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State Spotlight: Utah

UOTA is monitoring changes to Utah's Medicaid program to ensure continued access to OT services.

By Beth Puliti

Last updated on: February 1, 2012 | Posted on: January 30, 2012
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ADVANCE recently spoke with Kasey Mitchell, MOT, OTR/L, Utah Occupational Therapy Association (UOTA) legislative affairs committee chair, about some of the primary legislative efforts happening in the state that affect OTs.

Perhaps the biggest effort on the state level at the moment is that the state is reorganizing Medicaid, said Mitchell. "They're moving the program from a fee for service payment to capitated care," he explained.

UOTA is keeping a watchful eye on this proposal, making sure that if one of the larger hospitals manages this care, they don't spend all the money up front and neglect community, outpatient and home-health services. Occupational therapy must remain one of the members in the delivery of care to individuals with Medicaid, stressed Mitchell.

"We are making sure that occupational therapy is considered with this revamp of Medicaid, and that it's not something that is left out. We really want to ensure that access to care is maintained because it's an essential service for these individuals," he said, noting that it is often overlooked by providers because of poor reimbursement.

Otherwise, 2012 is looking to be a quiet year legislatively in the state. Mitchell mentioned that elements of the Affordable Care Act (the health care reform law) will be implemented regardless of whether it's repealed in November. He believes many people are simply waiting to see what happens.

On the federal level, UOTA is concerned about the Medicare therapy cap; the current limit would cap OT services under Medicare Part B at $1,880 a year. AOTA successfully advocated for an exceptions process to the therapy cap so that Medicare beneficiaries have access to the therapy they need, but it is set to expire March 1 of this year. UOTA is working to educate practitioners before the exceptions process expires.

Additionally, Mitchell said that the association is looking to change some of the language in its state practice act. "We are trying to build committees and we've approached our lobbyist to start changing language so that it is more reflective of [AOTA's] Model Practice Act," he said.

UOTA is continuously on the watch to make sure occupational therapy practice is protected. For example, a few years ago the state physical therapy organization changed their practice act to include some areas that were traditionally treated with occupational therapy, he said. UOTA negotiated with the PT organization to make sure that their definitions were very clear concerning areas such as ADLs and community reintegration.

"It worked out really well because they wanted to focus on functional mobility. They weren't trying to take over. We were able to help them change the language to reflect that," said Mitchell.

He noted that UOTA will need more involvement from its members in terms of participating in the legislative committee-especially when they start forming committees to look at the state's practice act. "We will need a lot of support for that," he acknowledged.

Occupational therapists who are interested in support the efforts of advancing the future of the OT profession in the state can contact Mitchell at govaffairs@utahotassociation.org or UOTA President Pollie Price at president@utahotassociation.org.

Beth Puliti is a frequent contributor to ADVANCE. 



     

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