Regulatory and Reimbursement Committee Welcomes Feedback

 

Aileen Deogracias, OTR/L, Chairperson of the Regulatory and Reimbursement Committee welcomes feedback on current challenges therapists are facing including:

  • Billing or reimbursement trends
  • Scope of practice creep from other licensed professions
  • Examples of exclusion from treatment team 
  • Non-credentialed practitioners providing occupational therapy services 
  • Current or upcoming legislative concerns 

Aileen Deogracias, OTR/L and GOTA Lobbyist Tom Bauer look forward to hearing from members. 

Aileen Deogracias, OTR/L
[email protected]

 

AIM/Anthem Update


10/23/2019
 
The Trialliance met with Aim/Anthem to get provider's questions answered regarding the new prior authorization process. I have drafted the notes from this meeting and we are waiting on formal approval from both AIM/Anthem. However, I thought it was important to share the information since it is time sensitive. AIM has also asked that we share a slide deck (which can be found here) as well as the microsite link (click here for deck). The microsite link will direct you to the clinical guidelines, processes/checklists for getting a PA, and covered CPT codes. Please let me know if you have any questions.

On another note, my office was told by BCBS that they are no longer going to be paying for developmental delay or F codes for children enrolled in the State Health Benefit Plan. This is going to be tough for some of our families as they were previously paying these codes. 
 
Notes from: Kelly J. Ball

Please make sure that your GSHA, PTAG, or GOTA membership is current. These organizations are the reason the Trialliance exists and your support is greatly needed. 
 
Nicole Walker MS OTR/L, BCP, SCFES
AOTA Board Certification in Pediatrics


AOTA® and NBCOT® to Collaborate on Interstate Licensure Compact


9/23/2019

The American Occupational Therapy Association (AOTA®) and the National Board for Certification in Occupational Therapy (NBCOT®) will be collaborating over the next 4 years to create an interstate licensure compact for the occupational therapy profession. AOTA and NBCOT will be working with the Council of State Governments (CSG), state occupational therapy regulatory entities, state occupational therapy associations, and other stakeholders to allow state licensure reciprocity. AOTA and NBCOT are committed to working together throughout the process of creating and implementing the licensure compact. Major funding from NBCOT will support the licensure compact initiative; AOTA and state associations will lead advocacy efforts to enact compact legislation in the states. Read the AOTA NBCOT joint statement.