Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982, as well as the subsequent amendment clauses provided for the state, paid medical assistance for children with disability. Under this act, children living with a disability can receive occupational therapy under a state-sponsored medical program. The act further states the criteria for eligibility to this program. The medical assistance under this act is mainly provided to children below 19 years of age and from families with relatively low income per person. Therefore, the act seeks to make occupational therapy available to children from underprivileged backgrounds.
The Direct Influence of TEFRA in Medicare
The provisions of TEFRA have greatly helped in enhancing the field of occupational health through the adoption of prospective payment systems in Medicare (Liu, 2001). Previously, hospitals were reimbursed for the services rendered by relying on what they projected in their budgets. However, the adoption of TEFRA had a significant effect on Medicare because hospitals payments were premised on the actual costs especially on special care and inpatient services (Liu, 2001). Notably, the cost of occupational therapy for disabled children is very high. Consequently, most medical health insurance covers are either not willing to cover or require exorbitant premiums for this medical coverage. It had previously limited the ability of most families with disabled children to obtain occupational therapy. The enactment of TEFRA has greatly enhanced the field of occupational therapy by enabling children from underprivileged families to access the health services as the provisions of Medicare dictate. Consequent, the client base of occupational therapists have greatly improved. More, the increase in complexity of cases presented by the diverse clientele necessitates further research and hence the development of the field of occupational therapy.
Delegate your assignment to our experts and they will do the rest.
In the rehab setting, TEFRA reimburses several services offered to children covered under this medical assistance program. First, the TEFRA reimburses the cost of therapy for the severe emotional disturbance that leads to mental illness and disability for the child. Secondly, the program reimburses the cost of therapy for mental illness that hinders the normal learning and development abilities of the child. Moreover, the reimbursement covers both short-term as well as long-term stay at the rehabilitation facilities (Thompson, 2002). This helps eligible children to get adequate and comprehensive therapy.
Populations Affected
The major populations affected by the provisions of TEFRA are children with disability particularly from the underprivileged families. This group of children has been positively affected by TEFRA in several ways. For instance, TEFRA has enabled them to access quality occupational therapy that would otherwise been beyond their ability (Gray & Metwalli, 2008). As already mentioned, the cost of occupational therapy is beyond the reach of many poor parents. Before the enactment of this act, disabled children from such families often remained in their state of disability, and the related limitations such come with such disability such as difficulties in learning and development. Therefore, TEFRA bridged the financial gap to ensure that this group of children was able to access therapy and effectively carry out activities that matter to them (Riley, 2013). Therefore, such children were the greatest beneficiaries of TEFRA.
TEFRA affects several diagnoses in children leaving with a disability. These diagnoses include mental retardation, developmental delays, cerebral palsy, learning disabilities and congenital anomalies among others. TEFRA covers therapy cost for children are mentally retarded to help them study and interact with other children comfortably (Riley, 2013: Cms.gov. (n.d.) ). Learning and development is a critical process in children. It enhances their cognitive ability as they grow up and helps them in their normal education programs. Therefore, children diagnosed with learning disabilities have equally obtained great benefit from the enactment of TEFRA.
The diagnoses identified above are affected by TEFRA in several ways. First, such conditions are mainly affected by children and identified at childhood level. Since TEFRA covers children, it therefore directly affects the diagnosis of such disability conditions that affect children. Secondly, effective therapy of such conditions heavily relies on early detection and diagnosis (Gray & Metwalli, 2008). Such early detection and diagnosis are efficient during the formative stages of a child. TEFRA guarantees the support that enables early detection and diagnosis of such disabilities in children. Therefore, TEFRA has a great influence and impact on the diagnosis identified above.
The impact of TEFRA on the diagnoses identified above as well as other diagnoses has greatly affected the outcome of the recovery process. Liu (2001) shows that the early detection and diagnosis of such disability conditions that TEFRA has enabled particularly among children from less privileged families have greatly contributed to the effectiveness and success of their therapy. When therapy begins early enough, the chances of its success are very high. As such, TEFRA has increased the effectiveness of diagnosis and therapy in general. Secondly, TEFRA pays for all the expenses for both a short as well as a long stay at rehabilitation and therapy facilities. Consequently, the diagnosed children are exposed to a conducive and supportive environment that largely contributes to the positive outcome of their therapy (Rao, 2012: Cms.gov. (n.d.) ). Therefore, the positive therapy outcome occasioned by the support of TEFRA has affected positively to the result in this context.
Reflections on What I Learned from the Assignment
This assignment has been very insightful to me concerning TEFRA its effect on occupational therapy. First, I have learned about the immense benefit and support that the enactment of TEFRA as well as the subsequent legislation has given to children with disability from underprivileged and low-income families. Without such support, most of these children would have failed got get any occupational therapy that they need. The high cost of such therapy has made it impossible for most low-income families to afford such therapy (Riley, 2013). Moreover, most insurance companies are unwilling to cover such medical expenses.
Secondly, this assignment has enabled me to identify how the enactment of TEFRA has greatly contributed to the development of the field of occupational therapy. I have learned that the increase in the number of clients seeking therapy has motivated many people to take up occupational therapy as a career. This goes n line with Thompson (2002) assertions that the increased clientele and diversity of cases occasioned by the support of TEFRA have necessitated further research in occupational therapy. Therefore, this assignment has enabled me to understand how the support provided for by TEFRA has greatly contributed to the field of Occupational therapy and revolutionized the entire profession.
Lastly, I have learned how the enactment of TEFRA supports the diagnosis of several disabilities and overall leads to positive outcomes in occupational therapy. The support that TEFRA has offered to underprivileged children has enabled them to therapy at early stages. This early detection and therapy contribute immensely to the positive outcome of the therapy. Secondly, the funding provided by the medical assistance program has greatly enhanced their ability to stay in rehab centers. In the end, they have been exposed to an environment that supports therapy and consequently leads to the positive outcomes.
Overall, TEFRA has greatly contributed positively to the development of the field of occupational therapy. It has further contributed to positive outcomes in such therapy. Therefore, there is need to support the program. Subsequent laws must now focus on how the program will be inclusive and reduce the rigidity of its eligibility criteria. In the end, it will further contribute to the revolutionizing of occupational therapy.
References
Gray, W. M., & Metwalli, A. M. (2008). Tax Equity and Fiscal Responsibility Act of 1982: An incentive to improve productivity in healthcare. Health Care Management Review, 12 (2)
Liu, K. (2001). Long-Term Care Hospitals under Medicare: Facility-Level Characteristics. HEALTH CARE FINANCING REVIEW/Winter 2001/Volume 23, Number 2. From https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/downloads/ltchurban.pdf
Rao, A. K. (2012). Occupational therapy in neurological disorders: looking ahead to the American Occupational Therapy Associations Centennial Vision. American Journal of Occupational Therapy, 66 (6).
Riley, J. (2013). Occupational science and occupational therapy: A contemporary relationship. Using Occupational Therapy Theory in Practice, 5 (4), 165-179.
Thompson, S. (2002). The Effect of the Tax Equity and Fiscal Responsibility Act of 1982 on Medicare and Medicaid reimbursement to hospitals. Hospital Topics, 60 (6), 8-11.
Cms.gov. (n.d.). Medicare Benefit Policy Manual. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c02.pdf
