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For Governor Cuomo: A lesson about the nature of the insurance industry
I have used this space as well as our Facebook page to chronicle the ongoing problems with municipal takeover of health care.  The problems with billing and payments to health care providers has gotten a lot of press lately and Governor Cuomo and his administration are taking some very well deserved lumps for their inept management of the Bureau of Early Intervention.There is an apparent inability to understand the nexus of their legislative and regulatory fiats with the corresponding impact on service delivery.  All we get from our government is statements that the problem lies with private insurers that have fa...
Source: ABC Therapeutics Occupational Therapy Weblog - August 8, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

More transparency to help in analysis of the NYS Early Intervention Program billing problems
On 7/15/13 I posted about how the interim State Fiscal Agent appeared to be trolling NYS Early Intervention Service Providers for private business.In the interest of transparency, I wanted to update that issue.In the email I referenced how UNYEIP stated that Director Hutton would write financial hardship letters for providers who have not been paid.  I attempted to verify this and the Bureau of Early Intervention would not admit that they would do this; this is the email that I received from them:I was not able to find out anything further about hardship letters.  However, BEI made the announcement below on Fri...
Source: ABC Therapeutics Occupational Therapy Weblog - August 5, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

Historical roots of occupational therapy: It is easy to forget
To paraphrase J.R.R. Tolkien...History became legend, legend became myth – and some things that should not have been forgotten … were lost.In Glen Gillen's Slagle lecture at the 2013 AOTA conference he stated "We need to reclaim what we do..."  This is not the first time that there has been a call back to our roots - we periodically re-visit this theme in occupational therapy.  In order for us to develop a plan to 'reclaim what we do' we need to KNOW what we did.  And why we did it.  And what set us on the path to begin with.In a previous entry in this series I showed how Dr. L...
Source: ABC Therapeutics Occupational Therapy Weblog - August 1, 2013 Category: Occupational Therapists Tags: history Source Type: blogs

Social Justice: What would Dr. Kielhofner say?
This article draws sharp distinctions between resident perceptions of barriers (being more systems-oriented) and staff perceptions of barriers (being a combination of systems and personal/client factors).  The authors suggest that there are no clear answers about how to resolve these differences, although they state that some integrated understanding of disability studies within a Model of Human Occupation (MOHO) context might be fruitful.  Again, this article seems to be rather even handed.In my understanding of MOHO, there is little need to integrate some new model because MOHO itself is based on a broad Genera...
Source: ABC Therapeutics Occupational Therapy Weblog - July 25, 2013 Category: Occupational Therapists Tags: Disability rights OT Education OT practice Source Type: blogs

Historical roots of occupational therapy: A beginning explanation for the inquiry.
In the previous installment I talked about the curious letter from Dr. Licht to Dr. Copeland, who was the Mayor of Clifton Springs, NY.  It was curious because Dr. Licht was so closely connected to Dr. Dunton, who was a Founder himself and attended the initial meeting at Consolation House.Looking back at the 50th year celebration of AOTA, we can see that Isabel (Newton) Barton, the wife of George Barton, was alive when Dr. Licht made his initial inquiry in 1967.  She even wrote an article that appeared in AJOT in 1968 about her memories of Consolation House.  This exemplifies the (probable) difficulty of inf...
Source: ABC Therapeutics Occupational Therapy Weblog - July 23, 2013 Category: Occupational Therapists Tags: history OT practice Source Type: blogs

Historical roots of occupational therapy: Introduction to a series
I have been sitting on some historical source material for quite some time.  I have been studying the material extensively, trying to decide the best way to share the information, and at times just putting it all aside out of frustration.When students learn about the founding of the occupational therapy profession they tend to read simple information in textbooks and it is somewhat devoid of context.  History without context provides opportunity for misinterpretation, and this is something that I believe is important to try to avoid.  I am not a historian and I am not a biographer and I think this ...
Source: ABC Therapeutics Occupational Therapy Weblog - July 21, 2013 Category: Occupational Therapists Tags: history OT practice Source Type: blogs

More on the NYS 'negotiated' rates and what it might mean for the future of the early intervention program
There was some very important information in the Early Intervention Billing FAQ that was distributed via email today:Q: ­If a provider accepts a lower rate for a payment from an insurance company, the municipality will bear a larger portion of the expense, correct?A: If a provider accepts a negotiated rate of payment and that payment from the insurer is made in an amount less than the State-approved early intervention rate for the service provided, the ISFA will process payments for the balance due the provider from the escrow account using municipal funds at State established rates for the EIP. Billing providers will rec...
Source: ABC Therapeutics Occupational Therapy Weblog - July 19, 2013 Category: Occupational Therapists Tags: health insurance OT practice Source Type: blogs

'Occupation' or 'function' as best descriptors for OT practice?
It is too hot to go outside and do anything and I had to shut down my office as we lost power in a (presumed) brownout so I came to my home office and have been trolling around the Internet all afternoon.  That rarely ends productively, but I was really happy to run across some comments from today's #occhat where there was a debate about use of terminology in the profession.I want to strongly encourage people to go read the Letter from the Editor in the Spring 2013 Open Journal of Occupational Therapy written by Diane Powers Dirette. In this letter she discusses issues related to terminology in the field related to us...
Source: ABC Therapeutics Occupational Therapy Weblog - July 17, 2013 Category: Occupational Therapists Tags: OT Education philosophy OT practice Source Type: blogs

Emails about early intervention while I was on vacation!
I was on vacation last week and had MANY emails about early intervention and billing in my inbox.  The most interesting one was from Chris Weis who states that he is a product manager for some billing software that is sold by the interim State Fiscal Agent for the NYS Early Intervention program.  It was my favorite email so I thought I would share my response that I copied to the EIP as well.  His initial email is in blockquote below.For background, I will again mention that I think transparency is important and that is why I post this information.  This blog is not chock full of great ideas about treat...
Source: ABC Therapeutics Occupational Therapy Weblog - July 15, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

A Fourth of July message for the occupational therapy profession
I write this second installment regarding public health in an attempt to document the pathway that the occupational therapy profession has taken with regard to its perspective on client autonomy, client-centered occupational therapy practice, and now calls to move toward public health models of intervention.An analysis of this topic can correctly start all the way back to the founding of the profession - including conversations about the musings of George Barton as he convalesced from tuberculosis - but for purposes of controlling the length and depth of the analysis I feel comfortable restricting the conversation to what ...
Source: ABC Therapeutics Occupational Therapy Weblog - July 4, 2013 Category: Occupational Therapists Tags: OT Education philosophy OT practice Source Type: blogs

Will a public health model make occupational therapy more relevant?
I just finished watching the COT 2013 Annual Conference plenary by Michael Iwama.  You can listen to his lecture by clicking here.  Hopefully we will have accompanying slides in the near future.  I was very anxious to listen to this presentation after watching the Twitter feed coming from the conference that included statements about our 'preoccupation with the individual' and that our 'practice has stalled' and that we were at a crossroads where we had an opportunity to take on a new role in a broader public health initiative.I was a little concerned about some of these statements and was not sure that I ag...
Source: ABC Therapeutics Occupational Therapy Weblog - July 3, 2013 Category: Occupational Therapists Tags: OT Education philosophy OT practice Source Type: blogs

Remember what was in the 2013-2014 NYS Executive Budget?
Go and remind yourself of Governor Cuomo's ideas for Early Intervention!!READ FROM PAGES 266-274 TO REMEMBER WHAT WAS PROPOSEDProviders, please remember! If the Governor had his way you would have been negotiating rates directly with third party payors.  NOW they say "Go ahead and just accept whatever they are willing to pay."NEXT YEAR they will probably try to put this language in again - and then you will regret JUST ACCEPTING whatever they are willing to pay.Sorry for the CAPS, but everyone needs to understand this and write a letter to the Bureau of Early Intervention and tell them that you WILL NOT just accept wh...
Source: ABC Therapeutics Occupational Therapy Weblog - June 28, 2013 Category: Occupational Therapists Tags: health insurance OT practice Source Type: blogs

Unintended consequences of NYS Early Intervention Payment Policies
We received this email from the NYS Bureau of Early Intervention today. I would like to advise providers as well as the Bureau of the potential unintended consequences of this policy Dear Colleague: The Bureau of Early Intervention has recently received numerous inquiries regarding agreements being sent to EIP providers by insurers or insurer clearinghouses in response to claims submitted for EIP services. The agreements ask EIP providers to accept claim amounts proposed by the insurer as payment in full from the insurer for the claim which are lower than the State-established EIP rate.This is to advise EIP provid...
Source: ABC Therapeutics Occupational Therapy Weblog - June 27, 2013 Category: Occupational Therapists Tags: health insurance OT practice Source Type: blogs

On arthritic knees and the hope of telerehabilitation
OK so there are days when I start wondering how many years I am going to spend crawling around on the floor with children.  Sometimes I just wonder how many miles are meant to be crawled in a lifetime.  This leads to thoughts about how appealing academia might be where I can spend a greater amount of my time sitting instead of running/hopping/crawling/etc.The concept of telerehabilitation appeals to me - instead of/in addition to academia maybe a career in telerehabilitation is another option for my decrepit knees?  I have no inherent bias against telerehabilitation; in fact, I kind of think it would be grea...
Source: ABC Therapeutics Occupational Therapy Weblog - June 13, 2013 Category: Occupational Therapists Tags: evidence-based practice school-based practice OT practice Source Type: blogs

Child passenger safety: A question about the epistemic culture of occupational therapy.
Well.  I sometimes write the titles to my blog posts before I write the posts themselves.   That is what happened with this post, but now I am derailed but I am going to keep the title because it is still apt.I just finished reading the June 3, 2013 issue of OT Practice.  The cover story is entitled 'On the Go: Safely Transporting Children with Special Health Care Needs.'  This is an excellent article, full of practical and relevant information about the topic.  The Riley Hospital for Children at the Indiana University School of Medicine has blazed this trail for years and years - and that fact ...
Source: ABC Therapeutics Occupational Therapy Weblog - June 6, 2013 Category: Occupational Therapists Tags: child passenger safety OT Education Source Type: blogs