AACVPR Health Policy & Reimbursement Update April 4, 2013

AACVPR Health Policy & Reimbursement Update
April 4, 2013

Day on the Hill (DOTH) 2013 – Member Action Needed


In 2008, AACVPR members obtained the support of more than 40% of all U.S. Senators and a majority of  members of the U.S. House of Representatives for a bill that went on to become part of Public Law 110-275. The successful passing of this bill mandated Medicare coverage cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) services. This was the first time in history both services became part of the Social Security Act as specific, defined benefit categories. Many of you participated in this massive effort and know first-hand how hard, yet how satisfying and significant the outcome was.

Once again, you were represented by your peers in March in Washington, D.C. in the 9th annual AACVPR DOTH 2013 event. This was in spite of a snow storm that closed airports and federal offices for a day and, unfortunately, did not allow some travelers to make it to their final destination.

AACVPR is seeking legislative action to improve your ability to provide cost-effective, safe programs for your cardiac and pulmonary rehab patients. U.S. Senate bill S.382 begins with the simple statement, “To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.” To date, already four Senators have signed on as co-sponsors of this bill.

The issue is really very simple. AACVPR has been advised by CMS (The Centers for Medicare and Medicaid Services) that a technical correction by Congress is necessary in order for Medicare to allow CR and PR to utilize qualified nonphysician practitioners (NPs, CNSs, & PAs) to meet the direct physician supervision requirement for hospital outpatient services. This flexibility was extended to all other hospital outpatient services requiring direct physician supervision in 2010, but CMS was unable to include CR and PR solely due to its interpretation of Public Law 110-275.

In 2011, members of the Senate Finance Committee sent a letter to CMS explaining that the intent of the legislation was not to create a roadblock to these programs, but to enhance access to these important services. CMS’ response was that due to the statutory definition of physician, Congress needs to revise terminology in the statute before CMS can allow NPPs to provide such supervision for CR and PR. (This is totally unrelated to the medical director physician role in CR and PR programs.)

Your state affiliate is ready to take action. Please become involved. Your voice made a difference once in securing the future of cardiac and pulmonary rehab programs. No one is too busy to care about our patients’ future opportunities to receive CR and PR services.

Action steps:

Use the template letter Follow up Template email for Senator-updated 2-15-13

to email Senator Burr and Hagan.

How to find Senators:  http://www.senate.gov/general/contact_information/senators_cfm.cfm

Every email counts!  Please take action!