Chuck:

I remember talking about it on this website, and the States listserv. The
Ohio RA and I did try to introduce it via a mention along with the direct
access issue, but it did not actually make it (we were late as you said).
You have a great memory! I thought there might actually be an RA Motion that
made it through. 

Either way, thanks for looking.

Joe


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Chuck Willmarth
Sent: Thursday, March 22, 2007 4:20 PM
To: [email protected]
Subject: Re: [OTlist] Direct Access to Physical Therapy Legislation
-CHUCK???

Joe,

If I'm not mistaken I thought you worked with an RA rep in Ohio several
years ago to introduced a motion around the topic.  It was introduced
late so it didn't get on the agenda.  Does this ring a bell?  It is
possible that I am not remembering the issues correctly.

I recently purged my email archived (140K messages!) so I don't have any
electronic documents...and the RA minutes online only only go back to
2002 so I would have to do some digging.

Chuck 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Joe Wells
Sent: Thursday, March 22, 2007 4:05 PM
To: [email protected]
Subject: Re: [OTlist] Direct Access to Physical Therapy Legislation
-CHUCK???

Chuck:

Thank you for your response. 

I do not necessarily disagree with the policy, I just do not quite agree
with the strategy. The current strategy alienates us in the tri-alliance
on this issue (since SLPs have officially supported the bill, and for
all practical purpose- OTs have stated that the current system is
required but lest there be a change, we must be included in it- i.e.,
the wrench). I feel, we should go in for the direct access without other
compulsions because that is the right thing to do (policy).

Also Chuck, I missed the RA on the Occupational Therapy diagnosis issue.
If possible, could you find me some information on it? And, what was the
outcome on the motion?

I agree, we need to do everything we can to discourage POOTS by non OT
personnel. Thanks. 

Joseph K. Wells, OTD, OTR/L
[EMAIL PROTECTED]

 


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Chuck Willmarth
Sent: Thursday, March 22, 2007 2:53 PM
To: [email protected]
Subject: Re: [OTlist] Direct Access to Physical Therapy Legislation
-CHUCK???

Joe,

Thanks for your message.   AOTA's current position is "if Congress
considers changes to the physician referral requirements for therapy
services under the Medicare program, any such changes should include
occupational therapy." 

If you disagree with that policy, then I urge you to raise it with your
representative to the Representative Assembly.

1. I think the letter pointed out that OT, PT and SLP are treated the
same under Medicare in that a physician's referral is required.   You
are correct on your observations about coverage.  It's also interesting
to note that because of the structure of the Medicare law, there was a
$1500 cap for OT and a $1500 cap for SLP/PT combined.

2. You are correct, PT Chapters have enacted a number of direct access
bills in the states.   There is no physician referral requirement in
most states for OT and except for NY/WV most states have exceptions to
the referral requirements for certain practice areas.  We continue to
work with state associations to eliminate state referral requriements
and/or broaden exceptions.

3. I haven't heard much about the concept of an occupational therapy
diagnosis lately.  I believe there was an RA motion on that topic a
while back.  You might consider bringing it up again.  

Chuck

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Joe Wells
Sent: Thursday, March 22, 2007 11:04 AM
To: [email protected]
Subject: Re: [OTlist] Direct Access to Physical Therapy Legislation
-CHUCK???

Dear Chuck:

 

I really hope that our current stance on this issue will not come back
to bite us. 

1. AOTA here apparently speaks for OT and SLP. Although, ASHA has
categorically stated that is in favor of the direct access for PT in
order to promote their ambitions for direct access. Also, SLP, PT and OT
are not "treated the same under Medicare". 

*         In private practice (where direct access is most applicable),
SLP
is not covered, but OT and PT are. 

*         In Home Health, OT is not a qualifying discipline but SLP and
PT
are.

*         For CORF/ Rehab Agency (again where direct access will
matter), PT
is a necessary service for enrollment. OT is not.

2. AOTA's assertion that "there were important public policy reasons to
ensure that physicians review ...therapy services" may jeopardize our
own direct access aspirations, while PT has been gaining much ground at
least in the states. It is important to note that PT already has much
leverage with more insurance companies and Medicaid programs compared to
OT. 

3. APTA has strategically changed its official definition on PT which
now includes "diagnosis". Interestingly, SLP and audiology do, too. PT
schools are offering radiology and differential diagnosis courses. The
argument that PTs can "diagnose" within their scope (as with any medical
specialization), and that they can medically screen for referrals to
other medical specialties for issues that is not, is well served.

 

As an OT in business, and a proponent of autonomous practice (as I
believe that is the true "professional" status), I feel the current
stance by AOTA (playing neutral) puts us in bad light. How can we say we
want both- direct access as well as physician control?

 

 

 

Joe Wells, OTD, OTR/L

 

For ASHA's viewpoint, click on-

HYPERLINK
"http://www.asha.org/about/publications/leader-online/archives/2005/0503
01/0
50301e.htm"http://www.asha.org/about/publications/leader-online/archives
/200
5/050301/050301e.htm

 

 

 

 

 

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Chuck Willmarth
Sent: Thursday, March 22, 2007 7:24 AM
To: [email protected]
Subject: Re: [OTlist] Direct Access to Physical Therapy Legislation
-CHUCK???

 

Ron,

 

As passed by the Representative Assembly in 2003, AOTA's position is "if
Congress considers changes to the physician referral requirements for
therapy services under the Medicare program, any such changes should
include occupational therapy." 

 

The PT legislation addresses direct access to physical therapists.

 

A recent MedPac report examines this issue and provides background
information.   The Medicare Payment Advisory Commission (MedPAC) is an
independent federal body established by the Balanced Budget Act of 1997
(P.L. 105-33) to advise the U.S. Congress on issues affecting the
Medicare program. The Commission's statutory mandate is quite broad: In
addition to advising the Congress on payments to private health plans
participating in Medicare and providers in Medicare's traditional
fee-for-service program, MedPAC is also tasked with analyzing access to
care, quality of care, and other issues affecting Medicare.

 

Report to the Congress: Eliminating Physician Referrals to Physical
Therapy (December 2004)
<http://www.medpac.gov/publications/congressional_reports/Dec04_PTaccess
.pdf
>  

 

http://www.medpac.gov/publications/congressional_reports/Dec04_PTaccess.
pdf

 

 

Chuck

 

________________________________

 

From: [EMAIL PROTECTED] on behalf of Ron Carson

Sent: Wed 3/21/2007 7:56 PM

To: [email protected]

Subject: [OTlist] Direct Access to Physical Therapy Legislation -
CHUCK???

 

 

 

======================================================================

The American Physical Therapy Association (APTA) strongly supports the

re-introduction  of  the Medicare Patient Access to Physical Therapist

Act  of  2007  (HR  1552  and  S.  932).  This legislation would allow

Medicare  beneficiaries  to  directly  access  physical therapists for

outpatient services as authorized by state law.

 

======================================================================

 

Chuck,  do  you  know if OT is considered in this legislation or is it

just PT?

 

Thanks,

 

Ron

 

 

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