Medicaid Work Requirements: What Occupational Therapy Practitioners Need to Know
Welcome to The Amplify OT Podcast with your host, Clarice Grote—occupational therapist, founder of Amplify OT, and self-proclaimed policy nerd who actually enjoys reading the long documents most people avoid.
No matter where you are in your occupational therapy journey, you belong here as an important part of this community. The work you do matters. Your voice matters. And advocacy isn’t just possible—it’s powerful.
Let’s get started—because change starts here.
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Episode Summary
Welcome back to the Amplify OT Podcast! After a year away (and welcoming a new baby!), Clarice is back to dive into some major federal policy updates.
In this episode, we unpack the recent passage of H.R.1, the historic budget cuts to Medicaid, and the upcoming national Medicaid work requirements set to take effect January 1, 2027.
We explore what these new rules actually mean, who is exempt, and how the new "functional testing" requirement for medical frailty could create both administrative challenges and unique opportunities for occupational therapy practitioners.
In this episode, I cover:
- Life & Amplify OT Updates: A quick personal update and the exciting launch of our new Deluxe Fieldwork Planners.
- Medicaid 101: A refresher on how Medicaid is funded, who it covers, and why OT is considered an "optional benefit."
- H.R. 1 & Budget Cuts: Breaking down the massive cuts to Medicaid and how those dollars are being redirected.
- Work Requirements Explained: What the new 80-hour/month community engagement requirement entails, which states are starting early, and who is exempt.
- Medical Frailty & Functional Testing: How the new exemption rules work and the specific opportunity for OTs to conduct functional capacity evaluations.
- The Ripple Effect on OT: How the administrative burden of work requirements could lead to lost coverage for patients and potential budget cuts for therapy services.
- Your Action Plan: How to advocate for your patients, prepare your clinic, and why joining your state association and AOTA is more important than ever.
00:33 Welcome Back & Updates
05:42 What Is Medicaid?
12:32 The One Big Beautiful Bill
23:07 Work Requirements Explained
31:34 Functional Testing & OT Opportunity
45:43 Call to Action
Amplify OT Resources
Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com to check ‘em out!
Additional Learning
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