April 8, 2021: OOTA has recently been made aware of restrictive policy regarding OTAs by Blue Cross Blue Shield in Tennessee; specifically, BCBS of TN has indicated that an OTA requires direct/close supervision for treatments. Communication from the Ohio Academic Fieldwork Coordinators a couple weeks ago informed us a fieldwork site in TN cancelled OTA students related to this policy. At that time, OOTA reached out to the State Presidents group and Chuck Wilmarth at AOTA to determine what the breadth of the issue was. BCBS plans are state-run, so changes in one state do not necessarily mean changes across multiple states. At that time, a check of the Ohio version of BCBS (Anthem) to see if any policy changes indicated Ohio Anthem does not have any language about OTAs indicating supervision beyond the general supervision that would be consistent with our scope.
AOTA confirmed that TN is the only state to show signs of language like this within BCBS guidance, and they are working with TNOTA to advocate for necessary changes that will make the BCBS consistent with best/standard practice for OTA supervision.
Here is language shared by AOTA with Academic Program Directors last week: 

We want to assure everyone that AOTA is aware of the issue regarding the BCBS TN OTA supervision level requirement that was posted on this listserv and others yesterday afternoon.   AOTA staff has been in touch with the TNOTA leadership and is coordinating a response to advocate for OTAs.  Our preliminary research indicates that this may not be a new supervision requirement and in fact may have been in place for a number of years - it was only just discovered by a facility when performing a close review of the provider manual.  However, that is part of our investigatory process and AOTA is attempting to determine those facts.  I only mention that in order to show that if that is the case, it would demonstrate that this is has not spread to date – we are not aware of any other BCBS plans that have implemented restrictive supervision requirements for OTAs.  We are also aware of the implication from New Jersey that this is being implemented across the country because there are BCBS plans across the country.  BCBS plans are independent franchisees, so just because one plan implements a policy does not mean that it will become policy in other states or other BCBS plans.

With that being said, we encourage members who become aware of problematic insurance company policies for OTPs to please notify AOTA.  You can do so by emailing either [email protected] or [email protected].  AOTA would like to thank all of those who reached out to AOTA immediately to notify us of this particular situation.

At this time, only TN appears to be affected so if you are not providing services in TN you should not be impacted.

If you have further questions, please do not hesitate to reach out to [email protected]