American Music Therapy Association, Inc.
8455 Colesville Road, Suite 1000
Silver Spring, Maryland 20910, USA
Phone: (301) 589-3300
Fax: (301) 589-5175
E-mail: info@musictherapy.org

Music Therapy and Public Policy
AMTA at Work for You

The revised timeline is now available on the Centers for Medicare & Medicaid Services (CMS) website. This timeline includes future draft deadlines and specifics on implementation. For further information, please click here.

On Tuesday, February 17, 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act (ARRA). The ARRA is an effort to jumpstart our economy, create or save millions of jobs, and put a down payment on addressing long-neglected challenges so our country can thrive in the 21st century (www.recovery.gov).

The American Recovery and Reinvestment Act is designed to help stimulate the economy and encourage recovery from the recession.

A substantial portion of the funding will go towards state fiscal stabilization, which will help states prevent cuts to health and human services programs, stimulate employment, avoid layoffs, and support special and regular education.

AMTA is focusing attention on the funding opportunities directed toward health and education agencies, since these could potentially have a positive impact on the provision of music therapy services. For more information, this e-news provides useful links to online resources on the distribution of ARRA funds.

To better understand where music therapists fit within the “big picture,” we recommend that you access information specific to your state. Although not all states have details posted yet, please visit: http://www.recovery.gov/?q=content/state-recovery-page for the latest updates on how your state is planning on utilizing ARRA funding. The primary avenues related to music therapy appear to be:

• Early Intervention;
• Special Education (Individuals with Disabilities Education Act-IDEA Part B);
• Research (National Institutes of Health-NIH), and
• Services for Medicaid Beneficiaries.

Some states are asking citizens to submit ideas on how best to spend the money received through the ARRA.

This is your opportunity to speak up and let your voice be heard! Let your state leaders know your recommendations for distribution of ARRA funds. When offering your ideas regarding music therapy, suggest service access through existing programs, as funding will go through established systems and agencies, not to individual providers.

For those states working on the AMTA and CBMT State Recognition Operational Plan through active task forces, this is not the venue for legislative or regulatory change requests. The focus of this effort should be the inclusion of music therapy within existing programs identified to receive funding through the ARRA.

AMTA understands the enormity of the challenges we face both as a nation and within the music therapy community and we hope that this information will be helpful in navigating the numerous opportunities associated with the enactment of the American Recovery and Reinvestment Act. We welcome any and all feedback on the usefulness of this information to our members and hearing any successes that result from your advocacy.

Online Resources

www.recovery.gov
Official government website that will contain any and all information related to the distribution of funds.

http://waysandmeans.house.gov/media/pdf/111/arra.pdf
Full summary of the ARRA.

http://www.ed.gov/policy/gen/leg/recovery
The US Department of Education has created a site dedicated specifically to ARRA developments as they relate to education. Information will be posted as it becomes available.

http://www.hhs.gov/recovery/statefundsmap.html
Recovery Act (ARRA): State Medicaid Funding Federal Medical Assistance Percentage (FMAP)

http://www.hhs.gov/recovery/fmapprocess.html
Recovery Act (ARRA) Medicaid Grant Award Process

http://www.recovery.gov/?q=content/state-recovery-page
Access state websites explaining how each state is spending funds allocated by the Recovery Act.

http://www.recovery.gov/files/Initial Recovery Act Implementing Guidance.pdf
This memorandum transmits the first installment of government-wide guidance for carrying out programs and activities enacted in the ARRA.

Most people are aware of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as the law which protects patients’ medical records privacy and protects access to health insurance coverage for certain situations.  But another mandate from HIPAA and its Administrative Simplification provisions was for the Department of Health and Human Services (HHS) to adopt a standard identification system for all health care providers, facilities, and health plans to help with the processing of standard transactions.  This system, developed by CMS, is called the National Plan and Provider Enumeration System (NPPES).  The NPPES assigns National Provider Identifiers or NPIs to each provider through an application process that can be completed online. 

Up until recently, the healthcare industry required healthcare providers and facilities to obtain different identification codes for each health plan they billed for reimbursement.  Often times, payment for services previously approved was delayed because of confusion over so many different identification codes.  This new system is designed to improve the billing and payment process through more effective transmission of health information.   All covered entities under HIPAA (anyone billing electronically) were required to obtain an NPI by May 23, 2007.  This number does not change and will stay with the provider regardless of job or location changes.  The same provider number is now being used by all health plans.

Obtaining an NPI does not replace the enrollment process that is often required to be a provider with a specific health plan.  In other words, just having the NPI will not insure reimbursement, as the provider will still need to communicate with the particular payer to receive pre-authorization and potentially be included on that plan’s provider list.  Having the NPI will allow providers to identify themselves in standard transactions such as billing claims and referral authorizations.

Music therapists can apply and receive (at no cost) their individual NPIs for use in billing private and public third party payers through the following website:

https://nppes.cms.hhs.gov/NPPES/Welcome.do.

All providers must list a taxonomy code that is available on the application.  Music Therapists are listed under “Respiratory, Developmental, Rehabilitative and Restorative Service Providers,” code 225A00000X.  The application process takes approximately 20 minutes and most providers receive their individual code within 2-3 weeks.  This national opportunity for music therapists to be recognized as service providers is an exciting example of the increased awareness of music therapy’s role in healthcare.

For more information or to apply, click here.

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