Legislative News & Alerts - Independent Practice

Legislative News & Alerts
Independent Practice
This page of the Governmental Affairs Committee (GAC) area includes resources and information important to the professional practice of art therapists, including but not limited to: reimbursement, the Health Insurance Portability and Accountability Act (HIPAA), and allied health professionals.

Licensure & Reimbursement
Licensure is often believed to be an automatic steeping stone to reimbursement of one's services as a mental health professional. However, licensure alone does not guarantee direct reimbursement. The insurance industry must be mandated by state law to reimburse licensed mental health professionals- only then is reimbursement guaranteed. This is often referred to as vendorship clause within a state law or regulations.

"Vendorship" is included in licensure legislation to seek mandated reimbursement and is obtained after a licensure law has been established for a period of time. The MA licensure law is one of the only ones in the country with vendorship specifically inclusive of expressive therapies. Of course, any state that has vendorship for counseling and allows equivalent degrees in art therapy to qualify for licensure would also include vendorship for those who become licensed.

What Can AATA's Chapters Do to Promote Reimbursement of Art Therapy Services?
When there is not mandated reimbursement for services, AATA Chapters should first contact the Governmental Affairs Committee (GAC) for direction and any previous licensure and/or reimbursement history in their region or state. Notifying and working with the GAC is the an important first step and the GAC can provide advice on what groundwork needs to be accomplished, how to lobby decision-makers and insurance companies, and steps to take in terms of title protection for art therapists if it is not already in place in your state. Chapters may also find the following documents, Art Therapy and Counseling , State Counseling Licensure Boards, and the AATA Reimbursement Survey, useful in their pursuits of licensure and reimbursement.

Art therapists interested in being reimbursed in their state for work with older adults must check state laws and contact providers in their state about reimbursement from Medicare and Medicaid. Medicaid is administrated at a state level and laws for reimbursement through Medicaid vary from state to state. Art Therapy is included as a reimbursable service within Partial Hospitalization for Geriatrics. Recently, this was expanded to include Outpatient Services as well.

Health Insurance Portability and Accountability Act (HIPAA)
To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Public Law 104-191, included "Administrative Simplification" provisions that required Health and Human Services (HHS) to adopt national standards for electronic health care transactions. At the same time, Congress recognized that advances in electronic technology could erode the privacy of health information. Consequently, Congress incorporated into HIPAA provisions that mandated the adoption of Federal privacy protections for individually identifiable health information. Most employers provide HIPAA training to their employees; if you are an independent practitioner, learn more about HIPAA through the following sites:

HIPAA OnLine - This interactive tool, provided by the Federal Government, helps answer your questions about health coverage and your rights and protections under the Health Insurance Portability and Accountability Act (HIPAA). If you have clients who have questions about getting and continuing health coverage during events such as losing or changing jobs, pregnancy, moving, or divorce, you can get answers here.

HIPAA.org - Website featuring a Provider HIPAA Readiness Checklist and other resources and information related to the laws and regulations of HIPAA.

Allied Health Professionals & the Health Professions Network (HPN) Art therapy is defined by the American Medical Association (AMA) as an Allied Health Profession. Art therapists who work in hospitals or medical settings should be aware of the Health Professions Network (HPN), a group of volunteers representing health professional associations interested in interdisciplinary communication, discussion, and collaboration Participants meet at least annually to engage in discussion of issues relating to health care and to serve as a conduit for interdisciplinary problem solving and preparation for future health care delivery. AATA is represented at all HPN meetings and participates in committees and advocacy activities with the Network. The structure of HPN includes an unlimited number of participating health professional organizations and individuals interested in an interdisciplinary perspective of health care delivery. Leadership is provided by a volunteer member Coordinating Team responsible for securing the site arrangements for the next meeting and coordinating the efforts of the Discussion Teams' activities for that meeting. Topics of discussion are decided by consensus of participants and developed by interested volunteers for interaction by HPN participants. For more information about HPN, contact the GAC or visit the HPN web site at http://www.healthpronet.org/about/index.html and see http://www.healthpronet.org/ahp_month/10_03.html on art therapy as an allied health profession.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - JCAHO's mission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. The Joint Commission evaluates and accredits more than 15,000 health care organizations and programs in the United States. An independent, not-for-profit organization, the Joint Commission is the nation's predominant standards-setting and accrediting body in health care. Since 1951, the Joint Commission has maintained state-of-the-art standards that focus on improving the quality and safety of care provided by health care organizations. The Joint Commission's comprehensive accreditation process evaluates an organization's compliance with these standards and other accreditation requirements.

The Joint Commission's evaluation and accreditation services are provided for the following types of organizations:

General, psychiatric, children's and rehabilitation hospitals.
Critical access hospitals.
Health care networks, including managed care plans, preferred provider organizations, integrated delivery networks, and managed behavioral health care organizations.
Home care organizations, including those that provide home health services, personal care and support services, home infusion and other pharmacy services, durable medical equipment services and hospice services.
Nursing homes and other long term care facilities, including subacute care programs, dementia special care programs and long term care pharmacies.
Assisted living facilities that provide or coordinate personal services, 24-hour supervision and assistance (scheduled and unscheduled), activities and health-related services.
Behavioral health care organizations, including those that provide mental health and addiction services, and services to persons with developmental disabilities of various ages, in various organized service settings.
Ambulatory care providers, for example, outpatient surgery facilities, rehabilitation centers, infusion centers, group practices as well as office-based surgery.
Clinical laboratories, including independent or freestanding laboratories, blood transfusion and donor centers, and public health laboratories. From http://www.jcaho.org/about+us/jcaho_facts.htm
The Joint Commission is governed by a 29-member Board of Commissioners that includes nurses, physicians, consumers, medical directors, administrators, providers, employers, a labor representative, health plan leaders, quality experts, ethicists, a health insurance administrator and educators. AATA is represented at JCAHO meetings to monitor changes in the commission and accreditation standards.