[Congressional Record Volume 161, Number 177 (Tuesday, December 8, 2015)]
[Senate]
[Pages S8495-S8496]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CARDIN (for himself and Mr. Heller):
  S. 2364. A bill to permit occupational therapists to conduct the 
initial assessment visit under a Medicare home

[[Page S8496]]

health plan of care for certain rehabilitation cases; to the Committee 
on Finance.
  Mr. CARDIN. Mr. President, I rise in support of the Medicare Home 
Health Flexibility Act of 2015, which I am introducing today with my 
colleague Senator Heller. This bipartisan, no-cost legislation would 
allow occupational therapists to perform the initial home health 
assessment in cases in which occupational therapy is ordered by the 
physician, along with speech language pathology and/or physical therapy 
services, and skilled nursing care is not required, ensuring that 
Medicare beneficiaries receive timely access to essential home health 
therapy services.
  Occupational therapy is frequently ordered as part of a physician's 
plan of care for patients requiring home health services, and, under 
certain circumstances, an occupational therapist is allowed to perform 
the comprehensive assessment to determine a Medicare beneficiary's 
continuing need for home health therapy services. However, under 
current Medicare law, occupational therapists are not permitted to 
conduct the initial assessment for home health cases, even when 
occupational therapy is included in the physician's order and when the 
case is exclusively related to rehabilitation therapy.
  By permitting occupational therapists to perform initial home health 
assessments in limited circumstances, the Medicare Home Health 
Flexibility Act can help prevent delays in Medicare beneficiaries 
receiving essential home health therapy services, especially in areas 
where access to physical therapists and speech language pathologists 
may be limited. It is important to note that this legislation would 
apply only to rehabilitation therapy cases in which skilled nursing 
care is not required. Nurses would still be required to conduct the 
initial assessment for all home health cases in which skilled nursing 
care is ordered by the physician. Also, although the Medicare Home 
Health Flexibility Act would allow occupational therapists to conduct 
initial home health assessments, it would not alter the existing 
criteria for establishing eligibility for the Medicare home health 
benefit.
  I urge my colleagues to join me and Senator Heller in supporting the 
Medicare Home Health Flexibility Act, which will help ensure timely 
access to essential home health therapy services for Medicare 
beneficiaries.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2364

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Home Health 
     Flexibility Act of 2015''.

     SEC. 2. PERMITTING OCCUPATIONAL THERAPISTS TO CONDUCT THE 
                   INITIAL ASSESSMENT VISIT UNDER A MEDICARE HOME 
                   HEALTH PLAN OF CARE FOR CERTAIN REHABILITATION 
                   CASES.

       (a) In General.--Notwithstanding section 484.55(a)(2) of 
     title 42, Code of Federal Regulations, or any other provision 
     of law, an occupational therapist may conduct the initial 
     assessment visit for an individual who is eligible for home 
     health services under title XVIII of the Social Security Act 
     if the referral order by the physician--
       (1) does not include skilled nursing care;
       (2) includes occupation therapy; and
       (3) includes physical therapy or speech language pathology.
       (b) Rule of Construction.--Nothing in subsection (a) shall 
     be construed to provide for initial eligibility for coverage 
     of home health services under title XVIII of the Social 
     Security Act solely on the basis of a need for occupational 
     therapy.
                                 ______