On June 10, 2010, the Industrial Commission of Arizona (ICA) held their annual public hearing to discuss recommended changes in the Physician’s Fee Schedule. The Physician’s Fee Schedule (PFS) is a manual, containing guidelines in medical procedures, coding and unit value for services. Occupational Therapy usually bills According to the Physical Medicine Guidelines and Special Services.
The focus of this year’s hearing was to update the Fee Schedule by incorporating the changes in the AMA 2009 CPT 4 Edition. (Current Procedural Terminology) as well as, review the values of new and selected codes.
Budget issues continue to dominate the legislative process in 2009, with very little progress in the past two months. No further action on the current year (FY2008-09) budget is planned, since the state will use federal stimulus monies to fund any additional deficit that arises in the next two months. Some budget cuts from the February 1 budget adjustment bill have now been mitigated, either through court action or legislative correction. These include restoration of some DES and DHS cuts, such as developmental disability, child care and behavioral health. In addition, the AHCCCS recheck of eligibility was moved back from 6 months to 12 months, so that the state could qualify for $1.6 billion in health care stimulus funds (this change can be reversed later by the legislature if it wishes).
The 2009 session of the Arizona Legislature convened on January 12. The state budget is the predominant issue for the session, both with respect to a deficit in the current fiscal year (2008-09) of about $1.6 billion, and a projected deficit for the next fiscal year of at least $3 billion. On February 1, the Legislature completed a special session to fix the current year, with substantial cuts to K-12 education, DHS, DES, AHCCCS and university funding. Of particular significance to ARIZOTA was a provision in the original budget bill that would have eliminated all AHCCCS coverage for both outpatient therapy (PT, OT and Speech) and durable equipment, prostheses and supplies such as oxygen. While these restrictions were deleted in the final version, the structure for doing so was to have AHCCCS perform a complete review of all coverages to assess effectiveness and cost. Accordingly, ARIZOTA will put its outpatient reimbursement bill on hold while it works with AHCCCS on demonstrating the cost effectiveness of such services.
An additional complication is that the Senate will not assign bills to committees for hearings until the new budget is completed. As a result, no bills have been heard in the Senate, and the House Committee hearings have been moving slowly, with very little floor action outside the special session on the budget fix.
Both houses have nearly entirely new leadership. House Majority Leadership is: Speaker, Kirk Adams; Majority Leader, John McComish; Whip, Andy Tobin. House Minority Leadership is: Minority Leader, David Lujan; Assistant Minority Leader, Kyrsten Sinema; Whip, Chad Campbell. Senate Majority Leadership is: President, Bob Burns; Majority Leader, Chuck Gray; Whip, Pamela Gorman. Senate Minority Leadership is: Minority Leader, Jorge Garcia; Assistant Minority Leader, Rebecca Rios; Whip, Linda Lopez. The House Health Committee Chair is Nancy Barto. The Senate Health Committee Chair is Carolyn Allen.
Bills of interest are listed below:
House Bills
HB 2015. County Retiree Health Coverage (Konopnicki). Repeals ban on small counties using public funds to pay for retiree health insurance.
HB 2158. Immunization Info (Barto). DHS must establish adult immunization information system.
HB 2205. Behavioral Health (Barto). Creates task force to assess the State’s behavioral health system.
HB 2207. Behavioral Analysts (Barto). Delays the starting date for regulation of behavioral analysts by the Board of Psychological Examiners.
HB 2237. AHCCCS Eligibility (Seel). AHCCCS must verify immigration status.
HB 2238. AHCCCS Fraud Reduction (Seel). AHCCCS must contract for fraud reduction technology and services.
HB 2324. Individual Health Policies (Boone). Allows health insurers to offer individual policies that are exempt from some mandatory coverages.
HB 2358. Learning Disability Designations (Crandall). Changes designations of some categories of learning disabilities in education statutes.
HCR 2005. Mental Health Coverage (Ableser). Resolution supporting full mental health coverage by insurers.
Senate Bills
SB 1014. ALTCS Eligibility (Harper). ALTCS eligibility is limited to persons with income no greater than 50% of federal poverty level.
SB 1018. Emergency Room Standard of Care (C. Allen). Medical malpractice standard of care for emergency rooms.
SB 1049. Fingerprint Clearance (L. Gray). Numerous changes to fingerprint clearance, including higher level for certain child services providers.
SB 1325. Individual Health Policies(Leff). Individual health insurance policies may exclude some mandated coverages.
Final Legislative Committee Report September 15, 2008
The 2008 Session of the Arizona Legislature convened on January 14 and adjourned on June 27. There were no bills with adverse effect on occupational therapy, and the major issue by far was the state’s budget situation.
The two specific bills of interest that were enacted both involved the Board of Occupational Therapy, the licensing body for OTs and COTAs. The Board went through its ten-year sunset review, and the Legislature extended it for another ten years. In addition, the Board itself introduced a bill to rewrite most of the disciplinary and enforcement provisions, and some of the licensing provisions. Much of this legislation was proposed in preparation for significant rule changes the Board will be considering.
On the budget, the Legislature closed a $1.8 billion dollar deficit in April, and then had to solve an additional $2.2 billion shortfall in June, in order to adopt a budget for Fiscal Year 2008-09. Fortunately, most of the state agencies and programs for which OT services are provided--AHCCCS, DES, DHS, Department of Education, and so on--did not receive drastic cuts. However, a portion of the accumulated funds generated by fees and held by the Board of Occupational Therapy to cover licensing and enforcement costs were swept into the general fund. ArizOTA, along with several other associations representing licensed health care professionals, anticipates seeking repayment of the swept amounts.
Unfortunately, the state budget situation has worsened, and a special session appears likely some time after the November election. Such a session, or action in the 2009 regular session, to address at least an additional $1 billion deficit, could well result in actual program cuts or larger fund sweeps, or both. The ArizOTA Legislative Committee will be tracking any proposals very closely, and will be working jointly with other health care organizations to protect key service and program areas.
During this past legislative session, the legislative committee and our lobbyist
Scot Butler has been working on an out- patient reimbursement bill,
to provide out-patient occupational therapy services for Arizona Health Care
Cost Containment System (AHCCCS ) individuals who are 22 years of age or older.
Individuals who are on AHCCCS may receive occupational therapy services as
in-patient (both acute care and rehabilitation services) and out-patient if
they are 22 years and younger. Individuals are also eligible once they get on
ALTCS (AZ long term care system) to receive out-pt occupational therapy services.
We opened SB 1526, in the beginning of the legislative session,(January 2007)
which would have provided AHCCCS coverage for out-patient Occupational Therapy
and Speech services for adult patients.
This bill passed the health committee, but died due to an inaccurate fiscal
report. Scot Butler our lobbyist was able to provide the correct information,
but the damage was done.
The bill was revived as an amendment to HB 2516; the bill was approved by the
health committee. The bill was able to by pass the appropriation committee and
was in the rules committee, awaiting the budget process
The bad new is: bill HB 2516 did not make into the budget. The bill has officially
died. The good news is: Occupational Therapy and the need for Occupational Therapy
services have been discussed and there are many individual in favor of OT services
for AHCCCS at the out-patient level.
The committee will continue to work on this issue during the next legislative
session.
The legislative committee meets monthly, the next meeting:
September 11, 2007 at
The meetings are held at Scot’s Butler office: 917 W Mc Dowell Rd
If you have any questions or would like more information about the legislative
committee, contact:
Association Info 
