Occupational Therapy Mental Health Parity Act Reintroduced in Senate
On May 15 2023, U.S. Senators Maggie Hassan (D-NH) and Tim Scott (R-SC) reintroduced the Occupational Therapy Mental Health Parity Act. The goal of this bill is to expand access to occupational therapy services for mental and behavioral health disorders under Medicare.
Occupational therapy practitioners often face challenges providing, and billing for, services that do not address physically related performance deficits. This has led to occupational therapy practitioners being an underutilized member of the mental health team in the United States. While today, we provide services in community settings such as Community Mental Health Centers (CMHCs), Certified Community Behavioral Health Clinics (CCBHCs), Medicare Partial Hospital Programs (PHPs), assertiveness community treatment (ACT) teams, psychosocial clubhouse, homeless and women's shelters, and correctional facilities, our presence in these settings is not guaranteed.
This legislation seeks to remove barriers to the provision of occupational therapy services for someone with a mental health diagnosis under Medicare—where these services are an allowed, but under-recognized benefit. This, in turn, would help Medicare beneficiaries more readily access occupational therapy services for behavioral health challenges impacting functional skills, and help address the current shortage of behavioral health professionals.
The Occupational Therapy Mental Health Parity Act was introduced in the 117th Congress and was included in draft legislation by the Senate Finance Committee when they considered efforts on improving the mental health workforce. We hope to build on this momentum and see this legislation signed into law in this - the 118th - Congress.
AOTA President Alyson Stover, MOT, JD, OTR/L, BCP said, “This legislation executes a vision in which occupational therapy is a typical member of behavioral health and mental health interdisciplinary teams. It also creates an opportunity to emphasize the value benefit of occupational therapy beyond addressing only physical health needs. We can prove that including spending for occupational therapy in mental health settings will improve patient outcomes for those with mental health diagnoses and behavioral health impairments in the same way it has been proven to do so for those with heart failure, pneumonia, and acute myocardial infarction (Rogers, et al., 2017 )[1].”
Services under Medicare
The Centers for Medicare & Medicaid Services (CMS) clearly authorizes the provision of occupational therapy services to Medicare recipients with a psychiatric disorder. Additionally, occupational therapy is a required component of Medicare partial hospitalization services both under statute and as a part of the conditions of participation. Notwithstanding this clear statement of CMS coverage there remains a lack of understanding of the role of occupational therapy in providing these services in more traditional settings, including improving functional performance and decreasing distressed behaviors.
This legislation requires the Secretary of the Department of Health and Human Services to provide education and outreach to stakeholders about the provision of occupational therapy services to a person with a mental health or substance use disorder under Medicare.
Increasing the Behavioral Health Workforce
Even before the pandemic, nearly one in five Americans had been diagnosed with a mental illness and more than 20 million had a substance use disorder. At the same time, there is a documented shortage of mental health professionals, with at least 152 million Americans living in a mental health professional shortage area. Despite this need, occupational therapy practitioners remain an untapped part of the behavioral health workforce and face particular challenges providing these services. The Occupational Therapy in Mental Health Parity Act will help make occupational therapy professionals a more utilized member of the mental and behavioral health team.
[1] Rogers, A. T., Bai, G., Lavin, R. A., & Anderson, G. F. (2017). Higher hospital spending on occupational therapy is associated with lower readmission rates. Medical Care Research and Review, 6, 668–686. https://doi.org/10.1177/1077558716666981