History
Medicaid initially only covered whom?Medicare?
Medicaid-Individuals who required cash assistance.
Medicare-Americans who did NOT have health insurance.
What Occupational therapy theory or model was created around this time 1960-1965?
Occupational Behavior by Mary Reilly
During which war did the U.S. experience a shift from States to the Federal Government as the preferred administrator of health insurance?
The Second World War
Medicare Part A covers this type of medical care include care provided in a hospital, SNF, hospice, or home.
Inpatient
What does SSI stand for?
Supplemental Security Income
Who signed the Medicare/Medicaid Act of 1965 into law?
President Lyndon B. Johnson signed them into law on July 30, 1965 in Independence, MO.
After Medicare and Medicaid laws were enacted there was a shift in the____
CMS shifted patient treatment focus and ended up decreasing the about of beds patients would take up, the financial loss of hospitals and and increase in care
What setting was early proposals of the act focused on?
Hospital settings
This law, which was signed in 2010, expanded access of health care insurance coverage for millions of uninsured Americans as well as advocating for OT practitioners, consumers, and services overall.
Affordable Care Act/Obamacare
What does ABN stand for?
Advanced Beneficiary Notice
How is Medicare funded? Medicaid?
Medicare - Payroll taxes paid by most employees, employers, and people who are self-employed. And other sources including interest earned on trust fund investments, income taxes pain on SS benefits, and Medicare Part A premiums from people who aren’t eligible for premium-free Part A.
Medicaid -The Medicaid program is jointly funded by the federal government and states. The federal government pays states for a specified percentage of program expenditures, called the Federal Medical Assistance Percentage (FMAP).
Why was medicare/medicaid law created
To give the more than 56% of the population over 65 health insurance, since they could no longer get it from work
What was President Kennedy’s rationale for the act, related to a global scale?
U.S. was behind, as most of Europe already has a similar system in place.
Under Medicare Part B, this term is used to describe two therapists of the same or different discipline may simultaneously provide service care for a patient.
Co-treatment
What does PACE stand for?
PACE stands for Program of All Inclusive Care for the Elderly.
Why did Congress choose to focus on the growing elderly population?
Many Americans were being covered by work insurance
In regards to the Medicare therapy cap on outpatient services, these two services are combined while there is a separate amount for just OT services
Speech Language Pathology (SLP) and Physical Therapy (PT)
What services were deliberately excluded from early drafts of the act?
Physician Care
This program incorporated a therapist to use G-codes, corresponding severity modifiers, and therapy modifiers to see the connection between rehab therapy and a patient’s progress during the initial evaluation, progression of treatment, and discharge.
Functional Limitation Reporting (FLR)