The Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice, from “direct” supervision to instead match state standards which require only “general” supervision of OTAs by OTs in forty-nine states. The legislation would also require the Government Accountability Office (GAO) to conduct a study on how the 15% reimbursement cut for OTAs and PTAs under Medicare Part B has impacted access to occupational therapy and physical therapy services in rural and medically underserved areas.

The EMPOWER Act was introduced by Representatives Debbie Lesko (R-AZ) and Annie Kuster (D-NH) in the House and Senators Tom Carper (D-DE) and John Barrasso (R-WY) in the Senate (S. 2459). The standardization of Medicare supervision requirements to match state regulation is a cost-effective way to reduce administrative burden for private practice while recognizing the expertise and value of occupational therapy assistants. Additionally, the study on the impact of the 15% reimbursement reduction for services provided by OTAs and PTAs will show whether this payment policy has impacted access to therapy services in rural and medically underserved areas, areas where occupational therapy assistants provide a high proportion of occupational therapy services.

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