Legislative Information

Policy impacts practice.  The Texas Occupational Therapy Association is committed to being proactive relative to legislative issues that impact you, the practitioner, and the clients we serve. We hope that you will find the information here helpful as you advocate for your profession and your future.  

 

Reimbursement Rate Reductions by Private Insurance Groups - What Can a Professional Association Do?  

State associations cannot and do not have the power to negotiate reimbursement rates for providers. By doing so they could risk violating anti-trust laws.  The laws are designed to protect the consumer and providers are considered sellers.  Insurance companies are considered buyers and buyers are consumers. 

Per the Federal Trade Commission, trade associations such as TOTA may represent its members before legislatures or government agencies, providing valuable information to inform government decisions.  State associations must be careful not to encourage, signal, or promote a boycott of an insurer.  The role of state associations can only be to educate our members. TOTA is committed to providing education and resources to our members on topics such as: 

  • Service denial management. 
  • The use of appropriate billing codes for services rendered. Companies or clinics that typically use the billing code that yields the highest reimbursement rate for all the services provided could be charged with upcoding.
  • Anti-trust laws 

TOTA will focus on empowering our members with knowledge and resources to build and maintain their private practice businesses.  AOTA already provides a wealth of information for entrepreneurs.  You will find them under Private Practice Essentials . We look forward to continuing to serve our members in 2024.  If you have questions or comments, please submit them here 

Familiarize yourselves with the CPT codes available for use and ensure you are using the most appropriate code for the services you are providing.  Click Here for a list of CPT® codes frequently used by occupational therapy practitioners.

 

Got Advocacy? 
Would you like more information about TOTA's role in state Advocacy? 
Would you like quick tips on what you can do today to improve your advocacy for tomorrow? 
TOTA is now offering free presentations for students and practitioners via zoom.  
If you are interested, email [email protected] to request a presentation for your class, clinic, or department.  

  

TOTA PAC:

The Texas Occupational Therapy Association Political Action Committee (TOTA PAC) is a state bipartisan political action committee. TOTA PAC provides financial support to candidates for state offices that support the profession of occupational therapy. 

Other Information: