Advocacy Issues
Commercial insurance advocacy
Several sources of public and private payment exist for occupational therapy services. Medicare is the single largest insurer in the United States; however, understanding the payer policies for Medicare Advantage (i.e., managed care) and other forms of private health insurance coverage is also critical to occupational therapy practitioners. These policies vary within each company and by the plan selected by an individual contracting entity. Learn more about AOTA’s multifaceted advocacy efforts to advance payment for occupational therapy by private insurers.
Why private insurance matters
For practitioners in the private practice/outpatient setting, private insurance reimbursement can be a significant portion of their practice revenue. Any change in benefit, coverage, or reimbursement policy for occupational therapy services by a commercial insurance company can have a profound impact on private practitioners and their clients.
AOTA monitors private insurance policies and plan communications, in addition to handing OT practitioner denials and questions regarding coverage decisions. AOTA also coordinates with state association leadership to develop a state-specific outreach strategy to the insurance company. By sharing information and engaging you in advocacy, AOTA and occupational therapy practitioners come together to protect the therapy services our clients need.
