The AOTA reckless plan to open up all state occupational therapy practice acts

reckless. adjective (of a person or their actions) without thinking or caring about the consequences of an action.
"reckless driving"
On February 6-7, 2017, AOTA convened an ad hoc committee. This group was charged with the task to explore current experiential requirements for OTs and OTAs. As a result, the ad hoc group recommended a new model of experiential education that makes several disruptive changes including changes to the length of fieldwork and creation of a post-graduate first year practitioner resident program. Under this plan, graduates would complete the certification examination and practice under a limited license until the residency was completed. The group identified that this would involve the revision of many state's practice acts. They indicate that they were informed by staff and content experts on implications of these decisions. However, there were no state regulators listed in the ad hoc group. There were no representatives from the certification…

Annual NY early intervention post

Early intervention providers in New York State should be aware that when Governor Cuomo does not get what he wants he just tries to cram it down everyone's throat via legislation - repeatedly.

Blogging about the annual attacks on the early intervention program got boring around 3 years ago.  At that point in time the State Fiscal Agent (SFA) that is costing the taxpayers of NY millions of dollars in contract fees was only collecting 15% of monies billed for services.  In 2016 nearly 85% of claims submitted by the SFA to private insurers were denied.

Now in 2017, 82% of claims submitted by the SFA to private insurers are being denied.  That is just pathetic.  They have no idea what they are doing.  It is boring to repeat the same thing every year, but if anyone ran their practice with the inefficiency of the SFA they would not have a practice.

What is more pathetic is that we have been identifying how pathetic the SFA is for years - but no one listens to the provider community.


Analysis of occupational therapy leadership statements on student debt and the doctoral mandate


Selective use of statistics to support a flawed advocacy position on Medicare therapy cap repeal

This is a recurring theme - what should occupational therapists focus on when they are making decisions about services?  Should they focus on the people that need services, or should they focus on the amount of money being spent?

These ethical choices have been discussed in this blog before.

This question also applies to the latest situation with the repeal of the Medicare therapy cap and the resultant payment differential that has been applied to OTAs.

When attempting to develop an advocacy position - should the occupational therapy profession measure impact in terms of lives affected or in dollars spent?  Here is an analysis of how the professional association is cherry-picking statistics in order to suit their chosen advocacy position.

Perhaps we can call this analysis "A Tale of Two Table Fours"

Here is Table 4 from the Moran Company Report, commissioned by AOTA to look at the Medicare cap issue.

The RED information indicates the numbers of people (beneficiaries) who wer…

When your honey-do list involves analysis of Medicare expenditures

The title explains my role in all this fully.

A rather complex report was commissioned by AOTA that involved data related to the distribution of fee for service therapy spending in the Medicare program, as well as how different cap thresholds would impact the system.  The report also breaks out information about where spending is happening based on place of service.

Now the reason why I was given this task is because if you read the report, and my first paragraph, your eyes might already be glazed over.  My purpose will be to put all of this in very plain language.

Here are the three primary takeaways from this report, and I will provide the detail below each statement:

1. The 'cap problem' impacted PT significantly more than it impacted OT.

The reason why the 'cap problem' impacts PT significantly more than it impacts OT is based on volume.  Of all the Medicare patients out there who use Part B services, 90% of them get PT.  By contrast, of all the Medicare patients o…

The curious incident of the changing dates and content of web pages.

I was a little surprised to see a message from AOTA today that states
After the late-night release of the bill, the following day, Tuesday February 6, while the Senate was still creating its version of the budget package, AOTA reached out to our Congressional champions to oppose these provisions, and, alongside the American Physical Therapy Association, proposed alternatives to the OTA provision—alternatives that would have stopped its adoption or minimized its impact. Additionally, on Tuesday AOTA changed all grassroots advocacy messages related to the repeal of the therapy cap, to include details of the OTA payment changes. 
This was surprising to me because I read every available piece of documentation on this as it was unfolding and I did not recall seeing any such messaging.  In fact, I was so distressed that AOTA did not inform anyone that I wrote a blog post about it.

I was surprised to go back today and re-read the AOTA 'messages' and I was surprised to find that they al…