Triadvocates Legislative Update - April 16, 2019

ArizOTA Members:

The Legislature has now completed nearly ninety-three days of session. The parking lot is less crowded and floor calendars are light—but that appearance is deceptive, as lawmakers have taken action on several critical bills over the past week or so, including a rapid move to repeal a portion of a decades-old law relating to HIV/AIDS education at the center of a lawsuit alleging discrimination against LGBTQ youth. The House also approved modifications to cosmetology licensing, and the governor celebrated the signing of a bill offering occupational licensing reciprocity to out-of-state professionals who relocate to Arizona. The first stage of budget negotiations – the so-called “small group” meetings – are just now starting, reviving hopes that session could wrap before May (although that remains unlikely).

Below is the most significant update of particular interest to ArizOTA:

Occupational Licensing

Last week, Governor Doug Ducey signed legislation making Arizona the first state in the country to accept out-of-state occupational licenses. The passage of HB 2569, which received bipartisan support in both chambers, represents the fulfillment of a top policy priority announced in the governor’s State of the State address earlier this year.

Under the new law, Arizona's licensing boards and commissions will recognize out-of-state occupational licenses for people who:

  • have been licensed in their profession for at least one year,
  • are in good standing in all states where they are licensed (no past or pending investigations or complaints),
  • pay applicable Arizona fees, and
  • meet all residency, testing, and background check requirements.

This law, however, does not recognize other states’ occupational licenses automatically. For example, workers licensed in other states who move to Arizona still must apply for a license through the appropriate Arizona licensing board before working. The board will be required to verify that an individual is in good standing in all states where they are licensed, and individuals seeking to work in occupations that require a background check, such as nurses and behavioral health professionals, will still need to complete those background checks. In addition, professionals receiving licenses under the new law can only become licensed in practice within areas they have been trained and certified to practice in their original state. Once cleared by respective licensing boards, workers will not be required to duplicate training and other requirements that often delay the licensure process. Occupations affected by this legislation include barbers, behavioral health professionals, chiropractors, contractors, cosmetologists, dentists, real estate agents, nurses, optometrists, pharmacists, physicians, respiratory therapists, and veterinarians, among others.

How this will impact OT specifically:

  •  An occupational therapist who is licensed in, let’s say, Nevada moves to Arizona. Before she can start seeing patients, she must first apply for a license through the Arizona Board of Occupational Therapy Examiners. The Board will then verify that she is in good standing in Nevada, has been licensed for at least one year, and will conduct a background check (A.R.S. § 32-3430 requires that the Board perform a state and federal criminal records check pursuant to A.R.S. §41-1750 and Public Law 92-544). Assuming all criteria are met, she will then, under state licensure, be permitted to begin seeing patients in Arizona—without having to complete the 928 hours of supervised fieldwork “as determined by the supervising institution, organization or sponsor” (as required for licensure under A.R.S. § 32-3423).
    •  Note: It is my understanding that all states require applicants for licensure to pass the NBCOT exam. Assuming this is correct, that aspect of reciprocity should not create any concerns.
  • The Arizona Board of Occupational Therapy Examiners, as the regulating entity, will maintain authority in respect to enforcement of the laws, rules and regulations for OTs in Arizona. Going back to the hypothetical situation with the OT who moves from Nevada to Arizona—she will be required to comply with all laws, rules and regulations for OTs in Arizona. The fact that she was originally licensed in Nevada is irrelevant once she is here in Arizona.
  • This will not affect direct access or anything currently established in OT rules in Arizona.
  • Credentialing is a separate issue.
  • Regarding jurisprudence—under the new law, the regulating entity that administers an examination on laws in Arizona as part of its licensure process (e.g., physical therapists) will still have the authority to require an applicant to take and pass an examination specific to Arizona law. Note: while this does not apply to OTs (as the Board does not administer an examination on laws in Arizona as part of the OT licensure process), several members have asked for general edification as to how this could affect PTs.

See the following link for a bill tracking a list of legislation we are monitoring for ArizOTA:

If you have any questions and/or concerns, please let us know.

Information From ArizOTA On AHCCCS Coverage And Process

This information is being provided for ArizOTA members as initial guidance from AHCCCS.  Updated information will be provided as it becomes available. Please refer to the ArizOTA contact information posted on this website.

  1. In September AHCCCS issued policy and guidance to the Acute care AHCCCS health plans. It advised that the coverage for adult outpatient occupational therapy services would commence as of October 1, the date for all health plan contract amendments to take effect. The AHCCCS policy is effective from October 1, 2017 through September 30, 2018 for acute care (as opposed to long-term care) services.
  2. All applicable parameters and requirements under AHCCCS rules, regulations and policies will apply to adult outpatient OT services.  This includes limitations on the number of visits, requirements for medically necessary determinations or referrals, and pre-authorization if the health plan requires it. 
  3. AHCCCS also advised the Acute health plans that responsibility for coverage and reimbursement lies with the health plan, regardless of whether the patient diagnosis is a physical or mental health condition. This means that an Acute health plan may not refuse to cover or pay for a condition even though it would normally refer a mental health diagnosis to a regional behavioral health authority (RBHA). This guidance applies to both juvenile and adult OT acute care services, and is in effect through September 30, 2018. For some health plans this may be an unfamiliar process, so refer them to the guidance they have received from AHCCCS.
  4. Each health plan should have a contact person who deals with provider questions or issues (this is not necessarily the same as the health plan representative to whom requests for authorization or reimbursement are submitted).  If you have an issue and are unable to identify the provider contact person, please inform ArizOTA. 
  5. ArizOTA recommends the following process for OTs seeking to resolve issues or disputes:  
  • First, attempt to resolve the issue or dispute directly with the health plan.  This may involve       more than one step, but it is important to exhaust the process that the health plan has available to resolve the issue.  

  • If the issue is not resolved by the health plan’s process, then please contact the ArizOTA President or Government Relations Committee Chairs. ArizOTA is working with the health plan trade association to set up methods of resolving issues or disputes without involving state government.  This approach is in the best interest of everyone, as it allows ArizOTA to keep track of health plan issues and avoids repeated complaints to AHCCCS.

  • If the issue cannot be resolved at the association level, then ArizOTA will assist in contacting AHCCCS to raise the issue and seek a resolution or further guidance.

  • Please do not contact AHCCCS without informing ArizOTA, and do not contact legislators or the Governor’s Office. They are not the appropriate people to resolve specific issues, and if there is a need for additional interpretation or clarification by AHCCCS or the Legislature, ArizOTA has existing processes to seek action.


Legislative Update - May, 2017

The Arizona Occupational Therapy Association (ARIZOTA) is pleased to report the enactment of its top legislative priority for 2017. This enactment amends the AHCCCS coverage statute, ARS 36-2907, to provide coverage for outpatient occupational therapy services regardless of the age of the patient, thus including adult coverage for the first time. Please note that this change will not be effective for at least 90 days, and more likely on October 1, 2017.

Click here for the legislative history of this bill.

The original bill was SB 1030, sponsored by Senator Nancy Barto, the Chair of the Senate Health and Human Services Committee. Senator Barto, who sponsored similar legislation in prior years, worked diligently to ensure the bill moved through the Senate, passing the Health and Human Services Committee, and the Appropriations Committee, before clearing the Senate on a 26-3 vote.  All three of the no votes in the Senate did not oppose the provisions of the bill but preferred that they be included in the AHCCCS budget, since the bill had a transitional cost of between $150,000 and $350,000 to the state budget.

In the House, SB 1030 passed the Health Committee without opposition. It was then held in the Rules Committee until the budget negotiations were completed.  At that point the provisions of SB 1030 were included in the Health Reconciliation Bills, HB 2542 and SB 1527. These bills do not appropriate any money, but provide direction from the legislature to the agencies and make policy changes. The budget bills were passed on May 4, at which time SB 1527 was substituted for HB 2542 on the floor of the House, and sent to the Governor on May 8. The Legislature adjourned for the year on May 10.  On May 12, the Governor signed SB 1527.

Funds for the cost of adding outpatient occupational therapy services were appropriated to AHCCCS, in the amount of $130,000 (this recognizes that the change will not be in effect for the full 2017-2018 Fiscal Year).  While the General Appropriations bill takes effect at the start of the fiscal year, July 1, 2017, the Reconciliation Bills such as SB 1527 are usually effective on the general effective date, which would be August 8, 2017. However, the contract year for the AHCCCS Health Plans, which contract and pay for covered services, runs from October 1 through September 30.  So ARIZOTA anticipates that the change to outpatient services will most likely become effective October 1, 2017. ARIZOTA will be meeting with AHCCCS during May and June to get clarification, and also to discuss whether there will be any different approach with respect to outpatient behavioral health services. ARIZOTA will provide additional information before July 1, and will cover the new changes at its fall conference.

Legislative Update February 9th, 2017

SB1030 has passed the Senate floor and will be moving to the House of Representatives. The roll call was 26 (in favor) - 3 (not in favor) - 1 (not voting). Please click the link below to find the breakdown of senators who supported/did not support the bill.

ArizOTA Legislative Update SB1030 - January 2017

UPDATE January 31st, 2017
SB1030 has passed the Senates Appropriations Committee. The roll call was 8 (in favor) - 1 (not in favor) - 1 (not voting). Please click the link below to find the breakdown of senators who supported/did not support the bill.

Please click the links below to find the information on Senate Bill 1030

Senate Bill 1030
Senate Bill 1030 Fact Sheet

The Arizona Occupational Therapy Association with the support of Senator Nancy Barto introduced senate bill 1030.

  • This bill requires Arizona Health Care Cost Containment System (AHCCCS) contractors to include occupational therapy in provided outpatient health services for adults.
  • On January 18th, 2017 the Senates Health and Human Services Committee voted 6-1 in support of the bill.
  • The bill still requires to go through more committees in order to become law.

How can you help?

  • Educate yourself on the bill. To view the bill and fact sheet please visit our website at
  • Stay up to date on where the bill is in the legislative processes by using the following link.
  • Everyones help is needed to support this bill. We urge you to contact your Senators to review and support this bill. Please do not contact house members as the bill has not reached the house yet.
  • Get to know your Senator first either online or their platform, discuss common ground and what you can possibly help them with, mention the bill and how importance it is with the impact for healthcare, ask for an email address if you don't already have one to send them.
  • Providing personal stories such as rural challenges, lack of PTs to address specific areas ADLS of stroke patients, traumatic hand injuries, etc... would be incredibly helpful.
  • To find your state senator please follow the link below and enter your address.

Please watch your emails and the ArizOTA website for updates and any call to action.

Thank you

Telehealth Update (June, 2016)

Telehealth is an emerging area of practice for OTs. Arizona's telehealth coverage law includes "Health Care Services" for the following conditions: trauma, burn, cardiology, infectious diseases, mental health disorders, neurological diseases including stroke, dermatology, and pulmonology. However this coverage only allowed for telehealth services in rural areas previously. In Arizona a bill was recently signed by Governor Doug Ducey in May of 2016 to pay for telemedicine services across the whole state and not just in rural areas increasing the amount of people who can received telehealth services. Although this is a step in the right direction there is still room for improvement. Please read the full article here:

AZ Telehealth Law

Legislative Update February 2016

Attention all OT's and OTA's!

Our legislative committee has been hard at work advocating for our profession. Our main focus for this fiscal year has been to get occupational therapy services covered for outpatient adult AHCCCS patients. We are currently in the process of getting this bill, SB1305, passed through various committee's. The bill has already passed through the Human Services Committee as well as the Appropriations Committee. We are now awaiting for it to be passed in the Rules Committee before it goes to the senate and house for a vote.

As you already know the passing of this bill would be a historic triumph for OT's and OTA's all around the state to start working with the adult AHCCCS population who would  benefit from our services greatly.

It is important for all OT's and OTA's to read and familiarize themselves with the proposed legislation. We have provided the appropriate documents below including the bill SB1305, fact sheet, and an update from our lobbyist Scot Butler. In the near future we may be requesting a call for action to assist with the passing of our bill. To keep up to date with the bill you can follow the AZ government link provided below.

SB1305 - Bill Overview and Process
SB1305 - AHCCCS; covered services
SB1305 - Fact Sheet
ArizOTA February, 2016 Legislatve Update

It is also important to know who your state legislators are in case you may need to contact them regarding this bill. One way to obtain this information please enter your information using the following website:

Please contact us with any questions or concerns at This email address is being protected from spambots. You need JavaScript enabled to view it..

Update on AHCCCS Proposed Legislation - February, 2015

At the beginning of December, Donna Gilbert and I met with the current AHCCCS government relations representative, Jennifer Carusetta. We reviewed the ArizOTA bill from 2007, under which OT and speech therapy would no longer be prohibited from receiving reimbursement for outpatient adult therapy. They were familiar with the concept and agreed to run some numerical models to see what the likely transition costs would be.

While waiting for the AHCCCS results, we contacted some legislators to work on possible sponsorship of a bill in the 2015 session. Senator Nancy Barto agreed to have a bill folder opened, but wanted to see the AHCCCS numbers before proceeding on with a bill. Regrettably, AHCCCS did not provide any numbers until Jan. 27, and the range provided was a cost of between $10.4 and $24.9 million. Needless to say, these numbers were not something that we wanted to use in connection with a bill, so we took two steps: (1) We noted for AHCCCS that in 2007 their analysis was that the cost was about $300,000, so we asked for an additional meeting; and (2) We notified Senator Barto and her staff that we would hold off seeking a bill until we could clarify some issues with AHCCCS.

The Senate bill deadline has now passed, so we will look at either an amendment or an item in the budget bills to promote the OT change. First, however, we must clarify what the costs actually are, since it is not helpful to have inaccurate numbers. A second meeting was held with AHCCCS on February 5. A complicating factor is the proposal from Governor Ducey to save money by reducing the reimbursements to AHCCCS providers by 3%. This proposal seems virtually certain to pass the Legislature, so ArizOTA will need to assess the impact of that change and whether it affects the goal of amending the adult outpatient statute.

We will advise the Board as soon as we have something from AHCCCS to report.

Scot Butler III
ArizOTA State Lobbyist

General Election Summary—Primary Results

* Denotes Incumbent

District 1 House:  Fann (R)*, Campbell (R)
District 1 Senate:  Pierce (R)*

District 2 House:  Clinco (D)*, Gabaldon (D)*, Ackerley (R)
District 2 Senate:  D’Alessandro (D)*, Estrella (R)

District 3 House:  Gonzales (D)*, Saldate (D)*
District 3 Senate:  Cajero Bedford (D)*

District 4 House: Otondo (D), Fernandez (D), Hopkins (R)
District 4 Senate:  Pancrazi (D)*, Uribe (R)

Read more: General Election Summary—Primary Results

ArizOTA Legislative Update - April 12, 2014

The Legislature passed the budget this past Monday, April 7, but the Governor had not yet acted on it. She can sign it, veto all of it, or make line item vetoes.

From the standpoint of healthcare and ARIZOTA, the budget is fairly positive. There are modest increases for AHCCCS and DHS, and no significant cuts. The key omission is funding for the new Child Welfare agency, where the Legislature issued some intent language, but the Governor will need to call a Special Session in about a month.

There are not many other bills of interest for ARIZOTA, as most of the bills on health care are quite specialized, and very few controversial ones are even still alive in the session (mostly abortion restrictions and similar bills). Obviously, the most controversial bill was SB 1062, which the Governor vetoed.

Once the budget passes, the session usually ends within 2-3 weeks. There are a couple hundred bills awaiting action, so we expect to see a lot of floor action starting this Monday. We will post a full and final report on the ARIZOTA website about two weeks after the session ends and the Governor takes action on all bills.

ArizOTA Response to DDD Rate Rebase Project

The Department of Developmental Disability (DDD) is in the process of proposing rate changes for services provided to their clients. One of the changes being looked at is the therapy rates. However, it was found that the rate difference between therapist and therapy assistants had too great of a difference. The significantly low rate for Therapy Assistants will negatively impact employers, current/future occupational therapy assistants, the occupational therapy assistant educational programs. If this domino affect happens, this will greatly impact client coverage for therapy services.

Read the Rate Rebase Project that ArizOTA Legislative Group put to together for details.

Thank you,
Jodi Lindstrom
ArizOTA President

ArizOTA Legislative Update - July 15, 2013

This is a brief legislative update for ARIZOTA members following the adjournment of the 2013 Legislative Session.  A final report will be available at the Annual Conference.

The 2013 Legislature was nearly two months late for normal adjournment when, on June 11, Governor Brewer called a Special Session to address the budget and her proposed Medicaid expansion.  In the Special Session, which adjourned on June 13, a coalition of all the Democrats and some Republicans passed a budget along the lines proposed by Governor Brewer, and also enacted her requested acceptance of the offer under the federal Affordable Health Care Act for states to increase their Medicaid eligibility to 130% of the federal poverty level and received matching funds of up to 90%.  The budget adopted by the Legislature restored some funding for both K-12 and higher education, another positive step. And the budget provided a 3% increase in the reimbursement rate for developmental disability providers, which did not make up for the 15% in previous rate reductions but was still better than nothing. The Legislature then adjourned the regular session one day later, on June 14.

ARIZOTA, along with nearly all other health care providers and many business organizations,  supported Governor Brewer and the Medicaid expansion.  This expansion will bring thousands of Arizonans back under health coverage and provide significant additional funding and services for both patients and providers. 

ARIZOTA also supported the Board of Occupational Therapy Examiners bill to clean up the confusion and problems involving supervision.  This bill, Senate Bill 1105, sponsored by Senator Nancy Barto, Senate Health Chair, passed and was signed by the Governor as Chapter 109. The bill will  become effective 90 days after the Legislature adjourned, which is September 13, 2013.

Please plan on attending the ARIZOTA Annual Conference, where the final budget and all bills of interest will be covered.