Bill Could Loosen Home Health Assessment Regulations

A new bill could expand who can conduct initial assessments for home health visits in certain cases. The bill, the Medicare Home Health Flexibility Act of 2016, would loosen some restrictions at a time when the industry has seen an influx of new, burdensome regulations.

The bill would permit occupational therapists to conduct the initial home health assessment for certain rehabilitation cases. Occupational therapists would be allowed to conduct the assessment if the referral is ordered by a physician when the order does not include skilled nursing care; if it includes occupational therapy; and for cases that include physical therapy or speech language pathology.

The bill, which has been brought up in Congress in the past, was introduced by Sen. Charles Boustany (R-LA 3rd District).


Currently, occupational therapists are allowed to conduct the initial home health assessment for therapy-only patients “for home occupational therapy ‘establishes eligibility,’” according to The American Occupational Therapy Association, Inc. (AOTA). Medicare restricts occupational therapy for home health eligibility to only when there is a continuing need. The AOTA advocates for fewer restrictions outside of Medicare, as well.

“Occupational therapy can be a valuable resource to conduct the initial visits, increasing the number of available staff to conduct initial visits, addressing home safety issues earlier and identifying established routines to share with team members for improved participation by the patient in the plan of care,” the AOTA says on its website.

Expansions Wanted


The bill comes as industry groups have pushed for more expansions in duties across the home health field. In some instances, regulations requiring strict assessment and certifications processes are challenging for agencies. For example, some agencies in Illinois have found that acquiring a physician’s signature as part of the Pre-claim Review Demonstration (PCRD) in a timely matter is difficult and adds additional administrative burdens.

In keeping with this sentiment, New York Governor Andrew Cuomo recently signed into law a bill that allows home health aides in the state who receive additional training to give medication to patients. Currently, home health aides are not allowed to administer medications, often leaving the responsibility to family caregivers.

The state will still have to draft regulations that specify training requirements, and the law is limited to home health aides who have worked at least one year, according to It will be up to 18 months before home health aides with this additional training are in the field, the news outlet reported.

Written by Amy Baxter

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