Occupational Therapist’s Thoughts on Bill to Expand Access to Occupational Therapy for Mental Health and Substance Use Disorders

Senators Hassan and Scott Introduce Bipartisan Bill to Expand Access to Occupational Therapy for Mental Health and Substance Use Disorders


WASHINGTON – U.S. Senators Maggie Hassan (D-NH) and Tim Scott (R-SC) introduced a bipartisan bill to expand access to occupational therapy for patients being treated for mental health and substance misuse disorders.

“Occupational therapists can play a key role in helping patients with mental health and substance use disorders,” said Senator Hassan. “This bipartisan bill would clarify that Medicare and Medicaid can provide for occupational therapy for mental health and substance use disorders. I encourage my colleagues to support this commonsense bill.”

“With the recent rise in substance abuse and mental health crises across the nation, it’s crucial that we get Americans the help they need,” said Senator Scott. “As ranking member of the Senate Committee on Aging, I’m especially glad that this bill could break down barriers to treatment for millions of Medicare beneficiaries, and I urge my colleagues to join me in this bipartisan effort.”

“Occupational therapy practitioners in NH have a long history in providing functionally based services to people with substance use and mental health diagnoses in acute inpatient settings.  We find ourselves limited in our ability to sustain those critical services as these people move to community settings secondary to reimbursement barriers. These barriers prevent community-based mental health and recovery service programs from providing occupational therapy services to people with substance use and mental health diagnoses. The New Hampshire Occupational Therapy Association strongly supports the Occupational Therapy Mental Health Parity Act as it addresses the underlying reimbursement challenges that limit OT services for people with mental and behavioral health disorders,” said the New Hampshire Occupational Therapy Association.

Occupational therapists can help patients by introducing exercises or lifestyle adjustments that can be pivotal for an individual’s treatment or recovery. Currently, due to ambiguous guidance, Medicare claim processers and state Medicaid programs often deny claims for occupational therapy for mental health or substance use disorders. This bill would clarify that under Medicare and Medicaid, occupational therapists can expand their care of psychiatric disorders to include mental health and substance misuse disorders.

This bipartisan effort builds on Senator Hassan’s work to support those struggling with substance misuse disorders and strengthen treatment for mental health. Since 2017, the Senator has worked to secure a nine-fold increase in funding to New Hampshire to address the substance use disorder epidemic. Last year following Senator Hassan’s advocacy, the Biden administration removed some requirements that limited health care providers’ ability to prescribe buprenorphine. Senator Hassan is continuing to press for passage of the Mainstreaming Addiction Treatment (MAT) Act, another bipartisan bill that she reintroduced last year with Senator Lisa Murkowski (R-AK), that would fully eliminate these unnecessary requirements.

My Thoughts

This is great news. I have been getting a lot of e-mails about the scope of practice in mental health for occupational therapists, particularly concerning 1:1 services. What we need is clear language that specifies what the scope of practice is for occupational therapists in mental health. One concern I’ve had and that other OTs have as well is if this will be overstepping some boundaries such as that of LMFT and psychologists. Even so, I would argue that there is a shortage of practitioners in mental health to fulfill this need.

Occupational therapy practitioners can provide a valuable service to clients in mental health using occupationally-based outcome measures and to promote engagement in meaningful occupations such as IADLs, socialization, work, rest, sleep, and health management. Other mental health practitioners may provide psychotherapy such as in their controlled setting, but OTs provide a unique service with engagement in the real-world context. If we can bill for services in the real-world setting such as shopping or leisurely activities, then I believe that would help with this mental health crisis in America.

What do you think? Write me or record a short message on the voicemail line to be played in a future episode!