VOTA Legislative Day was held Wednesday, January 30, 2013.
Legislative Day was a great opportunity to network with other practitioners and students. Our lobbyists, Alexander Macauley and Hunter Jameson, provided an overview of the legislative process.
General Assembly Overview:
The 2013 General Assembly session is underway. 2013 is a short session year, meaning that the General Assembly sits for only 45 days. Bills are considered in the chamber in which they were filed until February 5th, when all bills must cross-over for consideration by the other chamber. If a bill is defeated in its chamber of origination then it does not cross-over. Simultaneously, both the House of Delegates and the Senate craft a state budget which then crosses over to the other chamber for amendment. During the last week of the legislative session, a conference committee comprised of members from both chambers drafts a compromise budget bill. The conference reported budget and those legislative bills which passed both chambers are then sent to the Governor for his consideration. Finally, in late March, the General Assembly will reconvene to consider any vetoes or amendments recommended by the Governor. Bills passed by the General Assembly this session will become law on July 1, 2013, except for the budget bill, which this year takes effect upon signature by the Governor.
Workers Compensation Payment Reform:
Priority Bill: HB 1612 – VOTA Opposes This Bill
HB 1612 is an immediate threat to OT reimbursement in Virginia. This bill seeks to:
- Restrain increasing health care costs for workers compensation insurance patients by instituting a capitated fee schedule for provider fees.
- This fee schedule would be based on Medicare rates and would be substantially lower than current prevailing community rates.
- OTs, PTs, and Orthopedists are particularly being singled out in this debate as much of the increasing health care costs in recent years come from physical medicine expenses.
- This bill presents an excellent opportunity to remind legislators about the value and necessity of occupational therapy services.
Federal Health Care Reform Issues:
The Supreme Court upheld the Affordable Care Act but gave states the option of whether or not to comply with requirements to expand their Medicaid programs. Expanding Virginia’s program from the current 80% of Federal Poverty Level to 133% of the Federal Poverty Level would bring 400,000 uninsured Virginians into the Medicaid program. While recent projections show that Virginia could save money over the next five years by expanding its Medicaid population, concerns persist about the federal government’s ability to fulfill its cost-sharing portion of the expanded program. OTs are an important provider in Virginia’s Medicaid program and should be prepared to absorb increased Medicaid rolls.
Health Benefit Exchange
The federal Affordable Care Act requires that each state create a Health Benefit Exchange. The exchange is a marketplace of insurance plans that carry essential benefits. Federal premium subsidies are available for some prospective members based on income level. The Affordable Care Act requires that Exchanges must be operational by the end of 2013.
The General Assembly is considering several bills this session to implement a Health Benefit Exchange. Much of the debate centers on whether to have a federally administered exchange, a partnership exchange, or a state run exchange. While a state run exchange may be preferable for ease of addressing administrative concerns, VOTA’s interests in this debate center on the essential benefits included in exchange plans. Last year, VOTA was successful in reforming OT scope of practice laws in order to include recognition of OT’s role in both habilitation and rehabilitation. These have been identified by the federal government as essential benefits. Under the most recent federal rules, the benefits contained within the Anthem PPO plan will be used as a benchmark for Virginia’s exchange.
VOTA will continue to work with AOTA as final federal rules are established. In the meantime, it is important to remind legislators that any exchange established in Virginia must contain robust habilitation and rehabilitation benefits. This is a good opportunity to detail the role OTs play in these services.