Believe me there has been tons of networking. She has also been using hippot for
years. This is new from blue cross and blue shield. AHA is a huge organization that
provides the standards of practice for utilizing hippot. AHA has provided a
tremendous amount of monetary support for this case as the replications are huge for
all of us that utilize hippot. my larger concern has to do with the insurance
companies dictating are treatment tools.
Lisa
>>> [EMAIL PROTECTED] 08/28/01 03:26PM >>>
I would think this is an unusual case. I also know several therapists who have been
using hippotherapy for years...for example, Tidman Therapy in New Mexico...perhaps a
bit of networking would clarify the issues.
"Lisa M. Dean" wrote:
> Dear List,
>
> I am primarily a lurker on this list but now have a little to contribute in regards
>to a possible reimbursement issue. I am an OT who will frequently utilize
>hippotherapy as a treatment tool. Hippotherapy is a specialized area much like
>sensory integration, hand specialties, etc. In fact the American Hippotherapy
>Association in conjunction with AOTA and APTA, have developed a board certification
>to ensure that individuals who utilize this highly specialized treatment tool have
>the appropriate education and training. SLP's are also able to utilize hippotherapy
>as a treatment tool. Being a treatment tool, hippotherapy is in the same category
>as a swing, physio ball, scooter boards, etc. except more powerful. Riding skills
>are not taught.
>
> Now that the brief background is covered here is the issue. A PT in Maryland has
>been utilizing hippotherapy as a treatment tool for many years. she has appropriate
>documentation and also includes carry over activities in a traditional therapy room
>setting. After years of providing hippot, blue cross and blue shield audited her
>private practice and asked for $56,000 back from her. With the backing of AHA, she
>went to court and won. In addition, APTA and AOTA wrote letters stating the
>utilization of hippotherapy is within the individual practice acts and an appropriate
>treatment tool. The court decided Hippotherapy was an appropriate tool to be used by
>individuals with the appropriate training. However, after the battle was won, the
>decision went be for the state insurance commisioner who over turned the decision,
>forcing this PT to pay back the said amount. He Stated that insurance have a right
>to dictate to therapists the treatment tools utilized during therapy an!
d !
> also stating hippotherapy was experimental. However, if one does the research, one
>will find more documentation regarding the benefits of hippotherapy than the use of a
>physio ball.
>
> Now for the meat of the issue. When does the insurance industry have the right to
>dictate what treatment tools we utilize to achieve functional goals? AHA has since
>offered to pay some of the cost for the attorney's during the appeal, however, the
>funding is limited. I myself, would like to see AOTA and APTA become more involved.
>I would hate to see this court case become the basis from which insurance companies
>set the standards for how we practice our respective disciplines.
>
> What does this list think.
> Lisa
>
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