Occupational therapy still has a long way to go compared to other disciplines. During a discharge planning meeting, I had a patient on my caseload who would have benefitted from home health occupational therapy services. I believe they were Medicare. However, they were walking more than 300′ with an assistive device and would have been a better candidate for outpatient with physical therapy. However, this patient had severe anxiety with the thought of going to outpatient appointments.
I discussed the overall “big picture” with the PT and they agreed that home health for both disciplines would best therapeutic environment for this patient. It was the ideal choice as the patient could have benefited from a home assessment, it was more familiar for the patient, and for overall safety. To make a long story short, the doctor gave a lot of resistance (to the PT actually), but ultimately ordered home health PT to “allow for OT services to be possible in the home”. This was extremely frustrating and I am sure some of you practitioners have either encountered a similar situation or have been frustrated with the current limitations.
Occupational therapy qualifies patients for home health therapy services on a “continuing need basis.” This means that occupational therapy alone will not qualify someone for home health services. However, a person can receive OT if they also receive physical therapy (PT), speech, or nursing.
This quote is from an AOTA article written in 2017, so it is relatively recent. Their hope to cosponsor the Medicare Home Health Flexibility Act.
Update: June, 6, 2019.
“U.S. Reps. Lloyd Doggett (D-TX), Jason Smith (R-MO), Paul Tonko (D-NY), and David McKinley (R-WV) introduced the Medicare Home Heath Flexibility Act (H.R.3127) in the House of Representatives, while Senators Ben Cardin (D-MD) and Todd Young (R-IN) simultaneously introduced identical legislation in the Senate (S.1725). These bills would allow occupational therapists to open home health therapy cases under Medicare.”
This is exciting news. Let’s go OT!
Read the full article from AOTA here.