Free market
an economic system in which prices are determined by unrestricted competition between privately owned businesses.
Principle of Free Market:
§Supply and demand
§Competition
§Free choice based on information
Managed care
Managed care refers to providing services by a limited number of professionals for a fixed prepaid fee (capitated payment).
Payment Sources: Who pays for OT services?
Medicare
A federal program for people over 65 years and some individuals with long term disabilities”
Payment Sources: Who pays for OT services?
Medicaid
A state-run program for people who have limited income or high medical expenses..”
Payment Sources: Who pays for OT services?
Workers’ compensation
A state-administered program for workers injured on the job”
Payment Sources: Who pays for OT services?
Rehabilitation services administration
A federal agency that funds state vocational rehabilitation and independent living support services”
Payment Sources: Who pays for OT services?
Commercial insurance
Privately owned companies (HMOs, PPOs)”
Payment Sources: Who pays for OT services?
Out-of-pocket payment-
Recipients pay for services in case due to no insurance or a high deductible”
Americans with Disabilities Act (ADA):
- prohibits discrimination against individuals with disabilities in all areas of public life,
- Ensure people with disabilities have the same rights and opportunities as everyone else.
- Guarantees equal opportunity for individuals with disabilities in public accommodations, employment, transportation, state and local government services, and telecommunications.
Individuals with Disabilities Education Act (IDEA):
originally known as the Education of Handicapped Children Act, passed in 1975. …
-This federal legislation is designed to ensure that children with disabilities be granted a free appropriate public education (FAPE) in the least restrictive environment (LRE)
State Practice Acts
. The entire practice act, including accompanying rules, constitutes the law governing physical therapy practice within a state
Local jurisdiction requirements
(e.g., school system requirements)
Difference between licensure and certification:
§Licensure:
- provides the highest level of public protection by prohibiting unlicensed individuals from practicing occupational therapy or referring to themselves as occupational therapists/occupational therapy assistants.
- Licensure laws reserve a certain scope of practice for those who are issued a license.
Difference between licensure and certification:
Mandatory Certification:
- protects the public by prohibiting uncertified persons from referring to themselves as occupational therapists/occupational therapy assistants.
- Unlike licensure, individuals under certain circumstances can practice if they do not refer to their services as occupational therapy.
- Certification laws may provide for a definition of occupational therapy.
