115th Congress: Legislative Victories
The 115th Congress has been a productive one for occupational therapy, with a total of six bills directly referencing occupational therapy signed into law.
Legislation Signed into Law
The most important victory this Congress was the full repeal of the cap on Medicare Part B therapy services, also known as the “Therapy Cap.” AOTA fought for repeal of this policy for 20 years. During that time we were successful in achieving moratoria, patches, and temporary fixes to the cap, but had not been able to remove permanently the threat of a cap on therapy services. The Passage of the Bi-partisan Budget Act of 2018 (H.R. 1892) repealed the therapy cap once and for all, and assured no beneficiary would ever again be denied needed therapy services as a result of this policy.
At the end of 2017, AOTA was able to successfully fix a long-standing problem with the recognition of occupational therapy assistants as providers under Tricare. The FY 2018 National Defense Authorization Act (H.R. 2810) required the Department of Defense (DOD) to recognize OTAs as providers under the TRICARE program. DOD is currently working through the regulatory process to put this new statutory language in place and begin allowing occupational therapy assistants to provide services to Tricare beneficiaries.
This year, Congress passed The SUPPORT for Families and Communities Act (H.R. 6) to help address the current opioids crisis in our country. This bill strongly emphasized the need for an “all of the above” approach to the management of acute and chronic pain and included multiple provisions to promote non-pharmacological pain interventions such as occupational therapy. Additionally, the bill would allow occupational therapists who primarily work with people with, or in recovery from, substance disorders, to qualify for student loan forgiveness.
Other victories during this Congress included securing the place of occupational therapy in the Behavioral Health Workforce Education Training (BHWET) grant program and expanding funding for the program, passage of the Childhood Cancer STAR Act (S. 292), and passage of the Amy, Vicky, and Andy Act (S. 2152). OT educational programs were made eligible for the (BHWET) program in 2016, but several steps were needed to assure they remained eligible; AOTA was able to cement their place in this program. 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. Lastly, the Amy, Vicky, and Andy Act will help victims of child pornography receive appropriate restitution, which can include occupational therapy services.
Other Actions and Victories in the 115th Congress
AOTA Federal Affairs also sometimes plays defense, and there were many victories in what didn’t happen this Congress. Along with other coalition partners, we were able to fight off dramatic cuts to Medicaid, including the unraveling of guaranteed pediatric benefits such as occupational therapy. Together we stopped the weakening of essential health benefits (including habilitation and rehabilitation) which are guaranteed in the Affordable Care Act marketplace, and preserved protections for people with pre-existing conditions. We fought legislation that would have rolled-back the Americans with Disabilities Act, and we maintained access to affordable federal student loans.
Finally, we have also made progress in promoting the Home Health Flexibility Act, legislation that would allow occupational therapists to open home health cases in Medicare. We have done this by securing champions who are dedicated to passage of this legislation, including the incoming chair of the sub-committee with jurisdiction over this bill.
Your Advocacy Made the Difference
Current challenges to the profession, such as new Medicare Part A payment models in skilled nursing facilities and home health, and the 2022 payment differential for occupational therapists under Medicare Part B, will continue in the next Congress. But we go into the 116th Congress with momentum, a strong group of Senators and Representatives who support the importance of occupational therapy, and you, an amazing group of advocates for the profession. Thank you to everyone who wrote to their members of Congress through AOTA’s Legislative Action Center, participated in AOTA Hill Day, represented AOTA as an expert in discussions with policy makers, or advocated for the profession and those we serve through other advocacy organizations. Your collective voices made the difference in this Congress, and they will propel the profession forward in the next.