Medicare Home Health Accessibility Act would enable OT to be ordered as a solo home health service!  

Occupational therapy (OT) has long been recognized as an important home health service under Medicare; however, it is the only skilled service that does not qualify a beneficiary for the Part A home health benefit. This means that OT services cannot be ordered at the start of care unless nursing, PT or speech services are also ordered. As a result, some Medicare beneficiaries with conditions that do not require other home health services at the time will not receive OT which can impact their ability to live safely and thrive at home. This restriction can impact beneficiaries with low vision, dementia, diabetes, COPD or other conditions where the primary challenge at the time home health services are ordered can be managing activities of daily living.

Numerous studies indicate that OT services can generate savings to the Medicare system through the prevention of falls and other accidents that can result in emergency room visits, hospitalizations and even institutionalizations. Such savings have been demonstrated in acute care settings, and multiple studies have demonstrated that occupational therapy-led home safety evaluations paired with low-cost modifications decrease disability and result in significant cost savings.

Occupational therapy was added as a Part A Medicare home health qualifying benefit in 1980, but that status was changed in 1981 to non-qualifying as part of budgetary cost-saving measures. Under current rules, occupational therapy can already establish eligibility for the Medicare home health benefit on a continuing need basis after other services have been discharged and OT is the only service still needed by the beneficiary. Occupational therapy is also a stand-alone service in many states under the Medicaid home health benefit.

The Medicare Home Health Accessibility Act (H.R. 7148) was introduced in 2024 by Representatives Lloyd Smucker (R-PA), Lloyd Doggett (D-TX), John Joyce, MD (R-PA) and Paul Tonko (D-NY) to establish occupational therapy (OT) as a qualifying Medicare home health benefit. Passage of the bill would mean that the need for occupational therapy would allow a beneficiary to receive home health care services without having to also receive nursing, physical therapy, or speech services at the start of care as is now required under current Medicare policy.

Please contact your Representative to urge them to co-sponsor H.R. 7148!

Click this link to view AOTA's Handout on the Medicare Home Health Accessibility Act on our website.

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