Senators Introduce Legislation to Make Occupational Therapy Practitioners Permanent Telehealth Providers

Senators Steve Daines (R-MT) and Tina Smith (D-MN) have introduced the Expanded Telehealth Access Act (S.3193), which mirrors legislation previously introduced in the House of Representatives (H.R. 2168) that has attracted 57 co-sponsors to date. Senators Jerry Moran (R-KS) and Jacky Rosen (D-NV) have also signed on as original S.3193 co-sponsors. The bill would enable occupational therapy practitioners to provide occupational therapy (OT) services to Medicare beneficiaries via telehealth even after the current public health emergency (PHE) expires. 

Legislation is essential because the Centers for Medicare & Medicaid Services (CMS) has indicated that it does not have the authority to allow occupational therapists, occupational therapy assistants, or other therapy providers to provide services via telehealth after the PHE waivers expire, although it has proposed extending some OT telehealth CPT® codes through the end of 2023 regardless of the status of the PHE. Without Congressional action, however, no occupational therapy practitioners would be allowed to bill these codes, so occupational therapy services via telehealth would end for Medicare beneficiaries.

“The COVID-19 pandemic has demonstrated the effectiveness of occupational therapy delivered through telehealth and the importance of removing barriers to care,” observes Wendy C. Hildenbrand, PhD, MPH, OTR/L, FAOTA, President of the American Occupational Therapy Association (AOTA). She adds that, “telehealth has enabled occupational therapists and occupational therapy assistants to improve efficiency of care by minimizing therapy delays and missed appointments related to travel and access issues and improve outcomes by allowing visual access to a beneficiary’s home environment. Working with individuals virtually in their authentic home environment, occupational therapy practitioners can identify physical safety risks and contextual barriers to daily life performance which may not have been revealed otherwise. Occupational therapy through telehealth is now an essential part of health care.”

Senator Steve Daines, a Senate Finance Committee member, notes that “for many Montanans, the windshield time it takes to see a healthcare provider can be a significant barrier to getting the health care they need. Thankfully, telehealth is transforming how folks receive care. Particularly in our rural communities, telehealth is no longer just an innovative option for accessing services, it has become a vital lifeline to care.” Daines adds that “after the public health emergency ends, we need to ensure Montanans continue to have access to the telehealth services that they’ve come to rely on and are so important for maintaining the health of our communities and seniors.”

Senator Tina Smith, a Senate Health Committee member, notes that “during this pandemic, we’ve seen tens of thousands of people across the country get needed health care services with telehealth that may have otherwise been out of reach.” She adds that, “in my home state of Minnesota, it’s ensured that seniors and people living with disabilities - as well those in small towns and rural areas who must travel long distances - can still get health services when they are unable to see their provider in person. Our bill will help ensure telehealth will continue to be available and affordable to people who need it.”

When the pandemic struck, Congress enacted legislation that enabled CMS to waive restrictions on occupational therapy practitioners’ and other therapy providers’ ability to provide Medicare services via telehealth. CMS responded by issuing an emergency rule that added a series of therapy CPT® codes to the telehealth services list, then subsequently issued another rule that included occupational therapy practitioners as eligible Medicare telehealth providers, once Congress enacted legislation allowing them to do so. This effectively enabled OTs and OTAs to provide services via telehealth to Part B Medicare beneficiaries during the COVID-19 emergency; however, these waivers are not permanent.

In addition to S.3193/H.R. 2168, the Telehealth Modernization Act (TMA) has also been introduced in the House and Senate (S.368/H.R.1332). The TMA would make permanent many of the provisions that are essential to enable all qualified health care practitioners to continue to provide services via telehealth in Medicare, including the removal of geographic and originating site restrictions. The TMA would also enable CMS to make the necessary changes to continue OT and other therapy access via telehealth for Medicare beneficiaries. Because S.3193/H.R. 2168 is the only bill specifically focused on therapy, it provides the opportunity to demonstrate Congressional support for the inclusion of therapy services under the Medicare telehealth benefit. To see this provision signed into law, we need the support of as many co-sponsors as possible. Please go to AOTA’s Legislative Action Center and ask your Representative to co-sponsor this legislation.  AOTA will continue to work with Congressional champions to ensure that occupational therapy is included when Congress addresses this issue.