Medicare expands home health coverage for occupational therapy alone

What it does

This bill amends Medicare law to allow seniors to qualify for home health services based solely on a need for occupational therapy, rather than requiring them to also need skilled nursing or physical/speech therapy. Currently, occupational therapy alone does not trigger Medicare coverage of home health services; this bill removes that restriction, effective January 1, 2026.

Why we flagged it

The bill's sole operative function is to expand Medicare eligibility criteria for home health services by removing a restriction on occupational therapy as a standalone qualifying condition. This is a straightforward benefit-expansion amendment with no hidden mechanisms or riders.

What the text implies

• Expansion may increase Medicare home health utilization and associated program costs, though the bill contains no appropriations or cost-offset language — fiscal impact depends on uptake and CMS implementation.
• Occupational therapists and home health agencies may see increased demand and revenue, but the bill does not create new payment rates or carve-outs; reimbursement follows existing Medicare fee schedules.
• Seniors with functional limitations (arthritis, stroke recovery, cognitive decline affecting activities of daily living) who previously paid out-of-pocket for occupational therapy may shift to Medicare coverage, reducing private-pay market demand.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Medicare beneficiaries gain access to a covered health service (occupational therapy in the home) that was previously unavailable to them under the program, reducing out-of-pocket costs and improving access to rehabilitation and functional support for seniors with occupational therapy needs.

Who stands to gain

• home health agencies
• occupational therapists
• Medicare beneficiaries (reduced out-of-pocket costs)

Named in the bill

Medicare (Title XVIII, Social Security Act), Centers for Medicare & Medicaid Services (CMS), occupational therapists, home health agencies, Medicare beneficiaries

Where it stands

27 cosponsors: 14 Republicans, 13 Democrats.

• Mar 10, 2025 — Introduced · Congress.gov: “Introduced in House”
• Mar 10, 2025 — Referred to House Committee on Energy and Commerce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

3 lobbying clients named this bill on 4 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $3,428,000 in lobbying spend. A filing names 29 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 61% of bills with at least one filing.

Lloyd Smucker, the sponsor, reported $853,756 in PAC receipts in the 2026 cycle.

• America's Health Insurance Plans Inc (ahip) — $3,010,000 on 1 filing
• The American Occupational Therapy Association, Inc. (aota) — $378,000 on 2 filings
• American Occupational Therapy Association — $40,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.