With the closing of another year and looking ahead to a new Congress as well as a new presidential term, we can expect to see quite a few changes in healthcare policy. That’s why this week on The Amplify OT Podcast and my final episode of 2024, I am talking about healthcare changes for 2025!

As an exclusive bonus for podcast listeners, you can join the Amplify OT Collective at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy. Student plans are now available!

In this episode, I cover:

• Updates to the podcast, Amplify OT Collective, and learning platform. 
• With Donald Trump winning the election, Republicans will control the House and the Senate, making it significantly easier to pass legislation.
• What Trump’s cabinet appointments mean for the future of occupational therapy. 
• With a new year of Congress, anything that has been waiting to be passed will have to be re-introduced; this comes with its own set of implications, especially with Telehealth.
• Starting Jan. 1, 2025, Medicare Part B will allow general instead of direct supervision for OTA. 
• Caregiver codes under the Medicare Part B schedule have been expanded to include three additional codes. 
• Other Medicare Part B updates that will help reduce administrative burden and change the valuation of CPT codes, as well as a brief update to home health. 

Thanks for listening! As a reminder, I will be putting the podcast on pause for the months of December 2024 and January 2025 to bring exciting new things to the Amplify OT Collective. In the meantime, be sure to follow this podcast so you don’t miss it when I come back in February! And be sure to rate and review the show. To learn more about Amplify OT, head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

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LINKS MENTIONED IN THIS EPISODE:

• Sign up for the LIVE Webinar on December 18, 2024
• The Amplify OT Learning Platform
• Faculty: Get Your Free Trial Here
• The NPR Politics Podcast
• Ep 6: How Medicare Law is Made
• AOTA Legislative Action Center
• Ep 31: Direct Access in OT: Do I Need a Physician's Prescription?

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Join the Membership Today

The 2024 presidential election is upon us, and while healthcare plays an important role in every election cycle, this year’s election has a huge emphasis on healthcare and access to healthcare services. This, as we know, doesn’t just impact us as individuals but has an impact on our profession as a whole. That’s why this week on The Amplify OT Podcast, I am breaking down the 2024 election, covering each candidate’s platform in regards to the Affordable Care Act, ACA subsidies, Medicaid, and Medicare. 

Disclaimer: I am not endorsing any particular candidate on this podcast. This episode is meant to serve as an educational tool, as though I am from the party of occupational therapy, with a bias only about what is best for our profession as a whole. 

As an exclusive bonus for podcast listeners, you can join the Amplify OT Collective at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

KFF Comparison of Candidates Actions and Platforms on Health Policy

Note: This article is used as a reference for many of the sections below especially for Medicaid, LGBTQ, and Mental Health information. 

• Kamala Harris’ Platform
• Donald Trump’s Platform
• 2024 GOP Platform
• 2022 Election Demographics: 

• Kamala Harris Tweet/Video Referenced
• Donald Trump Tweet Referenced 
• Fact Check Graham-Cassidy Bill and Pre-existing Condition Coverage

• 2024 Marketplace Subsidies
• State-Based insurance premiums
• KFF Inflation Reduction Act Health Insurance Subsidies: What is Their Impact and What Would Happen if They Expire? 

• Medicaid Post-Partum Coverage Rate

• Harris/Walz Fact Sheet: A Historic Medicare at Home Plan to Support the Sandwich Generation
• Did Trump Propose Deep Medicare Cuts?
• Tax Policy Impact on Medicare and Social Security Insovency 

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

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CONNECT WITH AMPLIFY OT:

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As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

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While many programs appear too good to be true, PACE (Program of All-Inclusive Care for the Elderly) programs are the real deal. Courtney Barr joins me on the podcast as we dive into the transformative impact of these patient-centered, collaborative care programs. That’s why this week on The Amplify OT Podcast, I am talking about patient-centered care in action!

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

In this episode, I cover:

• What a PACE program is, who it helps, how eligibility and services are determined, and how many of these programs currently exist in the U.S. 
• Where funding for PACE programs comes from and how compensation for practitioners is billed. 
• The PACE program's patient-first model reduces administrative barriers, allowing the care team to work together and focus on patient needs first and foremost. 
• Advice for practitioners looking to pursue a role in a PACE program. 

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

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CONNECT WITH AMPLIFY OT:

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LINKS MENTIONED IN THIS EPISODE:

• National PACE Association
• Mastering Medicare Episode 25: PACE Program Deep Dive

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As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

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As clinicians, it is our job to find the balance between operating in a legal, ethical, and professional manner while always keeping the client’s well-being a top priority. As you may have experienced, these things don’t always line up and we find ourselves navigating incredibly difficult situations. We can be so quick to point out abuse from other professions, family members, etc. but can be hesitant to call out abuse when it comes to our colleagues, bosses, or other practitioners. But if we want to continue to strengthen our profession from within, it is our responsibility to recognize and address these red flags of fraudulent or unethical behavior, regardless of the consequences we may face. That’s why this week on The Amplify OT Podcast, I am talking about addressing fraud and upholding the professional integrity of OTs.

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Disclaimer: In this episode, I am sharing opinions on behalf of myself, Clarice Grote. I am not speaking on behalf of any other leadership roles I may have or organizations I am involved with. 

In this episode, I cover:

• Fraud is fraud; it’s not ok to pick and choose who we decide to report and who we turn a blind eye to. 
• Red flags for identifying fraud, inaccuracies, or unethical behavior within the profession. 
• Follow your gut, seek support, and investigate further with policies when something doesn’t feel right. 
• Resources and strategies for addressing fraud and abuse in healthcare. 

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

• Website
• Services
• Free Newsletter
• Instagram
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LINKS MENTIONED IN THIS EPISODE:

• Ep 56: Social Media's Impact on Our Professional Trust and Credibility [Strengthening Occupational Therapy from Within]
• Ep 34: Doing Your Due Diligence as a Licensed OT Practitioner with Raphie Wagner

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We tend to talk about advocacy as a way of trying to control external factors, predominantly policy and regulation, however, there is so much we can do as practitioners ourselves to change the future of our profession. One of these factors is simply how we use social media to either move the profession forward or hinder our growth. While social media is an amazing tool we can use to connect with others, in and out of our profession, we need to acknowledge that there is a lot of room for social media to drive us apart. This week on The Amplify OT Podcast, I am kicking off my Strengthening OT from Within series by talking about social media’s impact on our professional trust and credibility!

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Disclaimer: In this episode, I am sharing opinions on behalf of myself, Clarice Grote. I am not speaking on behalf of any other leadership roles I may have or organizations I am involved with. 

In this episode, I cover:

• Being an OT or an OTA is something we never turn off; we are a constant representation of our profession.
• What you post online is not only being viewed by fellow practitioners but students aspiring to be where you are; be mindful of your discouraging advice.
• The number of people who admit to or defend illegal or unethical practices on social media is shocking and not at all how we want our profession reflected. 

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

If you missed the Amplify Therapy Summit, you can catch the course replays by joining the Amplify OT Membership at amplifyot.com/membership 

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

• Website
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• Free Newsletter
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LINKS MENTIONED IN THIS EPISODE:

• Ep 54: Stop Saying "No One Knows What Occupational Therapy Is"
• Ep 16: False Claims Act - It's More Than Billing for Services That Weren't Provided

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As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today

If you’re in the Amplify OT Membership or you’ve been paying attention to the Supreme Court then you may have heard about the overturning of the Chevron deference. Regardless if you’ve joined the conversation or not, it’s time to start paying attention as the overturning of this precedence may have huge implications on the future of healthcare. Joining me to broach this topic is my father, John Miller, a lawyer with 40 years of experience in his field as he shares insights of how the legal landscape affects healthcare and what this ruling means for our profession moving forward. This week on The Amplify OT Podcast, my dad and I are talking about how the overturn of the Chevron deference will impact the future of healthcare!

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Registration is officially open for the virtual Amplify Therapy Summit July 25-27!

In this episode, we cover:

• Summarizing the 3 branches of government and their respective responsibilities.  
• The history and implications of Chevron deference and the shift in judicial approaches to agency interpretations of law.
• What this ruling means for the future of healthcare policy and reimbursement. 
• Action items for staying informed and influencing policy during the upcoming months of uncertainty. 

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

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LINKS MENTIONED IN THIS EPISODE:

• Register to Vote!

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As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today

I am standing on my soapbox when I say we have to stop saying, “No one knows what OT is”. I’ll be honest, I am guilty of this myself and am proactively working to change it because this phrase is detrimental to our profession and our perception of ourselves and prevents us from moving forward together. This week on The Amplify OT Podcast, I am sharing why we need to stop using the phrase, “No one knows what OT is” and what to do instead.

As an exclusive bonus for podcast listeners, you can join the OT Amplifiers Collective at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

In this episode, I cover:

• Updates coming to the Amplify OT Membership (now called the OT Amplifiers Collective). 
• There is a lack of awareness of what OT is and the scope of our practice, however, by further confirming this narrative, we can’t move forward. 
• We should look to overcome barriers, not let them stop us in our tracks. 
• Changing the phrase, “no one knows what OT is” to “they don’t understand OT right now” and taking ownership to do something about it.
• When explaining our profession, it’s important to consider the goals of the person you’re talking to and use language that is familiar to them. 

I understand that this episode may ruffle some feathers and that’s OK! I encourage you to join the discussion by joining the OT Amplifiers Collective and sharing your thoughts and opinions on our discussion board!

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

• Website
• Services
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©Amplify OT

Mentioned in this episode:

Join the Amplify OT Membership

As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today

As a therapy provider, you will see many insurance types including private insurance, Medicare, Medicaid, as well as others. That’s why this week on The Amplify OT Podcast, I am talking about how insurance impacts our plan of care!

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

In this episode, I review the common insurance terms and how visit limits and therapy coverage can impact how and when we provide care.

Grab the FREE Billing Guide at: https://amplifyot.com/billing/ 

Check out the link to the Amplify OT article on this topic: https://amplifyot.com/health-insurance-in-occupational-therapy-plan-of-care/

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

• Website
• Services
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©Amplify OT

Mentioned in this episode:

Join the Amplify OT Membership

As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today

Often skilled nursing facilities (SNF) and nursing homes are used interchangeably as many facilities offer both services, however, they are two separate things. With the negative stigma surrounding nursing homes, it is important to know the difference between the two and use proper terms when communicating with your patients and their families. That’s why this week on The Amplify OT Podcast, I am talking about the differences between skilled nursing facilities and nursing homes so you can better communicate the right care with your patients!

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

In this episode, I cover:

• The fundamental differences between SNFs and nursing homes come down to the reimbursement, type of services provided, and length of stay. 
• Statistics on SNFs and nursing homes, including ownership, profit status, and services offered. 
• Medicare and Medicaid’s role in funding these facilities and how this affects the services that patients receive. 
• Practical tips on discussing care options with patients, alleviating common fears, and overcoming the stigmas associated with these facilities.

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919)-341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

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LINKS MENTIONED IN THIS EPISODE:

• CMS.gov State Operations Manual- Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities
• U.S. Bureau of Labor Statistics: Occupational Employment and Wage Statistics for SNFs (May 2023)
• CDC.gov Nursing Home Care Statistics
• CMS.gov Health & Safety Standards: Nursing Homes 
• CMS.gov Skilled Nursing Facility Center
• ASPE Office of Health Policy: Ownership of Skilled Nursing Facilities

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As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today

You may have heard (or even said) that Medicare Advantage is great if you’re healthy but terrible if you’re sick. But why is that? This week on The Amplify OT Podcast, I’m sharing what Medicare Advantage is, why it’s popular, despite these claims, and how it has expanded into the Medicaid space with managed care organizations (MCOs).

Join the Amplify OT Membership

As an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

In this episode, I cover:

• Benefits and barriers that come with Medicare Advantage plans.
• The difference between traditional Medicare and Medicare Advantage. 
• Why managed care plans (MCOs) are popular, especially for governments. 
• Current and proposed regulatory changes that affect these plans and us as practitioners. 

Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ 

Have a question or just want to say hello? Call or text +1 (919) 341-9289 to have your questions answered on the podcast! *Message and Data Rates May Apply

Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

CLICK HERE to save 40% off Medbridge Today!

CONNECT WITH AMPLIFY OT:

• Website
• Services
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LINKS MENTIONED IN THIS EPISODE:

• Ep 50: Volume-Based vs. Value-Based Reimbursement Models in OT
• CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process [CMS.gov Article]
• Medicare Advantage in 2023: Enrollment Update and Key Trends [KFF.org Article]
• Medicaid: Last Week Tonight with John Oliver [YouTube]

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Mentioned in this episode:

Join the Amplify OT Membership

As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

Join the Membership Today