Occupational Therapy Mental Health Parity Act.
- Bill Number
- H.R. 4037
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-06-17: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-03-26T08:06:38Z
AI-Generated Summary
Purpose
The Occupational Therapy Mental Health Parity Act (H.R. 4037) aims to clarify and increase awareness of Medicare coverage for occupational therapy services specifically used to treat substance use disorders or mental health conditions. Occupational therapy involves helping people improve daily living skills, and this bill focuses on ensuring that such services are properly recognized under Medicare rules for these diagnoses.
Key Provisions
- Education and Outreach Requirement: Within one year of the bill's enactment, the Secretary of Health and Human Services (HHS) must conduct education and outreach efforts targeted at stakeholders.
- Focus Areas: The outreach will explain the Medicare Benefit Policy Manual's guidelines on occupational therapy services provided to Medicare beneficiaries for substance use or mental health treatment.
- Use of Coding Standards: These services must be billed using specific Healthcare Common Procedure Coding System (HCPCS) codes, which are standardized codes for medical procedures and services to ensure proper reimbursement.
Significant Changes to Existing Law
- This bill does not amend Medicare statutes or the Benefit Policy Manual directly. Instead, it introduces a mandate for proactive education to clarify existing coverage rules, potentially reducing confusion or underutilization without altering eligibility or payment structures.
Potential Impacts
- On Government Agencies: HHS will need to allocate resources for developing and distributing educational materials, which could involve coordination with Medicare contractors and involve minimal additional costs.
- On Citizens: Medicare beneficiaries (typically those aged 65+ or with certain disabilities) with mental health or substance use disorders may gain better access to occupational therapy, leading to improved treatment outcomes and reduced barriers to care.
- On International Relations: No direct impacts, as this is a domestic healthcare policy focused on U.S. Medicare.
Main Stakeholders Affected
- Medicare Beneficiaries: Particularly those with mental health or substance use diagnoses who could benefit from clearer access to occupational therapy.
- Healthcare Providers: Occupational therapists and related professionals who provide these services and rely on Medicare reimbursements.
- Government Entities: HHS and its Medicare administration, including the Centers for Medicare & Medicaid Services (CMS), responsible for implementing the outreach.
- Advocacy Groups: Organizations representing mental health patients, therapists, and Medicare users who may use the clarified information to advocate for services.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: Reinforces mental health parity principles (ensuring mental health treatment is covered similarly to physical health) under existing laws like the Mental Health Parity and Addiction Equity Act, without creating new enforcement mechanisms. It could lead to fewer billing disputes or denials for occupational therapy claims.
- Constitutional Implications: None significant; the bill operates within Congress's authority over federal spending programs like Medicare and does not raise separation of powers or rights issues.
- Political Implications: Supports broader efforts to address the mental health crisis by promoting equitable coverage, potentially appealing to bipartisan interests in healthcare access and cost efficiency, though its scope is narrow and administrative rather than transformative.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Kennedy, Timothy M. [D-NY-26]
Cosponsors (13)
Rep. Nunn, Zachary [R-IA-3], Rep. Davis, Donald G. [D-NC-1], Rep. Lee, Summer L. [D-PA-12], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Bresnahan, Robert P. [R-PA-8], Rep. Jackson, Jonathan L. [D-IL-1], Rep. Mannion, John W. [D-NY-22], Rep. Simon, Lateefah [D-CA-12], Rep. Balint, Becca [D-VT-At Large], Rep. Dean, Madeleine [D-PA-4], Rep. Moulton, Seth [D-MA-6], Rep. Bacon, Don [R-NE-2], Rep. Pocan, Mark [D-WI-2]
Recent Actions
- 2025-06-17: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-17: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-06-17: Introduced in House
- 2025-06-17: Introduced in House
Bill Versions
- Occupational Therapy Mental Health Parity Act. — issued 2025-06-17 — PDF (2 pages)