Advocacy in Action: Advancing and Protecting Occupational Therapy

Dr. Antonette Fernandez, DrOT, OTR/L
Florida Occupational Therapy Association (FOTA) President

President’s Message

The strength of occupational therapy lies not only in the clinical care we provide but also in our collective commitment to advocacy. Across Florida and the nation, important legislative and policy developments are shaping the future of our profession, the accessibility of services for those we serve, and the sustainability of the healthcare workforce. As members of the Florida Occupational Therapy Association (FOTA), we each play an important role in advancing the profession and protecting access to occupational therapy services.

Advancing the OT Practice Act: Dry Needling

One of the most significant legislative developments in Florida is the progress toward dry needling within the occupational therapy scope of practice. This initiative has successfully passed both chambers of the Florida Legislature and is currently awaiting the governor’s signature. If enacted, this update to the Florida Occupational Therapy Practice Act will represent an important milestone for occupational therapy practitioners across the state.

Dry needling is a skilled intervention used to address neuromusculoskeletal dysfunction and improve functional outcomes for clients experiencing pain and movement impairments. The inclusion of dry needling in the OT scope of practice reflects the evolving competencies of occupational therapy practitioners and the profession’s commitment to providing evidence-based interventions that support participation and occupational performance.

This achievement reflects the dedication and advocacy of FOTA members, leaders, and legislative partners who have worked collaboratively to ensure occupational therapy continues to evolve responsibly while maintaining high standards of safety and professional competence.

Graduate Student Loans and Workforce Sustainability

At the federal level, the U.S. Department of Education has proposed rules implementing changes passed by Congress related to graduate student loan programs. Occupational therapy is a graduate-level profession, and many students rely on federal loan programs to pursue their education and enter the healthcare workforce.

Changes to loan availability, borrowing limits, or repayment programs could significantly affect the ability of future practitioners to pursue occupational therapy education. These changes may also have long-term implications for workforce development and access to rehabilitation services across the country (U.S. Department of Education, 2024).

FOTA encourages members to contact their members of Congress and advocate for policies that protect access to graduate education funding. Ensuring that qualified students can pursue careers in occupational therapy without overwhelming financial barriers is essential to sustaining the healthcare workforce and maintaining access to critical rehabilitation services.

Protecting Access to Occupational Therapy Through Telehealth

The expansion of telehealth services during the COVID-19 public health emergency demonstrated the value of virtual care in increasing access to occupational therapy services. Telehealth has improved access for individuals living in rural communities, those with mobility limitations, and those who face transportation barriers.

However, many of the telehealth flexibilities currently in place remain temporary waivers. Congress must act to extend these waivers and develop permanent telehealth policies that support the continued delivery of occupational therapy services through virtual platforms when clinically appropriate (U.S. Department of Health and Human Services, 2024).

FOTA encourages members to advocate for policies that preserve telehealth as a viable service delivery model and ensure occupational therapy practitioners can continue meeting the needs of diverse populations.

Addressing Medicare Advantage Reimbursement

Another important issue affecting occupational therapy practitioners is the growing concern surrounding Medicare Advantage reimbursement practices. Many healthcare providers have reported delays in payments, denials of claims, and reimbursement rates that fall below those provided through traditional Medicare Fee-for-Service (FFS) programs.

Policy reforms are needed to ensure that Medicare Advantage payments for occupational therapy and other healthcare services at least match Medicare FFS reimbursement levels, require prompt payment of clean claims, and increase transparency from Medicare Advantage organizations regarding questioned claims (Centers for Medicare & Medicaid Services, 2024). Fair reimbursement policies are essential for sustaining access to occupational therapy services for Medicare beneficiaries.

Supporting the Occupational Therapy Mental Health Parity Act

Occupational therapy practitioners have long played a vital role in addressing the needs of individuals experiencing mental and behavioral health conditions. However, barriers remain within Medicare policy that can limit access to occupational therapy services for individuals with mental health diagnoses.

The Occupational Therapy Mental Health Parity Act would clarify that Medicare beneficiaries with mental or behavioral health diagnoses are eligible to receive occupational therapy services under occupational therapy CPT® codes. The legislation would require the Centers for Medicare & Medicaid Services (CMS) to publish guidance affirming that occupational therapy services are appropriate and reimbursable for individuals with mental health conditions (American Occupational Therapy Association [AOTA], 2024).

Advocacy for this legislation is essential to ensure equitable access to occupational therapy services within the mental health system.

Expanding Access to Home Health Services

Another important legislative priority is the Medicare Home Health Accessibility Act. Under current Medicare policy, beneficiaries must first receive skilled nursing, physical therapy, or speech-language pathology services before occupational therapy can initiate home health care.

Passage of this legislation would allow occupational therapy to serve as the initiating service for home health care when clinically appropriate. Removing this barrier would improve access to occupational therapy services for individuals who require support with daily living, safety, and independence within their homes (AOTA, 2024).

FOTA encourages members to contact their congressional representatives to support policies that reflect the essential role occupational therapy plays in home health care.

The Role of FOTA Members in Advocacy

Advocacy is a shared responsibility within our profession. FOTA members can contribute to these efforts by engaging with legislative initiatives, responding to advocacy alerts, and communicating directly with elected officials.

Members can support occupational therapy by:

• Contacting members of Congress regarding graduate student loan policies and healthcare workforce sustainability
• Advocating permanent telehealth policies that include occupational therapy
• Supporting reforms addressing Medicare Advantage reimbursement practices
• Encouraging passage of the Occupational Therapy Mental Health Parity Act
• Supporting the Medicare Home Health Accessibility Act

Through collective advocacy and professional engagement, we can strengthen the future of occupational therapy and ensure access to the services our communities rely upon.

References

American Occupational Therapy Association. (2024). Federal legislative priorities for occupational therapy. https://www.aota.org/advocacy

Centers for Medicare & Medicaid Services. (2024). Medicare Advantage program overview. https://www.cms.gov/medicare/health-plans/medicareadvantage

U.S. Department of Education. (2024). Federal student aid and graduate loan program updates. https://studentaid.gov

U.S. Department of Health and Human Services. (2024). Telehealth policy updates and guidance. https://telehealth.hhs.gov