House therapy champions reintroduce bill to make OT practitioners permanent telehealth providers in Medicare
Representatives Mike Kelly (R-PA), Mike Thompson (D-CA) and Adrian Smith (R-NE), have reintroduced legislation, H.R.1614, which would make occupational therapy practitioners (OTPs), physical therapists, speech language pathologists, and audiologists permanent Medicare telehealth providers. They introduced similar legislation last year, and the House Ways and Means Committee of which they are members voted last summer to include a 2-year therapy telehealth waiver extension as part of a package of healthcare bills for consideration by the full House. This package, however, including the waiver extension was derailed in late December by issues unrelated to Medicare or telehealth. Congress must now act before March 31, 2025 to extend waivers, or telehealth in Medicare will come to an end for most beneficiaries.
After years of lobbying by AOTA and a host of other healthcare advocacy groups, there is broad bi-partisan support to establish permanent telehealth policy in Medicare and at minimum to extend expiring waivers. Reps. Kelly, Thompson and Smith are leading telehealth advocates in Congress, and their introduction of this therapy-specific legislation demonstrates broad support for OTs inclusion as permanent Medicare telehealth providers. “Waivers authorizing occupational therapy professionals to provide services via telehealth in Medicare have enabled beneficiaries to receive effective occupational therapy intervention in new environments while removing barriers to care that often result in patients not receiving OT services at all,” said Alyson Stover, MOT, JD, OTR/L, BCP, President, American Occupational Therapy Association (AOTA). “AOTA champions the bi-partisan efforts of Representatives Kelly, Thompson and Smith to ensure that the provision of occupational therapy delivered via telehealth will remain an option for Medicare beneficiaries.”
OTPs were not eligible to provide services to Medicare beneficiaries via telehealth until Congress enacted waivers in response to the Covid-19 pandemic in 2020. These public health emergency waivers expired in May 2023; however, Congress enacted legislation that allowed OTPs and other therapy professionals to continue as Medicare telehealth providers through the end of March 2025. AOTA engaged with CMS to clarify that these extended waivers apply in all settings where OT services are provided after the clear intention of the law was misinterpreted in some cases.
This rapid expansion of telehealth to deliver OT services during this time enabled OTPs to demonstrate the clear value of these services provided alone or in conjunction with in-person services. Telehealth has been especially 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.
OTPs have reported that telehealth has reduced cancellations and postponements while making it easier to connect with beneficiary caregivers. Of critical importance, telehealth has enabled OTPs to conduct in-home “video tours” to identify home safety issues that would never be identified by the patient in a facility/office setting. This can be crucial in preventing falls, addressing functional decline, and avoiding costly emergency room visits and hospital admissions which can reduce the cost of care.
AOTA members and occupational therapy advocates are encouraged to contact their Representative and Senators urging them to extend telehealth waivers beyond March 31 by visiting AOTA’s Legislative Action Center. AOTA will continue to work with Congressional champions to ensure that occupational therapy is included when Congress addresses this issue.