New Options Allowing Medicare Access to Physical and Occupational Therapy Services

Article submitted by Tim Fox, Fox Rehabilitation Services.
For more information, he can be reached at 877-407-3422.

The proliferation of innovative drugs and medical treatments developed in recent years are allowing millions of older adults greater longevity. Diseases that were once insurmountable are now being controlled resulting in ever escalating life expectancies. While this ability to compete more successfully in the constant war on disease and aging is a fantastic occurrence, there is a downside to the trend.

Drugs may have given us the ability to maintain life in the face of conditions like heart disease, diabetes or emphysema, but they don't work to prevent the deterioration of the body itself. Millions of older Americans ever year become gradually weak and immobile as a result of an illness or simply as a result of inactivity combined with the aging process its self.

Consumers are not always aware of what they are entitled to under the Medicare system and find it difficult to access the medically necessary treatment that they need in order to maintain good functional health. Physical and Occupational Therapists are working to educate both older adults and health professionals that there are now good solutions to help this forgotten segment maintain independence and quality of life.

Many older adults receive orders from their physicians for therapies that they often find it difficult to comply with. Compliance means actually receiving the medically recommended therapies and then receiving the treatments at the recommended frequency and duration that produce the physiologic and functional gains expected.

The geriatric medical community is trending more and more towards preventive medicine; maintaining health in order to prevent a person from becoming weak due to chronic illnesses. The challenge comes in funding this care. Who pays for it?

Traditionally, there were only two ways for older adults receive Physical and Occupational Therapies; through out patient clinics and home health agencies. Typically, patients must meet "homebound" criteria in order to receive treatment through a home health agency and may be limited in the intensity of therapy treatments due to Medicare Part A regulations. Access to therapy (getting there) and therefore consistency of care may be limiting issues in out patient clinics.

A large segment of the older adult population has been left out as they indeed have the medical need for therapy services, but either cannot get to outpatient therapies or do not qualify as being homebound to receive home health services under Part A.

Today, Medicare beneficiaries have a new choice. Patients can now receive convenient HOMECARE PHYSICAL AND OCCUPATIONAL THERAPIES under Medicare Part B, which has no such above limitations. This means that anyone who has Medicare Part B coverage has the option to have a Physical and/or Occupational visit them in their own home to receive treatment that would otherwise require a visit to an out-patient clinic.

Therapists are now able to work proactively to improve conditions such as general weakness (deconditioning), unsteady walking (gait dysfunction), problems with the functions of daily living like bathing, dressing, eating, etc. (ADL dysfunction), mobility dysfunctions relating to dementia's and fall prevention in the home environment.