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2018 Legislative Update

 

NYSOTA Advocacy Day

NYSOTA’s 2018 Advocacy Day was on March 14th. The day was a great success, with attendance over 350. OT and OTA programs from all over the state attended. We got the Well! The "Well" is a central space on the first floor of the Legislative Office Building that provides us with maximum exposure to legislators, staff and the public. NYSOTA also had two tables for students to run public relations activities.

The New York State proposed budget provided a number of challenges and opportunities this year.

 

 Early Intervention

Regarding the early intervention program, the executive budget included changes to the evaluation process and insurance billing that included maximizing appeals of insurer payment denials. In addition, the executive budget also proposes increasing provider payment rates by 2%.

NYSOTA supported the 2% increase, but had to oppose amendments regarding evaluations to determine eligibility for early intervention services. The changes would have allowed that the child receive a multidisciplinary evaluation by one individual, and it allowed the evaluator to be licensed, certified "or other comparable standards."

NYSOTA also opposed an amendment that appeared to remove the right to a multidisciplinary screen or evaluation in another section of the law.

The Assembly supported the 2% increase, but opposed all of the executive's proposal regarding changes to the evaluation process. In addition, the Assembly made a rather radical proposal to remove all of the commercial insurance mandates for covering early intervention. To offset the money lost in that proposal, the Assembly proposed establishing a $25 million covered lives assessment, an annual surcharge on commercial insurance plans.

As budget negotiations moved forward, the early intervention section of the Executive proposal was completely removed. So there are no changes in EI evaluations for eligibility, no changes in billing insurance and no 2% increase.

The Governor also proposed adding early intervention services to public health law regarding insurance coverage for telehealth. The Senate and the Assembly agreed with this proposal, and the Governor has signed the bill into law. The bill calls on the department of health to work with other offices to develop a guidance document. NYSOTA has reached out to the director of the Bureau of Early Intervention and offered to provide input into the development of that guidance, and the director has accepted our offer. Occupational therapy practitioners with knowledge and experience in this area are invited to contact NYSOTA with any suggestions or information.

 

Medicaid Outpatient Therapy Visit Limits

In the budget, the Governor also proposed changing the Medicaid outpatient therapy visit limits, increasing physical therapy to 40 visits and limiting occupational therapy and speech therapy to a shared 20 visits. We were told at that time that this proposal was based on a recommendation from the Medicaid Redesign Team. NYSOTA lobbied for four different options:

  • increasing therapy visit limits to 40 each for all three professions
  • an appeals process that allows an override of the limits
  • an attestation process that would allow the providing therapist to attest that exceeding the visit limit is medically necessary
  • or, at the least, the Medicaid outpatient visit limits being restored to 20 each for occupational therapy and speech

This issue went unresolved in the budget negotiations for many days, but the final results ended up with physical therapy 40 visits, occupational therapy 20 visits and speech therapy 20 visits.

NYSTOA has followed up with meetings regarding this matter and learned that the PT increase to 40 visits was related to the opioid crisis and the idea of expanding the use of PT for pain management. NYSOTA is pursuing efforts to argue for OT getting 40 visits also.

 

Worker's Compensation Coverage of OTA Services

The NYSOTA workers compensation bill, A.1396-B, was passed by the Assembly again this year. This legislation is sponsored by Assembly member Zebrowski, co-sponsors Assembly members Weprin, Colton, Benedetto, and multi-sponsor Assembly member Walter. The bill amends the workers compensation law to allow payment for treatment services by occupational therapy assistants provided under the workers compensation program. Currently the workers compensation law only covers services by an occupational therapist. The bill in the Senate, s.5153-A, is sponsored by Senator Savino.  


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