medicare Part B.

Passage of the act would result in a dynamic cost-saving measure in terms of Federal Government expenditure for healthcare. According to the AOTA, an occupational therapist should be a member of every senior citizen’s primary healthcare team. The primary responsibility of the occupational therapist would be to educate seniors in the role occupational therapy techniques can play in fall prevention and overall safety during pursuit of daily activities.

Research statistics prove the goal of most seniors is to lead an independent life remaining in their own home for as long as possible. Having more people deemed capable of safely remaining in their own home as opposed to seeking entrance into assisted living or nursing home facilities will result in a drastic reduction in budgetary considerations for the Federal Government healthcare system.

Under current Medicare Part B, occupational therapy coverage must be strictly on a rehabilitative-need basis with treatment required to occur in an assisted-living or nursing home facility or out-patient therapy department of a hospital. In addition to an initial physician’s order, consideration for continuation of coverage requires submission of a patient-progress report every 30 days.

Unless treatment takes place in the out-patient therapy department of a hospital, the patient’s out-of-pocket expense is 20 percent until Part B deductible is reached. Expenditures beyond the current $1,880 cap require 100 percent responsibility on the part of the patient.

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